Science.gov

Sample records for men receiving hepatitis

  1. Viral Hepatitis: Information for Gay and Bisexual Men

    MedlinePlus

    VIRAL HEPATITIS Information for Gay and Bisexual Men What is viral hepatitis? Viral hepatitis is an infection of the liver caused by ... United States, the most common types of viral hepatitis are Hepatitis A, Hepatitis B, and Hepatitis C. ...

  2. Acute hepatitis C in patients receiving hemodialysis.

    PubMed

    Griveas, I; Germanidis, G; Visvardis, G; Morice, Y; Perelson, A S; Pawlotsky, J M; Papadopoulou, D

    2007-01-01

    Hepatitis C virus (HCV) infection is frequent in patients with end-stage renal disease treated by chronic dialysis, with a prevalence varying from 10-65% according to the geographical data. The prevalence is significantly associated with the duration of dialysis and the number of transfused blood products[1,2] and has dramatically declined with efficient blood screening.[3] We studied patients with acute HCV infection in a dialysis unit. The diagnosis was based on both anti-HCV detection and HCV-RNA detection. Other virological tools including HCV genotype determination was also used to tailor treatment to the individual patient and determine its efficacy for a one-year follow-up period. Seventeen patients (7 male and 10 female, mean age: 63.7 +/- 11.6 SD) with acute hepatitis C were enrolled to our study. All of them were followed up for a period of one year after the diagnosis was established. Phylogenetic analysis distinguished two separate HCV subtypes 1b, which were both responsible for this acute infection (see Figure 1). These types did not differ in their behavior on the clinical situation of our patients, as confirmed by the fact that in both groups of patients, there was only one patient who presented with acute illness. Six patients of our study group, three months after the acute infection, received pegylated interferon (Peg-IFNa2a) 135 mug for a six-month period. Four of them responded very well to therapy and at the first determination HCV RNA was below the cutoff point. One of our patients with very high HCV levels (HCV RNA > 50,000,000 IU/mL), despite receiving the same therapy, did not respond well and developed cirrhosis. In conclusion, it is clear from our experience that better information is needed about the current incidence, prevalence, and risk factors for HCV infection in dialysis patients. Algorithms for the diagnosis and management of hepatitis C should be developed by academic societies. Routine screening for hepatitis C also would allow

  3. Hepatitis vaccination and infection among gay, bisexual, and other men who have sex with men who attend gyms in New York City.

    PubMed

    Siconolfi, Daniel E; Halkitis, Perry N; Rogers, Meighan E

    2009-06-01

    The authors examined hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination rates, hepatitis infection, and health care access in a gym-attending sample of 311 gay, bisexual, and other men who have sex with men (MSM) in New York City. Overall, 69% reported having been vaccinated for HAV and 70% reported having been vaccinated for HBV. Multivariate models were used to identify predictors of HAV and HBV vaccination, and younger men, HIV-positive men, and men who had access to a doctor or clinic were more likely to be vaccinated than older men, HIV-negative men, and men without access to a doctor or clinic. Men with health insurance coverage were more likely to have received HBV vaccination than men without coverage. Findings indicate that there is still a significant proportion of unvaccinated men in our sample.

  4. Hepatitis vaccination of men who have sex with men at gay pride events.

    PubMed

    Storholm, Erik David; Fisher, Dennis G; Reynolds, Grace L; Napper, Lucy E; Morrisse, Timothy A; Kochems, Lee M

    2010-06-01

    Prevention researchers have advocated primary prevention such as vaccination in alternative venues. However, there have been major questions about both the attendance of, and the ability to, vaccinate high-risk individuals in such settings. The current study seeks to assess the feasibility of vaccinating high-risk men who have sex with men (MSM) at Gay Pride events. The research questions are: Do gay men who are sampled at Gay Pride events engage in more or less risky behavior than gay men sampled at other venues? Do the gay men who receive hepatitis vaccinations at Gay Pride engage in more or less risky behavior than gay men at Gay Pride who do not receive hepatitis vaccination? Of the 3689 MSM that completed the Field Risk Assessment (FRA), 1095/3689 = 29.68% were recruited at either the 2006 or 2007 Long Beach, California Gay Pride events. The remaining, 2594/3689 = 70.32% were recruited at Long Beach gay bars, gay community organizations and institutions, and through street recruitment in various gay enclaves in the Long Beach area. Logistic regression analysis yielded eight factors that were associated with non-attendance of Gay Pride: Age, had sex while high in the last 12 months, had unprotected anal intercourse (UAI) in the last 12 months, had sex for drugs/money in the last 12 months, been diagnosed with a sexually transmitted infection (STI) in the last 12 months, used nitrites (poppers) in the last 12 months, and used methamphetamine in the last 12 months. Identifying as White, Asian, or African American compared to Hispanic was also associated with non-attendance. Bivariate analysis indicated that, of the MSM sampled at Gay Pride, 280/1095 = 25.57% received a hepatitis vaccination there. The MSM sampled at Gay Pride who reported engaging in UAI or having used any stimulant (cocaine, crack-cocaine, or methamphetamine) in the last 12 months were more likely to receive hepatitis vaccination on-site. The results provide evidence for the viability of

  5. Who should receive hepatitis A vaccine?

    PubMed

    Arankalle, V A; Chadha, M S

    2003-05-01

    Though a potent vaccine represents a powerful preventive tool, the policy of its use is governed by epidemiological and economical factors. Hepatitis A, an enterically transmitted disease shows distinct association with socio-economic status, populations with improvement experiencing lower exposure to the virus. With the availability of vaccine, it is pertinent to consider its use in the effective control of the disease. However, with the varied epidemiological patterns and economical constraints in different countries it does not seem to be possible to evolve universal policy for immunization. Though, universal immunization may be the most effective way of control, the same is not practical for many countries. It is proposed that irrespective of endemicity of hepatitis A, high-risk groups such as travelers to endemic areas, patients suffering from chronic liver diseases, HBV and HCV carriers, tribal communities with high HBV carrier rates, food handlers, sewage workers, recipients of blood products, troops, and children from day-care centers should be immunized with hepatitis A vaccine. In addition, for populations with intermediate prevalence, infants, children from affordable families may be immunized. As coupling the vaccine with EPI schedule would be beneficial, use of combined A & B or A, B & E vaccine may be an attractive alternative.

  6. Protect Yourself against Hepatitis A and B: A Guide for Gay and Bisexual Men

    MedlinePlus

    Protect Yourself Against Hepatitis A and Hepatitis B... a guide for gay and bisexual men Men who have sex with men are at increased risk of becoming infected with both the hepatitis A virus and the hepatitis B virus. Although these ...

  7. Gay and Bisexual Men's Willingness to Receive Anal Papanicolaou Testing

    PubMed Central

    Reed, Alison C.; Reiter, Paul L.; Smith, Jennifer S.; Palefsky, Joel M.

    2010-01-01

    Objectives. We assessed the willingness of gay and bisexual men, who have high rates of anal cancer that might be prevented through regular screening, to receive anal Papanicolaou tests. Methods. We surveyed a national sample of men aged 18 to 59 years who self-identified as gay (n = 236) or bisexual (n = 70). Results. Most respondents were willing to accept free screening (83%), but fewer would pay for the test (31%; McNemar's χ2 = 158.02; P < .001). Willingness to pay for screening was higher among men who reported greater worry about getting anal cancer (OR [odds ratio] = 1.70; 95% confidence interval [CI] = 1.06, 2.72), higher perceived likelihood of anal cancer (OR = 1.88; 95% CI = 1.18, 2.99), and higher income (OR = 2.17; 95% CI = 1.18, 3.98), in adjusted analyses. Only 33% (17 of 51) of HIV-positive respondents, who have the highest risk for anal cancer, had received anal Papanicolaou tests. Conclusions. Anal cancer screening was highly acceptable to gay and bisexual men, although cost was a major barrier. Efforts to reduce anal cancer disparities should target beliefs about anal cancer and barriers to anal Papanicolaou testing in this population. PMID:20395576

  8. Acute hepatitis C infection in HIV-negative men who have sex with men.

    PubMed

    McFaul, K; Maghlaoui, A; Nzuruba, M; Farnworth, S; Foxton, M; Anderson, M; Nelson, M; Devitt, E

    2015-06-01

    Acute hepatitis C infection is recognized in HIV-infected men who have sex with men (MSM), but the risk in HIV-negative MSM remains unclear. We evaluated a population of MSM with acute hepatitis C. From January 2010 to May 2014, all cases of HCV antibody positive HIV-negative MSM were identified. European AIDS Network criteria were applied to determine acute infection, and 44 individuals fulfilled the criteria for acute hepatitis C. Ten were RNA negative at baseline and classed as prior spontaneous clearance. 15 (34.1%) had a previously negative HCV antibody within 1 year. 11 (25.0%) had significant elevation in ALT levels, and 18 (40.9%) were clinically diagnosed from risk exposure and history. Median age was 37 years (range 24-75). 41 (93.2%) individuals reported unprotected anal sex, 36 with (87.8%) both insertive and receptive intercourse, 4 (9.8%) with receptive intercourse, 1 (2.4%) with insertive intercourse, and no data were recorded for 3 (7.3%) patients. Individuals had an average of 7.3 reported (median 2, range 1-100) partners. 12 (27.3%) engaged in group sex, 11 (25.0%) practised fisting, 11 (25.0%) admitted using drugs during sexual activity, 16 (36.4%) reported nasal, and 9 (20.5%) reported injection drug use. 14 (31.8)% had unprotected sex whilst under the influence of recreational drugs. 29 individuals were aware of a partner's status. 2 (4.5%) individuals had sexual contact with a known HCV monoinfected partner, 13 (29.5%) with a HIV monoinfected partner and 6 (13.6%) with a HCV/HIV coinfected partner. 9 (20.5%) reported a partner/partners with no known infection. No data were available in 14 (31.8%) individuals. 13 (29.5%) individuals had a coexisting STI at the time of acute HCV diagnosis. 8 (18.2%) received HIV postexposure prophylaxis (PEP) within the 6 months prior to the HCV diagnosis (2 were participants in a HIV pre-exposure prophylaxis trial). 15 (34.1%) individuals achieved spontaneous clearance of HCV, and 11 patients received HCV

  9. Hepatobiliary scintigraphy in patients receiving hepatic artery infusion chemotherapy

    SciTech Connect

    Housholder, D.F.; Hynes, H.E.; Dakhil, S.R.; Marymont, J.H. Jr.

    1984-01-01

    Two patients receiving hepatic artery infusion chemotherapy (HAIC) required cholecystectomy for both acute and chronic cholecystitis with cholelithiasis suggesting chemical cholecystitis. To evaluate the incidence of gall bladder dysfunction in patients receiving HAIC, the authors performed hepatobiliary scintigraphy using Tc-99m DISIDA or PIPIDA on eight patients receiving HAIC through an indwelling hepatic artery catheter and Infusaid (trademark) pump. In 7 of 8 patients, there was non-visualization of the gall bladder throughout the hepatobiliary study. In the eighth patient, the gall bladder visualized at 2 hr. One patient with non-visualization of the gall bladder at 4 hr developed acute symptoms requiring cholecystectomy which showed acute and chronic cholecystitis with cholethiasis. There was prominent sclerosis which was thought to be due to chemical cholecystitis as well as cholelithiasis. In all 10 patients, no evidence of cholecystitis had been observed during the surgical placement of the hepatic artery catheter and Infusaid pump. The hepatobiliary scintigraphic finding of gall bladder dysfunction in all eight patients studied is most likely due to chemical cholecystitis from HAIC. This series suggests that chemical cholecystitis is common during HAIC and can be identified by hepatobiliary scintigraphy. The authors consider elective cholecystectomy during the operative placement of the hepatic artery catheter and Infusaid pump.

  10. Hepatic cyst penetration of cefazolin in patients receiving aspiration sclerotherapy.

    PubMed

    Lantinga, M A; Wijnands, T F M; Te Morsche, R H M; de Sévaux, R G L; Kuipers, S; Allegaert, K; Burger, D; Drenth, J P H

    2016-09-01

    Hepatic cyst infection is a potentially severe complication in cystic disease. Treatment demands effective antibiotic concentrations within the infected cyst. The aim of this study was to use elective hepatic cyst drainage as a unique pharmacokinetic model to investigate whether cefazolin, a first-generation cephalosporin, is able to penetrate hepatic cysts. Patients scheduled to undergo percutaneous aspiration sclerotherapy of a symptomatic non-infected, non-neoplastic hepatic cyst were eligible for this study. All participants received a single perioperative prophylactic dose of cefazolin (1000 mg, intravenously). We collected blood and cyst fluid samples to determine total and unbound cefazolin concentrations using HPLC. The primary outcome was hepatic cyst penetration, expressed as the ratio (%) of unbound concentration of cefazolin in cyst fluid to plasma (both in mg/L). We included eight patients [male = 25%, median age = 60 years (IQR 54-75), median estimated glomerular filtration rate = 97 mL/min/1.73 m(2) (IQR 67-102) and median serum albumin = 40 g/L (IQR 37-40)]. We detected low concentrations of unbound cefazolin in cyst fluid (≤1.0 mg/L). The median plasma unbound cefazolin peak level (immediately after cefazolin administration) was 36.6 mg/L (IQR 23.7-54.1) and the level at the time of cyst fluid aspiration was 16.1 mg/L (IQR 13.0-20.1). In total, the hepatic cyst penetration of free cefazolin was only 2.2% (IQR 0.7-5.2). We developed a study model to investigate the penetration of antibiotics into hepatic cysts. Cefazolin did not reach adequate intracystic concentrations. Future studies should explore alternatives. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  11. A comparison of hepatitis A and hepatitis B measures among vaccinated and susceptible online men who have sex with men.

    PubMed

    Gilbert, L K; Levandowski, B A; Scanlon, K E; Peterson, R S

    2010-06-01

    Hepatitis A virus (HAV) and hepatitis B virus (HBV) continue to be major health concerns among men who have sex with men (MSM). The Internet both facilitates high-risk sexual encounters and provides opportunities for promoting healthy behaviours. This study compared self-reported HAV and HBV vaccination levels, based on demographics, health characteristics, hepatitis knowledge, attitudes and risk behaviours among MSM using an online survey posted from February through June 2005. Each participant (n = 968) reported whether they were vaccinated, infected or susceptible for hepatitis A and/or for hepatitis B. Men whose health-care provider recommended vaccination were 12.91 (95% confidence interval [CI] 8.11, 20.55) times more likely to be vaccinated against HAV and 17.93 (95% CI 10.82, 29.70) times more likely to be vaccinated against HBV than those at risk of infection, respectively. These data provide essential information for public health professionals to successfully promote vaccination among members of this population.

  12. Risk of Myocardial Infarction in Older Men Receiving Testosterone Therapy

    PubMed Central

    Baillargeon, Jacques; Urban, Randall J.; Kuo, Yong-Fang; Ottenbacher, Kenneth J.; Raji, Mukaila A.; Du, Fei; Lin, Yu-li; Goodwin, James S.

    2014-01-01

    Background Testosterone therapy for older men has increased substantially over the past decade. Research on the effects of testosterone therapy on cardiovascular outcomes has yielded inconsistent results. Objective To examine the risk of myocardial infarction (MI) in a population-based cohort of older men receiving intramuscular testosterone. Method Using a 5% national sample of Medicare beneficiaries, we identified 6355 patients treated with at least 1 injection of testosterone between January 1, 1997, and December 31, 2005. We matched this cohort to 19 065 testosterone nonusers at a 1:3 ratio based on a composite MI prognostic score. Patients were followed until December 31, 2005, or until they lost coverage from Medicare, enrolled in a health maintenance organization, experienced a MI, or died. Result In a Cox regression analysis adjusting for demographic and clinical characteristics, receipt of testosterone therapy was not associated with an increased risk of MI (hazard ratio [HR] = 0.84; 95% CI = 0.69–1.02). In this analysis, there was an interaction between receipt of testosterone and quartile of risk of MI (P = 0.023). For men in the highest quartile of the MI prognostic score, testosterone therapy was associated with a reduced risk of MI (HR = 0.69; 95% CI = 0.53–0.92), whereas there was no difference in risk for the first (HR = 1.20; 95% CI = 0.88–1.67), second (HR = 0.94; 95% CI = 0.69–1.30), and third quartiles (HR = 0.78; 95% CI = 0.59–1.01). Conclusion Older men who were treated with intramuscular testosterone did not appear to have an increased risk of MI. For men with high MI risk, testosterone use was modestly protective against MI. PMID:24989174

  13. An audit of hepatitis B vaccination for men who have sex with men before and after sexual health service integration.

    PubMed

    Wielding, Sally; Ma, Andy Hy; Clutterbuck, Daniel J

    2016-09-01

    Scottish Government guidelines identify hepatitis B vaccination as a key standard reflecting access to sexual health care for men who have sex with men (MSM). This audit was performed before and after service redesign to assess the impact of the integration of genitourinary medicine and sexual and reproductive health services on the provision of care to MSM. There was no significant difference between the proportion of males receiving at least one dose of vaccination (p = 0.64, χ(2 )= 0.222), but a significant drop in the proportion of males receiving three doses of vaccination pre- and post-integration (p = 0.0157, χ(2 )= 5.834). Advised standards are being met but follow up and recall require improvement if previously reported completion rates are required for protection. © The Author(s) 2016.

  14. Adherence to hepatitis A virus vaccination in HIV-infected men who have sex with men.

    PubMed

    Kourkounti, Sofia; Paparizos, Vassilios; Leuow, Kirsten; Paparizou, Eleni; Antoniou, Christina

    2015-10-01

    Although vaccination against hepatitis A virus (HAV) is essential for human immunodeficiency virus (HIV)-infected patients, the uptake of HAV vaccine is reported to be very low. From 2007 to 2012, 912 HIV-infected men in Athens, Greece were screened for exposure to HAV. Two doses of an HAV vaccine were recommended to 569 eligible patients. Reminder cards with scheduled vaccination visits were given to each patient. Among eligible patients, 62.2% (354/569) received both doses. Patients who were fully vaccinated compared with non-adherent patients were natives, older, had undetectable HIV viral load, higher CD4 T cell counts and lower nadir CD4 T cell counts. Multivariate logistic regression revealed that the patient's country of origin (p = 0.024; OR = 2.712; 95% CI, 1.139-6.457), CD4 T cell count (p < 0.001) and nadir CD4 T cell count (p < 0.001) were factors directly associated with adherence. In conclusion, adherence to HAV vaccination was better than in previously published data. Because many of the factors related to vaccination completion are parameters of HIV infection, it appears that physician interest in HIV care and vaccination planning is crucial to enhancing vaccine uptake. © The Author(s) 2015.

  15. Benign hepatic tumours and tumour like conditions in men.

    PubMed Central

    Karhunen, P J

    1986-01-01

    In a consecutive medicolegal necropsy series benign hepatic tumours and tumour like conditions occurred in 52% of the 95 men aged 35-69 years. The incidence increased with age, mainly due to small bile duct tumours (n = 26; mean age 56.7 years; p less than 0.01; mean size 1.3 mm). The next most common tumours were cavernous hemangiomas (n = 19; mean age 53.9 years; mean size 5.2 mm) that were not related to age. Focal nodular hyperplasia (n = 3; mean size 8.0 mm) tended to occur in a younger age group (mean age 40.3 years; p less than 0.001). Multiple bile duct tumours were present in 46% and hemangiomas in 50% of the men studied. Liver cell adenoma, nodular regenerative hyperplasia, and peliosis hepatis were incidental findings (one case of each). Nodular regenerative hyperplasia was associated with the consumption of alcohol and a total dose of 21.5 g of testosterone. These results indicate that benign hepatic tumours and tumour like conditions are not rare in men but may remain undetected because of their small size. Images PMID:3950039

  16. Dutasteride in men receiving testosterone therapy: a randomised, double-blind study.

    PubMed

    Kacker, R; Harisaran, V; Given, L; Miner, M; Rittmaster, R; Morgentaler, A

    2015-03-01

    We investigate the impact of dutasteride on prostate specific antigen (PSA) and prostate volume in men receiving testosterone (T) therapy. Twenty-three men on stable dose T therapy were randomised to receive either dutasteride or placebo for 12 months. Serum levels of PSA, T and dihydrotestosterone (DHT) and responses to the International Index of Erectile Function (IIEF) and Male Sexual Health Questionnaire (MSHQ) questionnaires were determined at baseline and at 3, 6, 9 and 12 months. Prostate volume (PV) was measured using transrectal ultrasound (TRUS) at baseline and again after 12 months. A total of 22 men (mean age 57.3) completed the study, with 11 men receiving placebo and 11 receiving dutasteride. Men receiving dutasteride had a significant decrease in PSA (-0.46 ± 0.81 ng ml(-1) ; P = 0.04) and in PV (-6.65 ± 11.0%; P = 0.03) from baseline over 12 months. DHT decreased significantly for men on dutasteride compared with men receiving placebo (P = 0.02). When compared with men who received placebo, men who received dutasteride demonstrated nonsignificant trends towards decreased PSA (-0.46 versus 0.21 ng ml(-1) ; P = 0.11), PV (-6.65% versus 3.4%; P = 0.08) and MSHQ scores (-10.2 versus 5.6; P = 0.06). Dutasteride reduces PSA and PV for men on T therapy, but perhaps less so than in men without T therapy.

  17. Hepatitis C virus screening in patients with cancer receiving chemotherapy.

    PubMed

    Hwang, Jessica P; Suarez-Almazor, Maria E; Torres, Harrys A; Palla, Shana L; Huang, Donna S; Fisch, Michael J; Lok, Anna S F

    2014-05-01

    Reactivation of hepatitis C virus (HCV) replication can occur in patients receiving immunosuppressive therapy. We aimed to determine the prevalence and predictors of HCV screening at the onset of chemotherapy among patients with cancer. We conducted a retrospective cohort study of adults with cancer who were newly registered at MD Anderson Cancer Center from January 2004 to April 2011 and received chemotherapy. The primary study outcome was HCV antibody (anti-HCV) screening at chemotherapy onset. We calculated screening prevalence and predictors by comparing characteristics of screened and unscreened patients using multivariable logistic regression. A total of 141,877 new patients with cancer were registered at MD Anderson during the study period, of whom 16,773 (11.8%) received chemotherapy and met inclusion criteria. A total of 2,330 patients (13.9%) were screened for HCV, and 35 (1.5%) tested positive. Only 42% of patients with exposure-type HCV risk factors, such as HIV infection, injection drug use, hemodialysis, or hemophilia, were screened. Birth after 1965, Asian race, HCV risk factors, and anticipated rituximab therapy were significant predictors of HCV screening; black patients and patients with solid tumors were significantly less likely to be screened. The only significant predictor of a positive anti-HCV result was birth during 1945 to 1965. HCV screening rates were low, even among patients with risk factors, and the groups with the highest rates of screening did not match the groups with the highest rates of a positive test result. Misconceptions may exist about which patients should be screened for HCV infection. Copyright © 2014 by American Society of Clinical Oncology.

  18. Increased survival in men with metastatic prostate cancer receiving chemo and hormone therapy

    Cancer.gov

    Men with hormone-sensitive metastatic prostate cancer who received the chemotherapy drug docetaxel given at the start of standard hormone therapy lived longer than patients who received hormone therapy alone, according to early results from a NIH-supporte

  19. Hepatitis A and hepatitis B infection prevalence and associated risk factors in men who have sex with men, Bangkok, 2006-2008.

    PubMed

    Linkins, Robert W; Chonwattana, Wannee; Holtz, Timothy H; Wasinrapee, Punneeporn; Chaikummao, Supaporn; Varangrat, Anchalee; Tongtoyai, Jaray; Mock, Philip A; Curlin, Marcel E; Sirivongrangson, Pachara; van Griensven, Frits; McNicholl, Janet M

    2013-09-01

    Despite the availability of safe and effective vaccines, little is known about prevalence and risk factors for hepatitis A (HAV) and hepatitis B virus (HBV) infection among Thai men who have sex with men. The prevalence of HAV and HBV infection among men who have sex with men cohort in Bangkok was assessed. Baseline blood specimens were drawn and demographic and behavioral data were collected. Bivariate and multivariate logistic regression analysis was used to analyze risk factors for prevalent HAV and HBV infection. One thousand two hundred ninety-nine Thai men who have sex with men 18 years and older were enrolled. Among those with results, 349/1,291 (27.0%) had evidence of past or current hepatitis A infection. Of the 1,117 (86.5%) men with unambiguous HBV test results, 442 (39.6%) had serologic evidence of past/current infection, 103 (9.2%) were immune due to hepatitis B vaccination, 572 (51.2%) had no evidence of immunological exposure to HBV or vaccine. Of those with past/current HBV infection, 130 (29.4%) were HIV positive. Age >35 years was independently associated with both HAV and HBV infection. University education was protective against both HAV and HBV infection. Increased alcohol consumption, number of lifetime male sexual partners ≥10, and prevalent HIV infection were also independently associated with HBV infection. The prevalence of past/current HAV and HBV infection was high in Bangkok men who have sex with men. Age-cohorts with a higher prevalence of hepatitis B vaccine induced immunity may be expected in the future. Hepatitis A and B vaccination is recommended.

  20. Outbreak of hepatitis A associated with men who have sex with men (MSM), England, July 2016 to January 2017.

    PubMed

    Beebeejaun, Kazim; Degala, Srilaxmi; Balogun, Koye; Simms, Ian; Woodhall, Sarah Charlotte; Heinsbroek, Ellen; Crook, Paul David; Kar-Purkayastha, Ishani; Treacy, Juli; Wedgwood, Kate; Jordan, Kate; Mandal, Sema; Ngui, Siew Lin; Edelstein, Michael

    2017-02-02

    Between July 2016 and January 2017, 37 confirmed cases of hepatitis A with two unique IA genotype strains primarily among men who have sex with men, were reported across eight areas in England and Northern Ireland. Epidemiological and laboratory investigations indicate that these strains may have been imported several times from Spain, with secondary sexual transmission in the United Kingdom. Local and national public health services are collaborating to control this ongoing outbreak.

  1. Spontaneous Clearance of the Hepatitis C Virus Among Men Who Have Sex With Men.

    PubMed

    Seaberg, Eric C; Witt, Mallory D; Jacobson, Lisa P; Detels, Roger; Rinaldo, Charles R; Margolick, Joseph B; Young, Stephen; Phair, John P; Thio, Chloe L

    2015-11-01

    The probability of spontaneous hepatitis C virus (HCV) clearance ranges from 11% to 49%. Our previous cross-sectional study suggests that mode of acquisition explains some of this heterogeneity. We performed this prospective study to determine factors associated with spontaneous HCV clearance among men who have sex with men (MSM). A mixture-cure model was used to evaluate the probability of spontaneous HCV clearance among 101 MSM in the Multicenter AIDS Cohort Study with acute HCV infection between 1984 and 2012. Spontaneous HCV clearance occurred in 46% of MSM (49% in non-injection drug users [IDUs] and 23% in IDUs). In the multivariable analysis, age <30 years (clearance ratio [CR] = 2.43; 95% confidence interval [CI], 1.53-3.87) and being human immunodeficiency virus (HIV) uninfected (CR = 2.97; 95% CI, 1.98-4.46) were independently associated with spontaneous clearance. Among men aged ≥30 years, being HIV uninfected, not having unprotected anal intercourse, older age, and being on highly active antiretroviral therapy were independently associated with higher clearance. The interferon lambda rs12979860 single nucleotide polymorphism (SNP) was not associated with spontaneous clearance among the 88 MSM who were not active IDUs (CR = 0.74; 95% CI, .46-1.21 for CC vs CT/TT genotype). The high probability of spontaneous HCV clearance together with the lack of an association between the rs12979860 SNP and spontaneous clearance among MSM who do not use injection drugs suggests that the immune mechanisms involved with a successful response to acute HCV differ by mode of virus acquisition. Understanding potential mechanistic differences could be important for HCV vaccine development. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. IMPACT OF HIV ON LIVER FIBROSIS IN MEN WITH HEPATITIS C INFECTION AND HEMOPHILIA

    PubMed Central

    Ragni, Margaret V.; Moore, Charity G.; Soadwa, Kakra; Nalesnik, Michael A.; Zajko, Albert B.; Cortese-Hassett, Andrea; Whiteside, Theresa L.; Hart, Suzanne; Zeevi, Adriana; Li, Jie; Shaikh, Obaid S.

    2010-01-01

    Introduction Hepatitis C virus (HCV) is the major cause of liver disease in hemophilia. Few data exist on the proportion with liver fibrosis in this group after long-term HCV and HIV co-infection. Aim We conducted a cross-sectional multi-center study to determine impact of HIV on the prevalence and risk factors for fibrosis in hemophilic men with chronic hepatitis C. Methods Biopsies were independently scored by Ishak, Metavir, and Knodell systems. Variables were tested for associations with fibrosis by logistic regression and receiver operating curves (ROC). Results Of 220 biopsied HCV(+) men, 23.6% had Metavir ≥F3 fibrosis, with higher mean Metavir fibrosis scores among HIV/HCV co-infected than HCV mono-infected, 1.6 vs. 1.3 (p=0.044). Variables significantly associated with fibrosis included AST, ALT, APRI score (AST/ULN×100/platelet ×109/L), alpha-fetoprotein (all p<0.0001), platelets (p=0.0003), and ferritin (p=0.0008). In multiple logistic regression of serum markers, alpha-fetoprotein, APRI, and ALT were significantly associated with ≥ F3 fibrosis, AUROC=0.77 (95%CI 0.69, 0.86). Alpha-fetoprotein, APRI, and ferritin were significant in HIV(−), (AUROC 0.82 (95%CI 0.72, 0.92), and alpha-fetoprotein and platelets in HIV(+) (AUROC=0.77 (95%CI 0.65, 0.88). In a multivariable model of demographic and clinical variables, transformed (natural logarithm) of alpha-fetoprotein (p=0.0003), age (p=0.006), and HCV treatment (p=0.027) were significantly associated with fibrosis. Conclusion Nearly one-fourth of hemophilic men have Metavir ≥ 3 fibrosis. The odds for developing fibrosis are increased in those with elevated alpha-fetoprotein, increasing age, and past HCV treatment. PMID:20722744

  3. Linked Outbreaks of Hepatitis A in Homosexual Men and in Food Service Patrons and Employees

    PubMed Central

    Kosatsky, Tom; Middaugh, John P.

    1986-01-01

    Outbreaks of hepatitis A among patrons and employees of two food service establishments in Anchorage, Alaska, in November 1982 and April 1983 were linked to male food handlers infected with the virus. By case finding and contact tracing, we established that the food handlers in both outbreaks were associated with an epidemic of hepatitis A that was transmitted among Anchorage homosexual men for more than six months. Lacking specific serologic findings, physicians treating several of these homosexual men had incorrectly diagnosed the illness as hepatitis B, delaying recognition of the epidemic. ImagesFigure 3. PMID:3962292

  4. Hepatitis B infection and vaccination coverage in men who have sex with men consulting a Danish venereal disease clinic.

    PubMed

    Nielsen, Ulla Schierup; Simonsen, Anne Birgitte; Halkier-Sørensen, Lars; Larsen, Carsten Schade; Erikstrup, Christian

    2015-08-01

    Vaccination guidelines from the Danish Health and Medicines Authority recommend vaccination of all men who have sex with men (MSM) against hepatitis B virus (HBV). The only existing data on HBV infection in Danish MSM stem from 1984: 58% of MSM attending venereal clinics in Copenhagen had a prior and 4% had a chronic HBV infection. The aim of this study was to provide up-to-date data on the prevalence of HBV infection and vaccination coverage among Danish MSM. At the venereal clinic at Aarhus University Hospital, 1525 consecutive patients received a questionnaire covering risk group and vaccination status; moreover, HBV serology was performed. Prevalence proportions of serological signs of vaccination, infection, etc. were stratified according to self-reported risk group and vaccination status. In total, 141 patients were MSM. Among these, 14% (CI = 9-21%) were vaccinated, 7% (CI = 3-13%) had a prior infection and 1.4% (CI = 0.2-5%) were HBsAg positive. In patients recalling three doses of vaccination, 18% (CI = 11-26%) were anti-HBs negative and 0.8% (CI = 0.02-5%) were HBsAg positive. Similar data for other risk groups and the total clientele are presented. This study presents the first Scandinavian data on the prevalence of HBV infection and vaccination among MSM since the introduction of the vaccine. Danish health authorities should evaluate whether a carrier frequency of 1.4% and a vaccination coverage of 14% in MSM is acceptable or warrants intensified focus on vaccination. Prospective vaccination campaigns should consider prevaccination testing, since 18% of patients recalling three doses of vaccination were anti-HBs negative.

  5. Insulin resistance, hepatic lipid and adipose tissue distribution in HIV infected men

    PubMed Central

    He, Qing; Engelson, Ellen S.; Ionescu, Gabriel; Glesby, Marshall J.; Albu, Jeanine B.; Kotler, Donald P.

    2010-01-01

    Background A large proportion of HIV-infected subjects on antiretroviral medication develop insulin resistance, especially in the context of fat redistribution. This study investigates the interrelationships among fat distribution, hepatic lipid content, and insulin resistance in HIV-infected men. Design and methods We performed a cross-sectional analysis of baseline data from twenty-three HIV-infected participants in 3 prospective clinical studies. Magnetic resonance spectroscopy was applied to quantify hepatic lipid concentrations. Magnetic resonance imaging was used to quantify whole body adipose tissue compartments, i.e., subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes as well as inter-muscular adipose tissue (IMAT) subcompartment, and omental-mesenteric adipose tissue (OMAT) and retroperitoneal adipose tissue (RPAT) subcompartments of VAT. Homeostasis model for assessment of insulin resistance (HOMA-IR) was calculated from fasting glucose and insulin concentrations. Results Hepatic lipid content correlated significantly with total VAT (r=0.62, p=0.0014) but not with SAT (r=0.053, p=0.81). In univariate analysis, hepatic lipid content was associated with the OMAT (r=0.67, p=0.0004) and RPAT (r=0.53, p=0.009) subcompartments; HOMA-IR correlated with both VAT and hepatic lipid contents (r=0.61, p=0.057 and 0.68, p=0.0012, respectively). In stepwise linear regression models, hepatic lipid had the strongest associations with OMAT and with HOMA-IR. Conclusion Hepatic lipid content is associated with VAT volume, especially the omental-mesenteric subcompartment, in HIV-infected men. Hepatic lipid content is associated with insulin resistance in HIV-infected men. Hepatic lipid content might mediate the relationship between VAT and insulin resistance among treated, HIV-infected men. PMID:18572755

  6. Acute hepatitis C infection in HIV positive men who have sex with men in Paris, France, 2001-2004.

    PubMed

    Gambotti, L; Batisse, D; Colin-de-Verdiere, N; Delaroque-Astagneau, E; Desenclos, J C; Dominguez, S; Dupont, C; Duval, X; Gervais, A; Ghosn, J; Larsen, C; Pol, S; Serpaggi, J; Simon, A; Valantin, M A; Velter, A

    2005-05-01

    In mid-2004, three Parisian hospital wards informed the Institut de veille sanitaire of recent acute hepatitis C in HIV-infected (HIV+) men who had sex with men (MSM). These cases for whom none of the usual bloodborne routes for hepatitis C (HCV) transmission was found, reported having had unprotected sex. In October 2004, we conducted a retrospective investigation in Parisian hospital wards to explore HCV modes of transmission in recent acute hepatitis C in HIV+ MSM. Patient demographics, clinical and biological status of HIV infection, reasons for HCV testing, sexual behaviour and risk factors for HCV transmission within the 6 months before hepatitis onset were collected from medical records. An anonymous self-administered questionnaire on sexual behaviour within the six months before hepatitis onset was also offered to all cases. We identified 29 cases of acute hepatitis C in HIV+ MSM with onset from April 2001 to October 2004. HIV infection was asymptomatic for 76%. Median age at hepatitis C onset was 40 (28-54) years. In all records, were noted unprotected anal sex, fisting in 21% and a concomitant sexually transmitted infection (STI) in 41%. Median time between HIV diagnosis and HCV infection was 6.5 years (0-22). From the 11 self-administered questionnaires completed, 10 reported an STI, 8 'hard' sexual practices, 6 bleeding during sex and 5 fisting. HCV transmission probably occurred through bleeding during unprotected traumatic anal sex among HIV+ MSM and may be facilitated by STI mucosal lesions. This report stresses the continuous need to strongly advocate safer sex to MSM.

  7. Epidemiology of hepatitis C virus infection among people receiving opioid substitution therapy (ECHO): study protocol.

    PubMed

    Strada, Lisa; Schulte, Bernd; Schmidt, Christiane Sybille; Verthein, Uwe; Cremer-Schaeffer, Peter; Krückeberg, Sabine; Reimer, Jens

    2015-12-10

    Hepatitis C virus infection is highly prevalent among people who inject drugs. Opioid substitution therapy, the standard treatment for opioid dependence, provides an excellent opportunity for the treatment of hepatitis C virus infection due to the close and regular contact between patients and clinicians. However, there is little research on the impact of opioid substitution therapy on the prevalence of the hepatitis C virus at a national level. This paper describes the protocol for the Epidemiology of Hepatitis C Virus Infection among People Receiving Opioid Substitution Therapy (ECHO) study. The aim of this study is to estimate the national prevalence and incidence of hepatitis C virus infection among people receiving opioid substitution therapy in Germany and to describe factors associated with hepatitis C treatment uptake and seroconversion. An observational, longitudinal, multicentre study is being conducted between 2014 and 2016 in a representative sample of approximately 2500 people receiving opioid substitution therapy from about 100 clinicians providing opioid substitution therapy in Germany. Data will be collected during routine patient care and by means of patient and clinician questionnaires at baseline and 12-month follow-up. Stratified sampling will be performed to obtain a representative sample of clinicians providing opioid substitution therapy. The strata will be constructed based on the distribution of the total sample of clinicians providing opioid substitution therapy in Germany according to German Federal State and the number of patients per clinician. Opioid substitution therapy may be an important strategy to prevent the spread of hepatitis C virus in opioid dependent populations, but its effectiveness may be diminished by our limited understanding of factors associated with treatment uptake and seroconversion. The present study will provide important information for developing strategies to address hepatitis C virus-related disease burden in

  8. Acute exacerbation of hepatitis C in hepatocellular carcinoma patients receiving chemotherapy.

    PubMed

    Lin, Ji-Wei; Chang, Ming-Ling; Hsu, Chao-Wei; Chen, Yi-Cheng; Liang, Kung-Hao; Huang, Ya-Hui; Lin, Chen-Chun; Yeh, Chau-Ting

    2017-01-01

    Acute hepatitis C exacerbations can occur in cancer patients carrying hepatitis C virus (HCV) when receiving systemic chemotherapy. However, clinical studies evaluating these complications remain rare due to the lack of clinically proven effective and tolerable anti-HCV treatments at late cancer stages. Furthermore, no data were available regarding hepatitis C exacerbation in advanced hepatocellular carcinoma (HCC) patients receiving chemotherapy. To address this issue, 48 patients with HCV-related advanced HCC, who underwent systemic chemotherapy using 5- fluorouracil, cisplatin, and mitoxantrone from 2008 to 2014 were analyzed. Nine patients developed acute hepatitis exacerbations defined by HCV-RNA elevation ≥10-fold and alanine transaminase (ALT) elevation ≥5-fold of the upper normal limit. Six were genotype 1b and 3 were genotype 2. Three patterns of clinical courses were observed including single episode of exacerbation (n = 5), fluctuated flares (n = 3), and delayed exacerbation (n = 1). Hepatic failure developed in five patients. Patients with acute exacerbations were less likely to have pretreatment ascites (11.1% vs. 53.8%; P = 0.028) and displayed a lower baseline ALT (44.1 ± 28.5 U/L vs. 72.6 ± 19.2 U/L; P = 0.007). Paradoxically, despite a high risk of hepatic failure, occurrence of hepatitis C exacerbation was associated with a favorable overall survival (P = 0.027; 22.8 vs. 5.4 months). In conclusion, hepatitis C exacerbation can occur in HCC patients receiving chemotherapy, leading to liver failure. However, the flare was associated with a better overall survival, possibly due to its association with a better baseline liver function. J. Med. Virol. 89:153-160, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  9. Two decades after vaccine license: hepatitis B immunization and infection among young men who have sex with men.

    PubMed Central

    MacKellar, D A; Valleroy, L A; Secura, G M; McFarland, W; Shehan, D; Ford, W; LaLota, M; Celentano, D D; Koblin, B A; Torian, L V; Thiede, H; Janssen, R S

    2001-01-01

    OBJECTIVES: This study investigated hepatitis B immunization coverage and the extent of hepatitis B virus (HBV) infection among young men who have sex with men (MSM), a group for whom hepatitis B vaccine has been recommended since 1982. METHODS: We analyzed data from 3432 MSM, aged 15 to 22 years, randomly sampled at 194 gay-identified venues in 7 US metropolitan areas from 1994 through 1998. Participants were interviewed, counseled, and tested for serologic markers of HBV infection. RESULTS: Immunization coverage was 9% and the prevalence of markers of HBV infection was 11%. HBV infection ranged from 2% among 15-year-olds to 17% among 22-year-olds. Among participants susceptible to HBV infection, 96% used a regular source of health care or accessed the health care system for HIV or sexually transmitted disease testing. CONCLUSIONS: Despite the availability of an effective vaccine for nearly 2 decades, our findings suggest that few adolescent and young adult MSM in the United States are vaccinated against hepatitis B. Health care providers should intensify their efforts to identify and vaccinate young MSM who are susceptible to HBV. PMID:11392942

  10. Hepatitis B Infection and Association with Other Sexually Transmitted Infections Among Men Who Have Sex with Men in Peru

    PubMed Central

    Lama, Javier R.; Agurto, Hellen S.; Guanira, Juan V.; Ganoza, Carmela; Casapia, Martin; Ojeda, Nora; Ortiz, Abner; Zamalloa, Victoria; Suarez-Ognio, Luis; Cabezas, Cesar; Sanchez, Jose L.; Sanchez, Jorge

    2010-01-01

    To assess the epidemiology of hepatitis B virus (HBV) infection among men who have sex with men (MSM) in Peru, we evaluated the prevalence and associated risk factors for HBV serologic markers among participants of a HIV sentinel surveillance conducted in 2002–2003. The standardized prevalences for total antibodies to hepatitis B core antigen (anti-HBc) and hepatitis B surface antigen (HBsAg) were 20.2% and 2.8%, respectively. Individuals with human immunodeficiency virus (HIV-1) infection had significantly higher anti-HBc (44.3% versus 19.3%) and HBsAg (9.5% versus 2.3%) prevalences than uninfected men. Increasing age (adjusted odds ratio [AOR] = 1.06), versatile sexual role (AOR = 1.59), sex in exchange for money/gifts (AOR = 1.58), syphilis (AOR = 1.74), HIV-1 infection (AOR = 1.64), and herpes simplex virus type 2 (HSV-2, AOR = 2.77) infection were independently associated with anti-HBc positivity, whereas only HIV-1 infection (AOR = 3.51) and generalized lymph node enlargement (AOR = 3.72) were associated with HBsAg positivity. Pre-existing HBV infection is very common among Peruvian MSM and was correlated with sexual risk factors. MSM in Peru constitute a target population for further HBV preventive and treatment interventions. PMID:20595501

  11. Hepatitis B infection and association with other sexually transmitted infections among men who have sex with men in Peru.

    PubMed

    Lama, Javier R; Agurto, Hellen S; Guanira, Juan V; Ganoza, Carmela; Casapia, Martin; Ojeda, Nora; Ortiz, Abner; Zamalloa, Victoria; Suarez-Ognio, Luis; Cabezas, Cesar; Sanchez, Jose L; Sanchez, Jorge

    2010-07-01

    To assess the epidemiology of hepatitis B virus (HBV) infection among men who have sex with men (MSM) in Peru, we evaluated the prevalence and associated risk factors for HBV serologic markers among participants of a HIV sentinel surveillance conducted in 2002-2003. The standardized prevalences for total antibodies to hepatitis B core antigen (anti-HBc) and hepatitis B surface antigen (HBsAg) were 20.2% and 2.8%, respectively. Individuals with human immunodeficiency virus (HIV-1) infection had significantly higher anti-HBc (44.3% versus 19.3%) and HBsAg (9.5% versus 2.3%) prevalences than uninfected men. Increasing age (adjusted odds ratio [AOR] = 1.06), versatile sexual role (AOR = 1.59), sex in exchange for money/gifts (AOR = 1.58), syphilis (AOR = 1.74), HIV-1 infection (AOR = 1.64), and herpes simplex virus type 2 (HSV-2, AOR = 2.77) infection were independently associated with anti-HBc positivity, whereas only HIV-1 infection (AOR = 3.51) and generalized lymph node enlargement (AOR = 3.72) were associated with HBsAg positivity. Pre-existing HBV infection is very common among Peruvian MSM and was correlated with sexual risk factors. MSM in Peru constitute a target population for further HBV preventive and treatment interventions.

  12. Endurance Exercise Reduces Hepatic Fat Content and Serum Fibroblast Growth Factor 21 Levels in Elderly Men.

    PubMed

    Taniguchi, Hirokazu; Tanisawa, Kumpei; Sun, Xiaomin; Kubo, Takafumi; Higuchi, Mitsuru

    2016-01-01

    Age-related hepatic fat accumulation increases the risk of cardiometabolic diseases, and the fibroblast growth factor (FGF) 21-resistant state caused by fatty liver underlies the pathogenesis of these diseases. Previous studies suggested that a higher level of cardiorespiratory fitness was associated with both lower hepatic fat content and serum FGF21 levels; however, the effect of endurance exercise on hepatic fat content and serum FGF21 concentration has not been studied. Therefore, we aimed to elucidate whether endurance exercise reduced hepatic fat content and serum FGF21 levels. This is a randomized crossover trial. The study setting was an institutional practice. Thirty-three elderly Japanese men participated in the study. The intervention was a 5-week endurance exercise program comprising three cycle ergometer sessions per week. Hepatic fat content was assessed by proton magnetic resonance spectroscopy, and serum FGF21 level was determined by ELISA. A 5-week endurance exercise program decreased the hepatic fat content and serum FGF21 levels without weight loss, and the changes were higher in the exercise period than in the control period (P = .021 and P = .026, respectively). Correlation analysis demonstrated that only the change in hepatic fat content was significantly and positively correlated with change in serum FGF21 levels (r = 0.366, P = .006). A 5-week endurance exercise program decreased hepatic fat content and serum FGF21 levels without weight loss in elderly men, and exercise-induced hepatic fat reduction mediated the reduction in serum FGF21 levels. These findings suggest that endurance exercise modulates hepatic fat content and FGF21 resistance, regardless of obesity status.

  13. Intent to Receive an HPV Vaccine among University Men and Women and Implications for Vaccine Administration

    ERIC Educational Resources Information Center

    Jones, Melissa; Cook, Robert

    2008-01-01

    Objective and Participants: In 2006, the authors examined intention to receive an HPV vaccine among 340 college students. Methods: A total of 138 men and 202 women completed questionnaires. The authors measured intention by asking participants how likely they would be to accept an HPV vaccine that prevented against (1) all HPV, (2) cervical cancer…

  14. Intent to Receive an HPV Vaccine among University Men and Women and Implications for Vaccine Administration

    ERIC Educational Resources Information Center

    Jones, Melissa; Cook, Robert

    2008-01-01

    Objective and Participants: In 2006, the authors examined intention to receive an HPV vaccine among 340 college students. Methods: A total of 138 men and 202 women completed questionnaires. The authors measured intention by asking participants how likely they would be to accept an HPV vaccine that prevented against (1) all HPV, (2) cervical cancer…

  15. How can we improve the health of men who receive ADT?

    PubMed Central

    Saylor, Philip J.; Smith, Matthew R.

    2010-01-01

    Clinical research in recent years has produced a deepening appreciation of the metabolic consequences of androgen deprivation therapy. On the basis of this knowledge, proactive management of risk factors for diabetes and cardiovascular events is appropriate in men who receive this treatment for prostate cancer. PMID:19806171

  16. Increasing hepatitis A immunity in men who have sex with men in Sydney, 1996-2012.

    PubMed

    Ali, Hammad; Regan, David G; Guy, Rebecca J; Robertson, Peter; Watchirs-Smith, Lucy; McNulty, Anna M; Donovan, Basil

    2015-09-11

    We examined the hepatitis A virus status of all MSM seen at a large sexual health clinic in inner Sydney between 1996 and 2012. Overall, the proportion of MSM susceptible to hepatitis A decreased from 68.1% in 1996 to 36.2% in 2012; most of this reduction was attributable to vaccination.

  17. Hepatic Subcapsular Steatosis in a Diabetic CAPD Patient Receiving Intraperitoneal Insulin

    PubMed Central

    Jang, Eun Chul; Kim, Guilsun; Kim, Young Soo; Yoon, Sun Ae; Ku, Young Mi; Yang, Chul Woo

    2006-01-01

    Hepatic subcapsular steatosis is a rare and specific form of fatty change in the liver. It is a unique finding in diabetic patients receiving continuous ambulatory peritoneal dialysis (CAPD) and intraperitoneal insulin treatment. Intraperitoneal administration of insulin causes a unique pattern of fatty infiltration in the subcapsular location of the liver. Here we report a case of hepatic subcapsular steatosis in a diabetic CAPD patient who received intraperitoneal insulin. A 46-year-old diabetic woman on CAPD presented with general weakness. The patient received a total amount of 110 units of regular insulin via intraperitoneal and subcutaneous injection. Her initial blood chemistry showed increased serum lipid and liver enzyme profiles. Abdominal CT scan images and MRI revealed characteristic findings consistent with hepatic subcapsular steatosis. We assumed that the cause was CAPD and concomitant intraperitoneal insulin treatment; therefore, the patient was switched from CAPD to hemodialysis (HD) and began to receive insulin subcutaneously. Two months after the beginning of HD, the hepatic subcapsular steatosis completely resolved. PMID:17017674

  18. Ethnic and racial differences in HPV knowledge and vaccine intentions among men receiving HPV test results.

    PubMed

    Daley, Ellen M; Marhefka, Stephanie; Buhi, Eric; Hernandez, Natalie D; Chandler, Rasheeta; Vamos, Cheryl; Kolar, Stephanie; Wheldon, Christopher; Papenfuss, Mary R; Giuliano, Anna R

    2011-05-23

    We examined factors associated with HPV vaccine intentions by racial/ethnic group among men participating in a HPV natural history study. HPV knowledge, vaccine intentions and perceived barriers were assessed among non-Hispanic White, non-Hispanic Black and Hispanic men. Men were tested for HPV every 6 months. After receiving test results from their previous visit, participants (N=477) reported their intentions for HPV vaccination in a computer-assisted survey instrument (CASI). Vaccine intentions were high among all respondents, although differences were found between racial and ethnic groups in awareness and knowledge of HPV and, vaccine intentions and perceived access and barriers to receiving the HPV vaccine. In order to effectively disseminate the vaccine among men, factors that may promote or inhibit vaccine acceptability need to be identified. Identifying these factors related to vaccine intentions among minority and majority men offers an opportunity for addressing barriers to health equity and, in turn, reductions in HPV-related disparities. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Epidemiology of sexually transmitted viral hepatitis in human immunodeficiency virus-positive men who have sex with men in Asia.

    PubMed

    Lin, Ada W C; Sridhar, Siddharth; Wong, Ka Hing; Lau, Susanna K P; Woo, Patrick C Y

    2015-12-01

    Both human immunodeficiency virus (HIV) and viral hepatitis constitute major disease burden globally. As with other parts of the world, the HIV epidemic in Asia impacts mainly on men who have sex with men, one of the at-risk populations for sexually transmitted viral hepatitis. With the increasing availability of effective antiretroviral therapy, HIV-related mortality of people living with HIV has markedly reduced. Liver disease has become an important cause of mortality and morbidity in the HIV-infected population. With the improvement of socioeconomic conditions and availability of healthcare in Asian countries in recent years, the epidemiology of sexually transmitted viral hepatitis among HIV-positive men who have sex with men has also evolved. This review updates the epidemiology of different types of sexually transmitted viral hepatitis in this defined population in Asia. Copyright © 2015. Published by Elsevier B.V.

  20. Estimating the critical immunity threshold for preventing hepatitis A outbreaks in men who have sex with men.

    PubMed

    Regan, D G; Wood, J G; Benevent, C; Ali, H; Smith, L Watchirs; Robertson, P W; Ferson, M J; Fairley, C K; Donovan, B; Law, M G

    2016-05-01

    Several outbreaks of hepatitis A in men who have sex with men (MSM) were reported in the 1980s and 1990s in Australia and other countries. An effective hepatitis A virus (HAV) vaccine has been available in Australia since 1994 and is recommended for high-risk groups including MSM. No outbreaks of hepatitis A in Australian MSM have been reported since 1996. In this study, we aimed to estimate HAV transmissibility in MSM populations in order to inform targets for vaccine coverage in such populations. We used mathematical models of HAV transmission in a MSM population to estimate the basic reproduction number (R 0) and the probability of an HAV epidemic occurring as a function of the immune proportion. We estimated a plausible range for R 0 of 1·71-3·67 for HAV in MSM and that sustained epidemics cannot occur once the proportion immune to HAV is greater than ~70%. To our knowledge this is the first estimate of R 0 and the critical population immunity threshold for HAV transmission in MSM. As HAV is no longer endemic in Australia or in most other developed countries, vaccination is the only means of maintaining population immunity >70%. Our findings provide impetus to promote HAV vaccination in high-risk groups such as MSM.

  1. Single-dose pharmacokinetic studies of abiraterone acetate in men with hepatic or renal impairment.

    PubMed

    Marbury, Thomas; Lawitz, Eric; Stonerock, Robert; Gonzalez, Martha; Jiao, James; Breeding, Jim; Haqq, Christopher; Verboven, Peter; Stieltjes, Hans; Yu, Margaret; Molina, Arturo; Acharya, Milin; Chien, Caly; Tran, NamPhuong

    2014-07-01

    Three open-label, single-dose studies investigated the impact of hepatic or renal impairment on abiraterone acetate pharmacokinetics and safety/tolerability in non-cancer patients. Patients (n = 8 each group) with mild/moderate hepatic impairment or end-stage renal disease (ESRD), and age-, BMI-matched healthy controls received a single oral 1,000 mg abiraterone acetate (tablet dose); while patients (n = 8 each) with severe hepatic impairment and matched healthy controls received 125- and 2,000-mg abiraterone acetate (suspension doses), respectively (systemic exposure of abiraterone acetate suspension is approximately half to that of tablet formulation). Blood was sampled at specified timepoints up to 72 or 96 hours postdose to measure plasma abiraterone concentrations. Abiraterone exposure was comparable between healthy controls and patients with mild hepatic impairment or ESRD, but increased by 4-fold in patients with moderate hepatic impairment. Despite a 16-fold reduction in dose, abiraterone exposure in patients with severe hepatic impairment was about 22% and 44% of the Cmax and AUC∞ of healthy controls, respectively. These results suggest that abiraterone pharmacokinetics were not changed markedly in patients with ESRD or mild hepatic impairment. However, the capacity to eliminate abiraterone was substantially compromised in patients with moderate or severe hepatic impairment. A single-dose administration of abiraterone acetate was well-tolerated.

  2. The safety of intracytoplasmic sperm injection in men with hepatitis B

    PubMed Central

    Zheng, Zhong; Hong, Yan; Xu, Bing; Tong, Jing; Xia, Lan

    2016-01-01

    Introduction In this study, we aimed to evaluate the safety of using different sources of sperm when male partners were infected with hepatitis B virus (HBV). Material and methods A total of 338 couples receiving their first intracytoplasmic sperm injection (ICSI) cycle at the Department of Reproduction, Ren Ji Hospital, between 2007 and 2012 were enrolled if the female partner tested negative for HBV DNA, HBsAg, HBeAg, HBeAb and HBcAb. Couples were divided into HBV active infection (group B), convalescent infection (group C) and controls (group A). Subgroups were divided by source of sperm: ejaculated sperm and testicular sperm aspiration/percutaneous epididymal sperm aspiration (TESA/PESA) sperm. Results When using ejaculated sperm for ICSI, two pronuclear (2PN) fertilization rate, implantation rate, clinical pregnant rate, early miscarriage rate and live birth rate showed no significant difference between the three groups. However, in the three TESA/PESA groups, the early miscarriage rate was highest in men with active HBV infection (B2) (23.1%, p = 0.035). The 2PN fertilization rate and CPR were also lower in the active infection group (76.7%, 26.3%) than the convalescent infection (82.9%, 36.2%) and control group (78.2%, 50%), but the difference was not statistically significant. No malformed infant was found in any of these groups. Conclusions When men have an active HBV infection, using TESA/PESA sperm may cause lower fertilization, a high miscarriage rate and a lower live birth rate, which indicates that HBV active infection may cause adverse effects on ICSI reproductive performance when using testicular or epididymal aspirated sperm. PMID:27279852

  3. Lifestyle intervention in men with advanced prostate cancer receiving androgen suppression therapy: a feasibility study.

    PubMed

    Bourke, Liam; Doll, Helen; Crank, Helen; Daley, Amanda; Rosario, Derek; Saxton, John M

    2011-04-01

    Healthy lifestyle behaviors could have a role in ameliorating some of the adverse effects of androgen suppression therapy (AST) in men with prostate cancer. The primary aim of this study was to assess the feasibility of a tapered supervised exercise program in combination with dietary advice in men with advanced prostate cancer receiving AST. Advanced prostate cancer patients receiving AST for a minimum of 6 months were randomized to a 12-week lifestyle program comprising aerobic and resistance exercise, plus dietary advice (n = 25), or standard care (n = 25). Exercise behavior, dietary macronutrient intake, quality of life, fatigue, functional fitness, and biomarkers associated with disease progression were assessed at baseline, after the intervention, and at 6 months. The lifestyle group showed improvements in exercise behavior (P < 0.001), dietary fat intake (P = 0.001), total energy intake (P = 0.005), fatigue (P = 0.002), aerobic exercise tolerance (P < 0.001), and muscle strength (P = 0.033) compared with standard care controls. Although a high rate of attrition (44%) was observed at 6 months, the improvements in key health outcomes were sustained. No effects on clinical prostate cancer disease markers were observed. This preliminary evidence suggests that pragmatic lifestyle interventions have potential to evoke improvements in exercise and dietary behavior, in addition to other important health outcomes in men with advanced prostate cancer receiving AST. This study shows for the first time that pragmatic lifestyle interventions are feasible and could have a positive impact on health behaviors and other key outcomes in men with advanced prostate cancer receiving AST.

  4. Lack of evidence of hepatitis C and HIV co-infection among men who have sex with men in Peru.

    PubMed

    Lama, Javier R; Lucchetti, Aldo; Cabezas, Cesar; Suarez-Ognio, Luis; Sanchez, Jorge

    2009-07-01

    Hepatitis C virus (HCV) infection occurs among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) because of shared routes of transmission. To assess the association between HCV and HIV infection among MSM in Peru, we conducted a matched case-control study (162 HIV-positive cases and 324 HIV-negative controls) among participants of an HIV sentinel surveillance survey in six urban cities. The HCV infection was initially screened using anti-HCV ELISA and immunoblot assay, and thereafter confirmed by the HCV RNA qualitative assay. Among cases, no confirmed HCV infection was found while among controls, only two confirmed HCV infections were reported (0.62%). This matched case-control reports a very low probability of association between HCV and HIV co-infection and suggests a very low prevalence of HCV infection among MSM in Peru.

  5. An epidemic outbreak of hepatitis A among homosexual men in Stockholm. Hepatitis A, a special hazard for the male homosexual subpopulation in Sweden.

    PubMed

    Christenson, B; Broström, C; Böttiger, M; Hermanson, J; Weiland, O; Ryd, G; Berg, J V; Sjöblom, R

    1982-10-01

    In 1979-1980, a distinct outbreak of hepatitis A occurred among homosexual men in Stockholm, Sweden, city and county area. The epidemic comprised 145 known cases. It began in December 1979 and progressed in waves during the following 10 months, with three distinct peaks separated by about six-week intervals. Actually, the incidence of hepatitis A in the Stockholm area showed a fivefold increase during 1980 as compared to the previous year. Clinical serologic, and social characteristics were studied more closely in 98 of the 145 homosexual men. Verification of hepatitis A was made by a solid-phase radioimmunoassay technique for detection of antibody to hepatitis A virus of the immunoglobulin M class. In addition, 64% of the men showed findings consistent with a prior hepatitis B (antibody to hepatitis B core antigen and/or antibody to hepatitis B surface antigen) and 34% were Treponema pallidum immobilization-positive from a prior or concomitant syphilis. Employment in risk professionals was common; thus, 19% worked in restaurants or otherwise handled food and 20% were engaged in medical care as compared to the 1% occupied in either branch of work among the general population in Sweden. Sexual habits with multiple partners and oral-anal sexual contacts were judged to be of major importance in the spread of this epidemic. Some spread of hepatitis A to the general population probably occurred due to the risk occupations of many homosexual men.

  6. The Efficacy of Social Role Models to Increase Motivation to Obtain Vaccination against Hepatitis B among Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Vet, R.; de Wit, J. B. F.; Das, E.

    2011-01-01

    This study assessed the effects of role models in persuasive messages about risk and social norms to increase motivation to obtain hepatitis B virus (HBV) vaccination in men who have sex with men (MSM). MSM at risk for HBV in The Netherlands (N = 168) were recruited online via a range of websites and were randomly assigned to one of four…

  7. The Efficacy of Social Role Models to Increase Motivation to Obtain Vaccination against Hepatitis B among Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Vet, R.; de Wit, J. B. F.; Das, E.

    2011-01-01

    This study assessed the effects of role models in persuasive messages about risk and social norms to increase motivation to obtain hepatitis B virus (HBV) vaccination in men who have sex with men (MSM). MSM at risk for HBV in The Netherlands (N = 168) were recruited online via a range of websites and were randomly assigned to one of four…

  8. Shedding of Hepatitis C Virus in Semen of Human Immunodeficiency Virus-Infected Men

    PubMed Central

    Turner, Samuel S.; Gianella, Sara; Yip, Marcus J-S.; van Seggelen, Wouter O.; Gillies, Robert D.; Foster, Andrew L.; Barbati, Zachary R.; Smith, Davey M.; Fierer, Daniel S.

    2016-01-01

    Background. The epidemic of sexually transmitted hepatitis C virus (HCV) infection among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) has been documented for over a decade. Despite this, there is no consensus as to the risk factors for sexual acquisition of HCV in these men. Methods. We obtained paired semen and blood samples at 2-week intervals from HIV-infected MSM with recent and chronic HCV infection and quantified HCV in semen. Results. Hepatitis C virus was quantified in 59 semen specimens from 33 men. Hepatitis C virus was shed in 16 (27%) of semen specimens from 11 (33%) of the men. Median HCV viral load (VL) in semen was 1.49 log10 IU/mL. Hepatitis C virus VL in blood was significantly higher at the time of HCV shedding in semen than when HCV shedding in semen was not detected (P = .002). Furthermore, there was a significant correlation between the HCV VL in blood and semen overall (rs = 0.41; P = .001), and in the subgroup with recent HCV infection (rs = 0.37; P = .02), but not in the subgroup with chronic HCV infection (rs = 0.34; P = .1). Conclusions. One third of HIV-infected MSM coinfected with HCV shed HCV into their semen. Based on the HCV VL in semen in this study, an average ejaculate would deliver up to 6630 IU of virus into the rectum of the receptive partner. Therefore, our data strongly support that condoms should be used during anal intercourse among MSM to prevent transmission of HCV. PMID:27186582

  9. Toremifene to Reduce Fracture Risk in Men Receiving Androgen Deprivation Therapy for Prostate Cancer

    PubMed Central

    Smith, Matthew R.; Morton, Ronald A.; Barnette, K. Gary; Sieber, Paul R.; Malkowicz, S. Bruce; Rodriguez, Domingo; Hancock, Michael L.; Steiner, Mitchell S.

    2011-01-01

    Purpose Androgen deprivation therapy is associated with fracture risk in men with prostate cancer. We assessed the effects of toremifene, a selective estrogen receptor modulator, on fracture incidence in men receiving androgen deprivation therapy during a 2-year period. Materials and Methods In this double-blind, placebo controlled phase III study 646 men receiving androgen deprivation therapy for prostate cancer were assigned to toremifene (80 mg by mouth daily) and 638 were assigned to placebo. Subjects were followed for 2 years. The primary study end point was new vertebral fractures. Secondary end points included fragility fractures, bone mineral density and lipid changes. Results The 2-year incidence of new vertebral fractures was 4.9% in the placebo group vs 2.5% in the toremifene group, a significant relative risk reduction of 50% (95% CI –1.5 to 75.0, p = 0.05). Toremifene significantly increased bone mineral density at the lumbar spine, hip and femoral neck vs placebo (p <0.0001 for all comparisons). There was a concomitant decrease in markers of bone turnover (p <0.05 for all comparisons). Toremifene also significantly improved lipid profiles. Venous thromboembolic events occurred more frequently with toremifene than placebo with 7 subjects (1.1%) in the placebo group experiencing a venous thromboembolic event vs 17 (2.6%) in the toremifene group. Other adverse events were similar between the groups. Conclusions Toremifene significantly decreased the incidence of new vertebral fractures in men receiving androgen deprivation therapy for prostate cancer. It also significantly improved bone mineral density, bone turnover markers and serum lipid profiles. PMID:20723926

  10. Prevalence of hepatitis C virus infection among HIV+ men who have sex with men: a systematic review and meta-analysis.

    PubMed

    Jordan, Ashly E; Perlman, David C; Neurer, Joshua; Smith, Daniel J; Des Jarlais, Don C; Hagan, Holly

    2017-02-01

    Since 2000, an increase in hepatitis C virus infection among HIV-infected (HIV+) men who have sex with men has been observed. Evidence points to blood exposure during sex as the medium of hepatitis C virus transmission. Hepatitis C virus prevalence among HIV + MSM overall and in relation to injection drug use is poorly characterized. In this study, a systematic review and meta-analysis examining global hepatitis C virus antibody prevalence and estimating active hepatitis C virus prevalence among HIV + MSM were conducted; 42 reports provided anti-hepatitis C virus prevalence data among HIV + MSM. Pooled prevalence produced an overall anti-hepatitis C virus prevalence among HIV + MSM of 8.1%; active HCV prevalence estimate was 5.3%-7.3%. Anti-hepatitis C virus prevalence among injection drug use and non-injection drug use HIV + MSM was 40.0% and 6.7%, respectively. Among HIV + MSM, hepatitis C virus prevalence increased significantly over time among the overall and non-injection drug use groups, and decreased significantly among injection drug use HIV + MSM. We identified a moderate prevalence of hepatitis C virus among all HIV + MSM and among non-injection drug use HIV + MSM; for both, prevalence was observed to be increasing slightly. Pooled prevalence of hepatitis C virus among HIV + MSM was higher than that observed in the 1945-1965 US birth cohort. The modest but rising hepatitis C virus prevalence among HIV + MSM suggests an opportunity to control HCV among HIV + MSM; this combined with data demonstrating a rising hepatitis C virus incidence highlights the temporal urgency to do so.

  11. Impaired responsiveness of homosexual men with HIV antibodies to plasma derived hepatitis B vaccine.

    PubMed

    Carne, C A; Weller, I V; Waite, J; Briggs, M; Pearce, F; Adler, M W; Tedder, R S

    1987-04-04

    Thirty five homosexual men (17 positive for antibody to the human immunodeficiency virus (HIV) and 18 consistently negative) were vaccinated against hepatitis B virus infection. Eight of the 17 seropositive patients failed to develop detectable hepatitis B surface antibody within three months of the third injection compared with only one of the 18 seronegative patients (p less than 0.01). HIV infection is prevalent in the developed world in groups at risk for hepatitis B infection and in certain Third World countries where widespread vaccination programmes exist. This study shows the impact that coincident HIV infection may have on an otherwise efficacious vaccine. The efficacy of this and other vaccines in patients infected with HIV needs to be studied urgently.

  12. Favorable Socioeconomic Status and Recreational Polydrug Use Are Linked With Sexual Hepatitis C Virus Transmission Among Human Immunodeficiency Virus-Infected Men Who Have Sex With Men

    PubMed Central

    Chen, Yun-Chi; Wiberg, Kjell J.; Hsieh, Yu-Hsiang; Bansal, Arun; Bolzan, Philipe; Guy, Janelle A.; Maina, Erastus N.; Cox, Andrea L.; Thio, Chloe L.

    2016-01-01

    Background. Sexual transmission of hepatitis C virus (HCV) among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) is an emerging issue. Studies addressing the temporal trends and risk factors associated with incident HCV in HIV-infected MSM in the community-based primary care settings in the United States are scarce. Methods. Using a retrospective cohort study design, HCV incidence, defined as HCV antibody seroconversion, was determined in 1147 HIV-infected men receiving care at Chase Brexton Health Care clinics in Baltimore, Maryland between 2004 and 2014. Multivariate regression analyses were used to identify factors associated with incident HCV. Results. There were 42 incident HCV infections during 5242 person-years (PY) of follow up (incidence rate [IR], 8.01/1000 PY). Thirty-seven (88%) of the incident infections were in MSM, of whom 31 (84%) reported no injection-drug use (IDU). The annual IRs for MSM were 13.1–15.8/1000 PY between 2004 and 2007, decreased to 2.7–6.2/1000 PY between 2008 and 2011, and increased to 10.4/1000 PY and 13.3/1000 PY in 2013 and 2014, respectively. Injection-drug use was strongly associated with incident HCV among all MSM (IR ratio [IRR], 14.15; P = .003); however, among MSM without IDU, entering care between 2010 and 2013 (IRR, 3.32; P = .01), being employed (IRR, 3.14; P = .03), and having a history of ulcerative sexually transmitted infections (IRR, 3.70; P = .009) or of polydrug use (IRR, 5.54; P = .01) independently predicted incident HCV. Conclusions. In this cohort of HIV-infected men, a re-emerging HCV epidemic was observed from 2011 to 2014 among MSM. In addition to IDU, high-risk sexual behaviors, favorable socioeconomic status, and polydrug use fueled this increase in HCV infections. PMID:27703998

  13. Incident hepatitis C virus infection in men who have sex with men: a prospective cohort analysis, 1984-2011.

    PubMed

    Witt, Mallory D; Seaberg, Eric C; Darilay, Annie; Young, Stephen; Badri, Sheila; Rinaldo, Charles R; Jacobson, Lisa P; Detels, Roger; Thio, Chloe L

    2013-07-01

    Prospective characterization of hepatitis C virus (HCV) transmission in both human immunodeficiency virus (HIV)-infected and -uninfected men who have sex with men (MSM) over the entire HIV epidemic has not been comprehensively conducted. To determine the trends in and risk factors associated with incident HCV in MSM since 1984, 5310 HCV antibody (anti-HCV)-negative MSM in the Multicenter AIDS Cohort Study were prospectively followed during 1984-2011 for anti-HCV seroconversion. During 55 343 person-years (PYs) of follow-up, there were 115 incident HCV infections (incidence rate, 2.08/1000 PYs) scattered throughout the study period. In a multivariable analysis with time-varying covariates, older age (incidence rate ratio [IRR], 1.40/10 years, P < .001), enrollment in the later (2001-2003) recruitment period (IRR, 3.80, P = .001), HIV infection (IRR, 5.98, P < .001), drinking >13 alcoholic drinks per week (IRR, 1.68, P < .001), hepatitis B surface antigen positivity (IRR, 1.68, P < .001), syphilis (IRR, 2.95, P < .001), and unprotected receptive anal intercourse with >1 male partner (IRR, 3.37, P < .001) were independently associated with incident HCV. Among HIV-infected subjects, every 100 cell/mm(3) increase in CD4 count was associated with a 7% (P = .002) decrease in the HCV incidence rate up to a CD4 count of 500 cells/mm(3), whereas there was no association with highly active antiretroviral therapy. The spread of HCV among both HIV-infected and -uninfected MSM in the United States has been ongoing since the beginning of the HIV epidemic. In HIV-infected men with <500 CD4(+) T cells, the HCV incidence rate was inversely proportional to CD4 T-cell count.

  14. Hepatitis B vaccination uptake and correlates of serologic response among HIV-infected and uninfected men who have sex with men (MSM) in Bangkok, Thailand.

    PubMed

    Chonwattana, Wannee; Raengsakulrach, Boonyos; Holtz, Timothy H; Wasinrapee, Punneeporn; Tongtoyai, Jaray; Chaikummao, Supaporn; Pattanasin, Sarika; McNicholl, Janet M; van Griensven, Frits; Curlin, Marcel E

    2016-04-12

    Vaccination against hepatitis B virus (HBV) is recommended for all HBV-susceptible men who have sex with men (MSM). There is limited information on correlates of immunity to HBV vaccination in this group. We present serologic response rates to hepatitis B vaccine and identify factors associated with impaired response among HIV-uninfected and HIV-infected Thai MSM. HBV-susceptible volunteers were offered hepatitis B vaccination at months zero, one, and six. We measured baseline (pre-vaccination) total serum IgG and IgG subclasses (all participants), baseline CD4 count, and plasma HIV-1 viral load (PVL) (HIV+ participants). HBV serologies were retested at 12 months. Serologic responses were compared between all groups in men receiving three vaccine doses. 511/651 HIV-negative and 64/84 HIV-positive participants completed the three-dose series. Response rates in HIV-uninfected and -infected participants were 90.1% vs. 50.0% (p<0.0001). Median pre-vaccination IgG was higher among non-responders than responders overall (1238.9.0 vs. 1057.0mg/dL, p=0.003) and among HIV-infected participants (1534.0 vs. 1244.5mg/dL, p=0.005), but not significantly among HIV-uninfected participants (1105.5 vs. 1054.3mg/dL, p=0.96). Pre-vaccination IgG1 and IgG3 levels were higher among HIV-positive than HIV-negative participants (median 866.0 vs. 520.3, and 105.8 vs. 83.1mg/dL, respectively, p<0.0001). Among HIV-infected participants, median CD4 count in non-responders was 378 cells/μL vs. 431 cells/μL in responders (p=0.20). Median PVL in non-responders was 64,800 copies/mL vs. 15500 copies/mL in responders (p=0.04). Participants with pre-vaccination plasma IgG >1550 mg/dL and PVL >10,000 copies/mL were almost always non-responsive (p<0.01). HIV infection was associated with poor vaccine responses. High plasma viral load, elevated pre-vaccination total serum IgG and elevated pre-vaccination IgG1 are associated with poorer response to vaccination among HIV-infected MSM. In this group

  15. Hepatitis B virus reactivation in patients receiving cancer chemotherapy: natural history, pathogenesis, and management.

    PubMed

    Liu, Chun-Jen; Chen, Pei-Jer; Chen, Ding-Shinn; Kao, Jia-Horng

    2013-06-01

    Chronic hepatitis B virus (HBV) infection is endemic in the Asian-Pacific region, and reactivation of HBV post-cancer chemotherapy has become an emerging clinical challenge. Patients with detectable serum HBV DNA before chemotherapy and those receiving intensive chemotherapy are particularly at a risk of HBV reactivation. Most patients with HBV reactivation are positive for hepatitis B surface antigen (HBsAg) and are, therefore, easily identified by recommended serological screening before chemotherapy. However, a small, but significant proportion of subjects who have apparently recovered from HBV infection as reflected by HBsAg negativity and hepatitis B core antibody positivity in HBV endemic areas may also experience reactivation when host immunity is severely compromised by cancer chemotherapy. Serum alanine aminotransferase, HBsAg, and/or HBV DNA should be monitored closely in these subjects and antiviral therapy should be administered immediately when any evidence of HBV reactivation is detected during chemotherapy. The prophylactic use of nucleos(t)ide analogs before chemotherapy and its continuation until reconstitution of host immunity remain the mainstay of effective prevention of hepatitis B reactivation in this special clinical entity.

  16. Factors associated with hepatitis B vaccination among men who have sex with men: a systematic review of published research.

    PubMed

    Vet, Raymond; de Wit, John Bf; Das, Enny

    2017-05-01

    This systematic review identified and synthesised evidence from published research regarding personal and environmental factors associated with hepatitis B virus (HBV) vaccination uptake among gay men and other men who have sex with men (MSM) in low prevalence, high-income countries. A systematic literature search identified 18 eligible papers that addressed factors potentially associated with HBV vaccination uptake among MSM, of which 16 reported research conducted in the US. Studies assessed possible associations between HBV vaccination among MSM and socio-demographic characteristics, behavioural and social-cognitive factors and indicators of health service access. Converging evidence was found for associations between HBV vaccination and younger age, gay self-identification, and not using alcohol and drugs; evidence suggests a lack of association between HBV vaccination and ethnicity. There was converging evidence for associations between HBV vaccination and social-cognitive factors, in particular knowledge, perceived vulnerability and perceived severity regarding HBV infection, and perceived barriers to HBV vaccination. Evidence further supported associations between HBV vaccination and indicators of health service access. While research regarding factors associated with HBV vaccination among MSM remains limited, the identified correlates of HBV vaccination among MSM provide important guidance for the development of health promotion interventions to effectively increase coverage of HBV vaccination among MSM.

  17. Social capital strategies to enhance hepatitis C treatment awareness and uptake among men in prison.

    PubMed

    Lafferty, L; Treloar, C; Guthrie, J; Chambers, G M; Butler, T

    2017-02-01

    Prisoner populations are characterized by high rates of hepatitis C (HCV), up to thirty times that of the general population in Australia. Within Australian prisons, less than 1% of eligible inmates access treatment. Public health strategies informed by social capital could be important in addressing this inequality in access to HCV treatment. Twenty-eight male inmates participated in qualitative interviews across three correctional centres in New South Wales, Australia. All participants had recently tested as HCV RNA positive or were receiving HCV treatment. Analysis was conducted with participants including men with experiences of HCV treatment (n=10) (including those currently accessing treatment and those with a history of treatment) and those who were treatment naïve (n=18). Social capital was a resourceful commodity for inmates considering and undergoing treatment while in custody. Inmates were a valuable resource for information regarding HCV treatment, including personal accounts and reassurance (bonding social capital), while nurses a resource for the provision of information and care (linking social capital). Although linking social capital between inmates and nurses appeared influential in HCV treatment access, there remained opportunities for increasing linking social capital within the prison setting (such as nurse-led engagement within the prisons). Bonding and linking social capital can be valuable resources in promoting HCV treatment awareness, uptake and adherence. Peer-based programmes are likely to be influential in promoting HCV outcomes in the prison setting. Engagement in prisons, outside of the clinics, would enhance opportunities for linking social capital to influence HCV treatment outcomes. © 2016 John Wiley & Sons Ltd.

  18. Obesity and hepatocellular carcinoma in patients receiving entecavir for chronic hepatitis B.

    PubMed

    Lee, Jaemin; Yoo, Sun Hong; Sohn, Won; Kim, Hyung Woo; Choi, Yong Sun; Won, Jung Ho; Heo, Jin Young; Park, Sang Jong; Park, Young Min

    2016-09-01

    This study aimed to clarify the effect of obesity on the development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients receiving antiviral treatment. This study applied a retrospective analysis to a historical cohort in Bundang Jesaeng Hospital. In total, 102 CHB patients were treated with entecavir as an initial treatment for CHB and checked for obesity using a body composition analyzer. Hepatic steatosis was measured semiquantitatively using Hamaguchi's scoring system in ultrasonography. Risk factors for the development of HCC were analyzed, including obesity-related factors (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], visceral fat area [VFA], and hepatic steatosis). The median follow-up duration of the patients was 45.2 months (interquartile range: 36.0-58.3 months). The cumulative incidence rates of HCC at 1 year, 3 years, and 5 years were 0%, 5.3%, and 9.0%, respectively. Univariable analysis revealed that the risk factors for HCC development were a platelet count of <120,000 /mm(2) (hazard ratio [HR]=5.21, P=0.031), HBeAg negativity (HR=5.61, P=0.039), and liver cirrhosis (HR=10.26, P=0.031). Multivariable analysis showed that the significant risk factor for HCC development was liver cirrhosis (HR=9.07, P=0.042). However, none of the obesity-related risk factors were significantly associated with HCC: BMI ≥25 kg/m(2) (HR=0.90, P=0.894), WC ≥90 cm (HR=1.10, P=0.912), WHR ≥0.9 (HR=1.94, P=0.386), VFA ≥100 cm(2) (HR=1.69, P=0.495), and hepatic steatosis (HR=0.57, P=0.602). HCC development is associated with liver cirrhosis but not obesity-related factors in CHB patients receiving entecavir.

  19. Exposure to hepatitis C virus in homeless men in Central Brazil: a cross-sectional study.

    PubMed

    Ferreira, Priscilla Martins; Guimarães, Rafael Alves; Souza, Christiane Moreira; Guimarães, Lara Cristina da Cunha; Barros, Cleiciane Vieira de Lima; Caetano, Karlla Antonieta Amorim; Rezza, Giovanni; Spadoni, Lila; Brunini, Sandra Maria

    2017-01-18

    Homeless men are highly vulnerable to acquisition of the hepatitis C virus (HCV) compared to the general population. In Brazil, a country of continental dimensions, the extent of HCV infection in this population remains unknown. The objective of this study is to investigate the epidemiological profile of exposure to HCV in homeless men in Central Brazil. A Cross-sectional study was conducted in 481 men aged over 18 years attending therapeutic communities specialized in the recovery and reintegration of homeless people. Participants were tested for anti-HCV markers using rapid tests. Poisson regression analysis was used to verify the risk factors associated with exposure to HCV. The prevalence of HCV exposure was 2.5% (95.0% CI: 1.4 to 4.3%) and was associated with age, absence of family life, injection drug use, number of sexual partners, and history of sexually transmitted infections (STI). Participants reported multiple risk behaviors, such as alcohol (78.9%), cocaine (37.1%) and/or crack use (53.1%), and inconsistent condom use (82.6%). Injection drug use was reported by 8.7% of participants. The prevalence of HCV infection among homeless men was relatively high. Several risk behaviors were commonly reported, which shows the high vulnerability of this population. These findings emphasize the need for the development of specific strategies to reduce the risk of HCV among homeless men.

  20. Hepatitis A outbreak among men who have sex with men (MSM) predominantly linked with the EuroPride, the Netherlands, July 2016 to February 2017

    PubMed Central

    Freidl, Gudrun S; Sonder, Gerard JB; Bovée, Lian PMJ; Friesema, Ingrid HM; van Rijckevorsel, Gini GC; Ruijs, Wilhelmina LM; van Schie, Frank; Siedenburg, Evelien C; Yang, Jyh-Yuan; Vennema, Harry

    2017-01-01

    Between July 2016 and February 2017, 48 male cases of hepatitis A were notified in the Netherlands. Of these, 17 identified as men who have sex with men (MSM). Ten of the 13 cases for whom sequencing information was available, were infected with a strain linked with the EuroPride that took place in Amsterdam in 2016. This strain is identical to a strain that has been causing a large outbreak among MSM in Taiwan. PMID:28251892

  1. Hepatitis A outbreak among men who have sex with men (MSM) predominantly linked with the EuroPride, the Netherlands, July 2016 to February 2017.

    PubMed

    Freidl, Gudrun S; Sonder, Gerard Jb; Bovée, Lian Pmj; Friesema, Ingrid Hm; van Rijckevorsel, Gini Gc; Ruijs, Wilhelmina Lm; van Schie, Frank; Siedenburg, Evelien C; Yang, Jyh-Yuan; Vennema, Harry

    2017-02-23

    Between July 2016 and February 2017, 48 male cases of hepatitis A were notified in the Netherlands. Of these, 17 identified as men who have sex with men (MSM). Ten of the 13 cases for whom sequencing information was available, were infected with a strain linked with the EuroPride that took place in Amsterdam in 2016. This strain is identical to a strain that has been causing a large outbreak among MSM in Taiwan.

  2. Racial differences in bone mineral density and fractures in men receiving androgen deprivation therapy for prostate cancer

    PubMed Central

    Morgans, Alicia K.; Hancock, Michael L.; Barnette, K. Gary; Steiner, Mitchell S.; Morton, Ronald A.; Smith, Matthew R.

    2013-01-01

    Purpose Whether race influences bone loss and fracture risk during androgen deprivation therapy (ADT) for prostate cancer is unknown. Using data from a prospective, clinical trial, we compared bone mineral density (BMD) and fracture between African American and Caucasian men receiving ADT. Materials and Methods Subjects (n=516) were in the placebo group of a two-year randomized placebo controlled fracture prevention trial and were African American (n=68) or Caucasian (n=448). We compared baseline characteristics, changes in BMD, and rates of new fractures between races. Results Compared to Caucasian men, African American men had higher baseline hip BMD (0.98 ± 0.15 g/m2 versus 0.91 ± 0.15 g/m2; P=0.001) and similar spine BMD (1.09 ± 0.22 versus 1.11 ± 0.22; P=0.51). There was no difference in prevalent vertebral fractures between African American and Caucasian men (7.4% versus 15.0%; P=0.13). Percentage change in hip BMD at two years was similar between African American and Caucasian men (−2.21 ± 0.59% versus −2.54 ± 0.26%; P=0.65). Changes in BMD of the lumbar spine were also similar between African American and Caucasian men (−1.74 ± 0.69 versus −1.30 ± 0.33%; P=0.64). No new vertebral fractures were reported in African American men versus two fractures in Caucasian men. Conclusions In a clinical trial, African American men receiving ADT for prostate cancer have higher hip BMD and tended to have fewer prevalent vertebral fractures than Caucasian men. Despite lower baseline risk of osteoporosis and fracture, African American men experience a decline in BMD that is similar to Caucasian men. PMID:22245322

  3. FACTORS ASSOCIATED WITH HEPATITIS B TESTING AMONG CAMBODIAN AMERICAN MEN AND WOMEN

    PubMed Central

    Taylor, Victoria M.; Bastani, Roshan; Burke, Nancy; Talbot, Jocelyn; Sos, Channdara; Liu, Qi; Jackson, J. Carey; Yasui, Yutaka

    2012-01-01

    Background Cambodian Americans have an elevated risk of liver cancer. This health disparity is attributable to high rates of hepatitis B virus (HBV) infection. Our study examined factors associated with HBV testing among Cambodian men and women. Methods A population-based survey was conducted in the Seattle area. The Health Behavior Framework guided our survey instrument development. We attempted to interview a man and a woman in each household. Results The sample included 300 men and 367 women. About one-half of the male (45%) and female (54%) respondents had been tested for HBV. Two factors were independently associated with testing among men and women: a doctor had recommended testing and had asked a doctor for testing. Knowing that someone who looks and feels healthy can spread HBV was independently associated with testing among men. Discussion Low levels of HBV testing remain a public health problem among Cambodians. Interventions should improve patient-provider communication by encouraging providers who serve Cambodians to recommend HBV testing, as well as by empowering Cambodians to ask for testing. PMID:22002705

  4. Risk Factors for Renal Functional Decline in Chronic Hepatitis B Patients Receiving Oral Antiviral Agents.

    PubMed

    Shin, Jung-Ho; Kwon, Hee Jin; Jang, Hye Ryoun; Lee, Jung Eun; Gwak, Geum-Youn; Huh, Wooseong; Jung, Sin-Ho; Lee, Joon Hyeok; Kim, Yoon-Goo; Kim, Dae Joong; Oh, Ha Young

    2016-01-01

    Renal functional decline that is frequently seen during chronic hepatitis B (CHB) treatment can exert adverse effects on overall prognosis. It, however, is difficult to distinguish vulnerable patients who may experience renal dysfunction because most previous CHB studies were conducted in relatively healthy individuals. In this retrospective observational study, renal functional decline in CHB patients receiving oral antiviral agents for more than 6 months was analyzed and risk factors of chronic kidney disease (CKD) progression were determined. Renal functional decline was defined when the estimated glomerular filtration rate (eGFR) decreased by more than 25% from baseline and rapid CKD progression was defined as eGFR decreased by more than 5 mL/min/1.73 m2/y among patients who experienced renal functional decline. A total of 4178 patients were followed up for a median 23 months. Antiviral agents included lamivudine (17.0%), adefovir (3.7%), entecavir (70.4%), telbivudine (0.6%), tenofovir (4.0%), or clevudine (4.3%). Renal functional decline occurred in 706 (16.9%) patients. Based on multivariate Cox regression analysis, age, hypertension, diabetes, history of liver or kidney transplantation, underlying underlying CKD, and simultaneous administration of diuretics increased the hazard ratio for renal functional decline; however, clevudine reduced risk. The eGFR significantly increased over time in patients receiving telbivudine or clevudine compared with lamivudine. Among the 3175 patients followed up for more than 1 year, 407 (12.8%) patients experienced rapid CKD progression. Patients with rapid CKD progression showed lower serum albumin, higher total bilirubin, and prolonged prothrombin time compared with patients with stable renal function, but hepatitis B envelope antigen positivity and hepatitis B virus deoxyribonucleic acid level did not differ between the control and rapid CKD progression groups. Age, diabetes, kidney transplantation, underlying CKD, and

  5. Changing trend of HIV, Syphilis and Hepatitis C among Men Who Have Sex with Men in China

    PubMed Central

    Qin, Qianqian; Tang, Weiming; Ge, Lin; Li, Dongmin; Mahapatra, Tanmay; Wang, Liyan; Guo, Wei; Cui, Yan; Sun, Jiangping

    2016-01-01

    Dearth of information regarding the trend and correlates of HIV, syphilis and Hepatitis C (HCV) in a country-wide sample of understudied though high-risk Chinese men who have sex with men (MSM) called for a comprehensive serial cross-sectional study. Using a multistage mixed-method strategy, 171,311 MSM from 107 selected cities/counties in 30 provinces of mainland China, were interviewed and tested. Descriptive, bivariate, multivariate and Cochran-Armitage trend analyses were conducted using SAS 9.2. During 2009-13, recent (71.5% to 78.6%, p < 0.001) and consistent (40.4% to 48.8%, p < 0.001) condom use as well as condom use during commercial anal sex (46.5% to 55.0%, p < 0.001) were increasing. In contrast, commercial anal sex with male (11.9% to 7.1%, p < 0.001) and drug use (1.9% to 0.8%, p < 0.001) were decreasing over time. HIV prevalence increased gradually (5.5% to 7.3%, p < 0.001), while syphilis (9.0% to 6.3%, p < 0.001) and HCV prevalence (1.5% to 0.7%, p < 0.001) decreased over time. A positive correlation was observed between HIV and syphilis prevalence (r = 0.38). HIV infection was associated with HIV-related knowledge, services and injecting drug use. An increasing trend of HIV prevalence was observed during 2009–13 among MSM in China. While gradual reduction of risk behaviors along with syphilis and HCV prevalence supported expansion of testing and prevention services, increasing HIV burden called for deeper thematic investigations. PMID:27535092

  6. Prevalence, patterns and predictors of substance use among Latino migrant men in a new receiving community

    PubMed Central

    Kissinger, Patricia; Althoff, Meghan; Burton, Nicole; Schmidt, Norine; Hembling, John; Salinas, Oscar; Shedlin, Michele

    2014-01-01

    Background The purpose of this study was to evaluate the prevalence, patterns and predictors (individual, social, cultural, and environmental) of illicit drug use and binge drinking in a cohort of Latino migrant men (LMM) in a new receiving community. Methods A cohort of LMM in New Orleans (n = 125) was assembled in 2007 using respondent driven sampling and interviewed quarterly for 18 months regarding past month substance use and other potential covariates. Baseline frequencies were weighted using RDSAT and longitudinal analyses included generalized estimating equations (GEE) and the Cochran–Armitage test for trends. Results At baseline, substance use behaviors were: drug use 15.0% (range 7.3–25.0%) and binge drinking 58.3% (range 43.6–74.6%). All three of these behaviors decreased over follow-up (P < 0.01). Baseline alcohol dependence and drug problem were 11.8% (range 5.6–24.3%) and 0.08% (range 0.00–2.7%) and both remained the same over time. Baseline rate of chlamydia was 9% (range 0.00–22.4%); all men tested negative for gonorrhea, HIV, and syphilis. For both binge drinking and drug use, having sex with a female sex worker was associated with increased risk, whereas belonging to a club or organization was associated with less risk. Additional factors associated with increased drug use were: having a friend in New Orleans upon arrival, symptoms of depression, and working in construction. An additional factor associated with less binge drinking was having family in New Orleans upon arrival. Conclusion Among LMM, substance use is influenced by social and environmental factors. Interventions increase community connectedness may help decrease usage. PMID:24099968

  7. Liver enzymes are associated with hepatic insulin resistance, insulin secretion, and glucagon concentration in healthy men and women.

    PubMed

    Bonnet, Fabrice; Ducluzeau, Pierre-Henri; Gastaldelli, Amalia; Laville, Martine; Anderwald, Christian H; Konrad, Thomas; Mari, Andrea; Balkau, Beverley

    2011-06-01

    The pathophysiological mechanisms to explain the association between risk of type 2 diabetes and elevated concentrations of γ-glutamyltransferase (GGT) and alanineaminotransferase (ALT) remain poorly characterized. We explored the association of liver enzymes with peripheral and hepatic insulin resistance, insulin secretion, insulin clearance, and glucagon concentration. We studied 1,309 nondiabetic individuals from the Relationship between Insulin Sensitivity and Cardiovascular disease (RISC) study; all had a euglycemic-hyperinsulinemic clamp and an oral glucose tolerance test (OGTT) with assessment of insulin secretion and hepatic insulin extraction. The hepatic insulin resistance index was calculated in 393 individuals. In both men and women, plasma concentrations of GGT and ALT were inversely related with insulin sensitivity (M/I) (all P < 0.01). Likewise, the hepatic insulin resistance index was positively correlated with both GGT (r = 0.37, P < 0.0001, men; r = 0.36, P < 0.0001, women) and ALT (r = 0.25, P = 0.0005, men; r = 0.18, P = 0.01, women). These associations persisted in multivariable models. Increased GGT and ALT were significantly associated with higher insulin secretion rates and with both reduced endogenous clearance of insulin and hepatic insulin extraction during the OGTT (P = 0.0005 in men; P = 0.003 in women). Plasma fasting glucagon levels increased over ALT quartiles (men, quartile 4 vs. quartile 1 11.2 ± 5.1 vs. 9.3 ± 3.8 pmol/L, respectively, P = 0.0002; women, 9.0 ± 4.3 vs. 7.6 ± 3.1, P = 0.001). In healthy individuals, increased GGT and ALT were biomarkers of both systemic and hepatic insulin resistance with concomitant increased insulin secretion and decreased hepatic insulin clearance. The novel finding of a positive correlation between ALT and fasting glucagon level concentrations warrants confirmation in type 2 diabetes.

  8. Prevalence and Risk Factors for Hepatitis C Virus Infection among Young Thai Men

    PubMed Central

    Jatapai, Anchalee; Nelson, Kenrad E.; Chuenchitra, Thippawan; Kana, Khunakorn; Eiumtrakul, Sakol; Sunantarod, Ekachai; Rangsin, Ram

    2010-01-01

    Epidemiologic studies of hepatitis C virus (HCV) infection are unusual in developing countries, especially Thailand. We evaluated the prevalence and risk factors for HCV among military conscripts, including a sample of 5,246 men (1:30 sample), and human immunodeficiency virus (HIV)-1 positive men (N = 500) between 2005 and 2008. The HCV prevalence was 2.2% in the sampled group and 8.4% in HIV-1 sero-positives. Among the sampled group, HIV-1 infection, injection drug use (IDU) history, and unsafe injections were associated with HCV infection; adjusted prevalence rate ratios [RRs; 95% confidence intervals (CIs)] were 3.7 (1.04–12.77), 1.9 (1.04–3.54), and 1.8 (1.02–3.11), respectively. Among HIV-1 sero-positives, an IDU history and residence in southern Thailand were associated with HCV prevalence; adjusted RRs (95% CIs) were 3.5 (1.71–7.24) and 2.6 (1.18–5.61), respectively. Public health measures to prevent HCV in Thailand should focus on reducing injection drug use and other exposures to unsafe injections among young Thai men. PMID:20682895

  9. Response to booster doses of hepatitis B vaccine among young adults who had received neonatal vaccination.

    PubMed

    Chan, Paul K S; Ngai, Karry L K; Lao, Terence T; Wong, Martin C S; Cheung, Theresa; Yeung, Apple C M; Chan, Martin C W; Luk, Scotty W C

    2014-01-01

    Newborns who have received hepatitis B immunization in 1980s are now young adults joining healthcare disciplines. The need for booster, pre- and post-booster checks becomes a practical question. The aim of this study is to refine the HBV vaccination policy for newly admitted students in the future. A prospective study on medical and nursing school entrants to evaluate hepatitis B serostatus and the response to booster doses among young adults. Among 212 students, 17-23-year-old, born after adoption of neonatal immunization, 2 (0.9%) were HBsAg positive, 40 (18.9%) were anti-HBs positive. At 1 month after a single-dose booster for anti-HBs-negative students, 14.5% had anti-HBs <10 mIU/mL, 29.0% and 56.5% were 10-100 and >100 mIU/mL, respectively. The anti-HBs levels were significantly higher for females than males (mean [SD]: 431 [418] vs. 246 [339] mIU/mL, P = 0.047). At 2-4 month after the third booster dose, 97.1% had anti-HBs >100 mIU/mL and 2.9% had 10-100 mIU/mL. Pre-booster check is still worthwhile to identify carriers among newly recruited healthcare workers born after adoption of neonatal immunization. A 3-dose booster, rather than a single dose, is required for the majority to achieve an anti-HBs level >100 mIU/mL, as memory immunity has declined in a substantial proportion of individuals. Cost-effectiveness of post-booster check for anti-HBs is low and should be further evaluated based on contextual specific utilization of results.

  10. Ongoing hepatitis A among men who have sex with men (MSM) linked to outbreaks in Europe in Tel Aviv area, Israel, December 2016 - June 2017.

    PubMed

    Gozlan, Yael; Bar-Or, Itay; Rakovsky, Aviya; Savion, Michal; Amitai, Ziva; Sheffer, Rivka; Ceder, Noa; Anis, Emilia; Grotto, Itamar; Mendelson, Ella; Mor, Orna

    2017-07-20

    Between December 2016 and June 2017, 19 Hepatitis A virus (HAV)-positive cases, 17 of which were among men who have sex with men (MSM) were identified in the Tel Aviv area. Seven of the 15 sewage samples collected between January and June 2017 were also HAV-positive. All sequences clustered with two of the three strains identified in the current European HAV outbreak. We demonstrate that despite an efficient vaccination programme, HAV can still be transmitted to an unvaccinated high-risk population. This article is copyright of The Authors, 2017.

  11. Notes from the Field: Increase in Reported Hepatitis A Infections Among Men Who Have Sex with Men - New York City, January-August 2017.

    PubMed

    Latash, Julia; Dorsinville, Marie; Del Rosso, Paula; Antwi, Mike; Reddy, Vasudha; Waechter, HaeNa; Lawler, Jacqueline; Boss, Heather; Kurpiel, Philip; Backenson, P Bryon; Gonzalez, Charles; Rowe, Shannon; Poissant, Tasha; Lin, Yulin; Xia, Guo-Liang; Balter, Sharon

    2017-09-22

    Since 2011, the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has typically been notified of three or fewer cases of hepatitis A virus (HAV) infection each year among men who have sex with men (MSM) who reported no travel to countries where HAV is endemic. This year, DOHMH noted an increase in HAV infections among MSM with onsets in January-March 2017, and notified other public health jurisdictions via Epi-X, CDC's communication exchange network. As a result, 51 patients with HAV infection involving MSM were linked to the increase in NYC.

  12. Efficacy of walking exercise in promoting cognitive-psychosocial functions in men with prostate cancer receiving androgen deprivation therapy.

    PubMed

    Lee, C Ellen; Kilgour, Andrea; Lau, Y K James

    2012-07-30

    Prostate cancer is the most commonly diagnosed non-melanoma cancer among men. Androgen deprivation therapy (ADT) has been the core therapy for men with advanced prostate cancer. It is only in recent years that clinicians began to recognize the cognitive-psychosocial side effects from ADT, which significantly compromise the quality of life of prostate cancer survivors. The objectives of the study are to determine the efficacy of a simple and accessible home-based, walking exercise program in promoting cognitive and psychosocial functions of men with prostate cancer receiving ADT. A 6-month prospective, single-blinded, randomized controlled trial will be conducted to compare the Exercise Group with the Control Group. Twenty men with prostate cancer starting ADT will be recruited and randomly assigned to one of the two groups: the Exercise Group will receive instructions in setting up an individualized 6-month home-based, walking exercise program, while the Control Group will receive standard medical advice from the attending physician. The primary outcomes will be psychosocial and cognitive functions. Cognitive functions including memory, attention, working memory, and executive function will be assessed using a battery of neurocognitive tests at baseline and 6 months. Psychosocial functions including depression, anxiety and self-esteem will be assessed at baseline, 3 and 6 months using the Center for Epidemiological Studies Depression Scale, Spielberger State-Trait Anxiety Inventory, and Rosenberg Self-Esteem Scale. The significance of the cognitive-psychosocial side effects of ADT in men with prostate cancer has only been recently recognized, and the management remains unclear. This study addresses this issue by designing a simple and accessible home-based, exercise program that may potentially have significant impact on reducing the cognitive and psychosocial side effects of ADT, and ultimately improving the health-related quality of life in men with prostate

  13. Factors associated with chronic hepatitis in patients with hepatitis E virus infection who have received solid organ transplants.

    PubMed

    Kamar, Nassim; Garrouste, Cyril; Haagsma, Elizabeth B; Garrigue, Valérie; Pischke, Sven; Chauvet, Cécile; Dumortier, Jérome; Cannesson, Amélie; Cassuto-Viguier, Elisabeth; Thervet, Eric; Conti, Filomena; Lebray, Pascal; Dalton, Harry R; Santella, Robert; Kanaan, Nada; Essig, Marie; Mousson, Christiane; Radenne, Sylvie; Roque-Afonso, Anne Marie; Izopet, Jacques; Rostaing, Lionel

    2011-05-01

    Hepatitis E virus (HEV) infection can cause chronic hepatitis in recipients of solid organ transplants. However, the factors that contribute to chronic infection and the outcomes of these patients are incompletely understood. We performed a retrospective analysis of data from 17 centers from Europe and the United States that described the progression, outcomes, and factors associated with development of chronic HEV infection in recipients of transplanted solid organs. We studied data from 85 recipients of solid organ transplants who were infected with HEV. Chronic HEV infection was defined by the persistent increases in levels of liver enzymes and polymerase chain reaction evidence of HEV in the serum and/or stool for at least 6 months. Fifty-six patients (65.9%) developed chronic hepatitis. Univariate analysis associated liver transplant, shorter times since transplant, lower levels of liver enzymes and serum creatinine, lower platelet counts, and tacrolimus-based immunosuppressive therapy (rather than cyclosporin A) with chronic hepatitis. On multivariate analysis, the independent predictive factors associated with chronic HEV infection were the use of tacrolimus rather than cyclosporin A (odds ratio [OR], 1.87; 95% confidence interval [CI], 1.49-1.97; P = .004) and a low platelet count at the time of diagnosis with HEV infection (OR, 1.02; 95% CI, 1.001-1.1; P = .04). Of patients with chronic hepatitis, 18 (32.1%) achieved viral clearance after the dose of immunosuppressive therapy was reduced. No HEV reactivation was observed after HEV clearance. HEV infection causes chronic hepatitis in more than 60% of recipients of solid organ transplants. Tacrolimus therapy is the main predictive factor for chronic hepatitis. Dose reductions of immunosuppressive therapy resulted in viral clearance in more than 30% of patients. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

  14. Prevalence of hepatitis B surface antigen among women receiving prenatal care at the Palm Beach County Health Department.

    PubMed

    Malecki, J M; Guarin, O; Hulbert, A; Brumback, C L

    1986-03-01

    Pregnant women receiving prenatal care at the maternity clinics of the Palm Beach County Health Department were tested for hepatitis B surface antigen. Routine screening of pregnant women for the antigen is discussed. The results of this study indicate the need for routine screening of our medically indigent pregnant population.

  15. Ongoing outbreaks of hepatitis A among men who have sex with men (MSM), Berlin, November 2016 to January 2017 - linked to other German cities and European countries.

    PubMed

    Werber, Dirk; Michaelis, Kai; Hausner, Marius; Sissolak, Dagmar; Wenzel, Jürgen; Bitzegeio, Julia; Belting, Anne; Sagebiel, Daniel; Faber, Mirko

    2017-02-02

    Since 14 November 2016, 38 cases of hepatitis A have been notified in Berlin; of these, 37 were male and 30 reported to have sex with men (MSM). Median age of MSM cases is 31 years (range: 24-52 years). Phylogenetic analysis revealed three distinct sequences, linking cases in Berlin to those in other German cities and to clusters recognised in other European countries in 2016. This article is copyright of The Authors, 2017.

  16. Ongoing outbreaks of hepatitis A among men who have sex with men (MSM), Berlin, November 2016 to January 2017 – linked to other German cities and European countries

    PubMed Central

    Werber, Dirk; Michaelis, Kai; Hausner, Marius; Sissolak, Dagmar; Wenzel, Jürgen; Bitzegeio, Julia; Belting, Anne; Sagebiel, Daniel; Faber, Mirko

    2017-01-01

    Since 14 November 2016, 38 cases of hepatitis A have been notified in Berlin; of these, 37 were male and 30 reported to have sex with men (MSM). Median age of MSM cases is 31 years (range: 24–52 years). Phylogenetic analysis revealed three distinct sequences, linking cases in Berlin to those in other German cities and to clusters recognised in other European countries in 2016. PMID:28183391

  17. Immune Responses in U.S. Military Personnel Who Received Meningococcal Conjugate Vaccine (MenACWY) Concomitantly with Other Vaccines Were Higher than in Personnel Who Received MenACWY Alone

    PubMed Central

    Romero-Steiner, Sandra; Rajam, Gowrisankar; Johnson, Scott E.; Milton, Andrea; Kim, Ellie; Choi, Lisa J.; Radin, Jennifer M.; Schmidt, Daniel S.; Carlone, George M.; Messonnier, Nancy; Faix, Dennis J.

    2016-01-01

    Immunological responses to vaccination can differ depending on whether the vaccine is given alone or with other vaccines. This study was a retrospective evaluation of the immunogenicity of a tetravalent meningococcal conjugate vaccine for serogroups A, C, W, and Y (MenACWY) administered alone (n = 41) or concomitantly with other vaccines (n = 279) to U.S. military personnel (mean age, 21.6 years) entering the military between 2006 and 2008. Concomitant vaccines included tetanus/diphtheria (Td), inactivated polio vaccine (IPV), hepatitis vaccines, and various influenza vaccines, among others; two vaccine groups excluded Tdap and IPV. Immune responses were evaluated in baseline and postvaccination sera for Neisseria meningitidis serogroups C and Y 1 to 12 months (mean, 4.96 months) following vaccination. Functional antibodies were measured by using a serum bactericidal antibody assay with rabbit complement (rSBA) and by measurement of serogroup-specific immunoglobulin G (IgG) antibodies. The percentage of vaccinees reaching threshold levels (IgG concentration in serum, ≥2 μg/ml; rSBA titer, ≥8) corresponding to an immunologic response was higher postvaccination than at baseline (P < 0.001). Administration of MenACWY along with other vaccines was associated with higher geometric means of IgG concentrations and rSBA titers than those measured 4.60 months after a single dose of MenACWY. In addition, higher percentages of vaccinees reached the immunological threshold (range of odds ratios [ORs], 1.5 to 21.7) and more of them seroconverted (OR range, 1.8 to 4.8) when MenACWY was administered with any other vaccine than when administered alone. Additional prospective randomized clinical trials are needed to confirm the observed differences among groups in the immune response to MenACWY when given concomitantly with other vaccines to U.S. military personnel. PMID:27280619

  18. Immune Responses in U.S. Military Personnel Who Received Meningococcal Conjugate Vaccine (MenACWY) Concomitantly with Other Vaccines Were Higher than in Personnel Who Received MenACWY Alone.

    PubMed

    Broderick, Michael P; Romero-Steiner, Sandra; Rajam, Gowrisankar; Johnson, Scott E; Milton, Andrea; Kim, Ellie; Choi, Lisa J; Radin, Jennifer M; Schmidt, Daniel S; Carlone, George M; Messonnier, Nancy; Faix, Dennis J

    2016-08-01

    Immunological responses to vaccination can differ depending on whether the vaccine is given alone or with other vaccines. This study was a retrospective evaluation of the immunogenicity of a tetravalent meningococcal conjugate vaccine for serogroups A, C, W, and Y (MenACWY) administered alone (n = 41) or concomitantly with other vaccines (n = 279) to U.S. military personnel (mean age, 21.6 years) entering the military between 2006 and 2008. Concomitant vaccines included tetanus/diphtheria (Td), inactivated polio vaccine (IPV), hepatitis vaccines, and various influenza vaccines, among others; two vaccine groups excluded Tdap and IPV. Immune responses were evaluated in baseline and postvaccination sera for Neisseria meningitidis serogroups C and Y 1 to 12 months (mean, 4.96 months) following vaccination. Functional antibodies were measured by using a serum bactericidal antibody assay with rabbit complement (rSBA) and by measurement of serogroup-specific immunoglobulin G (IgG) antibodies. The percentage of vaccinees reaching threshold levels (IgG concentration in serum, ≥2 μg/ml; rSBA titer, ≥8) corresponding to an immunologic response was higher postvaccination than at baseline (P < 0.001). Administration of MenACWY along with other vaccines was associated with higher geometric means of IgG concentrations and rSBA titers than those measured 4.60 months after a single dose of MenACWY. In addition, higher percentages of vaccinees reached the immunological threshold (range of odds ratios [ORs], 1.5 to 21.7) and more of them seroconverted (OR range, 1.8 to 4.8) when MenACWY was administered with any other vaccine than when administered alone. Additional prospective randomized clinical trials are needed to confirm the observed differences among groups in the immune response to MenACWY when given concomitantly with other vaccines to U.S. military personnel. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  19. Lack of evidence for increased risk of hepatitis A infection in homosexual men.

    PubMed Central

    Corona, R.; Stroffolini, T.; Giglio, A.; Cotichini, R.; Tosti, M. E.; Prignano, G.; Di Carlo, A.; Maini, A.; Mele, A.

    1999-01-01

    In 1997, prevalence of and risk factors for hepatitis A virus (HAV) infection were evaluated in 146 homosexual and 286 heterosexual men attending a Sexually Transmitted Disease (STD) Clinic in Rome, Italy. Total HAV antibody (anti-HAV) was detected in 60.3% of homosexuals and 62.2% of heterosexuals. After adjustment for the confounding effects of age, years of schooling, number of sexual partners, use of condoms, and history of STD, homosexuals were not found to be at increased risk of previous HAV exposure than heterosexuals (OR 1.1; 95% CI 0.7-1.9). Independent predictors of the likelihood of anti-HAV seropositivity among homosexuals and heterosexuals were: age older than 35 years and positive syphilis serology which is likely a proxy of lifestyles that increase the risk of faecal-oral infections. These findings do not support a higher risk in homosexual men but could suggest a role for the vaccination of susceptible patients attending STD clinics. PMID:10487644

  20. Asymptomatic rectal mucosal lesions and hepatitis B surface antigen at sites of sexual contact in homosexual men with persistent hepatitis B virus infection.

    PubMed

    Reiner, N E; Judson, F N; Bond, W W; Francis, D P; Petersen, N J

    1982-02-01

    To ascertain why active and passive oral-anal and genital anal intercourse correlate strongly with hepatitis B virus (HBV) infection in homosexual men, we studied 22 men with HBV infection for the presence of hepatitis B surface antigen (HBsAg) in gingival and anorectal mucosa, feces, and semen. Thirteen of 22 (59%) patients had asymptomatic rectal mucosal lesions consisting of punctate bleeding points. Seventy-seven percent of swabbed specimens from lesions, 62% from feces, 59% from rectal mucosa, and 50% from anal canal mucosa contained HBsAg. Sera diluted serially and tested for HBsAg by radioimmunoassay showed that men with serum titers of 105 or greater were more likely to have HBsAg in specimens from lesions (p = 0.034), feces (p = 0.032), and normal mucosa (p = 0.001) than men with titers under 10 5. Asymptomatic rectal bleeding is frequent in homosexual men with persistent HBV infection. Rectal mucosa, feces, and anal canal mucosa become contaminated with HBsAg, creating a setting for de facto parenteral transmission when there is contact with oral or urethral mucosa.

  1. Nursing case management, peer coaching, and hepatitis a and B vaccine completion among homeless men recently released on parole: randomized clinical trial.

    PubMed

    Nyamathi, Adeline; Salem, Benissa E; Zhang, Sheldon; Farabee, David; Hall, Betsy; Khalilifard, Farinaz; Leake, Barbara

    2015-01-01

    Although hepatitis A virus (HAV) and hepatitis B virus (HBV) infections are vaccine-preventable diseases, few homeless parolees coming out of prisons and jails have received the hepatitis A and B vaccination series. The study focused on completion of the HAV and HBV vaccine series among homeless men on parole. The efficacy of three levels of peer coaching (PC) and nurse-delivered interventions was compared at 12-month follow-up: (a) intensive peer coaching and nurse case management (PC-NCM); (b) intensive PC intervention condition, with minimal nurse involvement; and (c) usual care (UC) intervention condition, which included minimal PC and nurse involvement. Furthermore, we assessed predictors of vaccine completion among this targeted sample. A randomized control trial was conducted with 600 recently paroled men to assess the impact of the three intervention conditions (PC-NCM vs. PC vs. UC) on reducing drug use and recidivism; of these, 345 seronegative, vaccine-eligible subjects were included in this analysis of completion of the Twinrix HAV/HBV vaccine. Logistic regression was added to assess predictors of completion of the HAV/HBV vaccine series and chi-square analysis to compare completion rates across the three levels of intervention. Vaccine completion rate for the intervention conditions were 75.4% (PC-NCM), 71.8% (PC), and 71.9% (UC; p = .78). Predictors of vaccine noncompletion included being Asian and Pacific Islander, experiencing high levels of hostility, positive social support, reporting a history of injection drug use, being released early from California prisons, and being admitted for psychiatric illness. Predictors of vaccine series completion included reporting having six or more friends, recent cocaine use, and staying in drug treatment for at least 90 days. Findings allow greater understanding of factors affecting vaccination completion in order to design more effective programs among the high-risk population of men recently released from

  2. Nursing Case Management, Peer Coaching, and Hepatitis A and B Vaccine Completion Among Homeless Men Recently Released on Parole: Randomized Clinical Trial

    PubMed Central

    Nyamathi, Adeline; Salem, Benissa E.; Zhang, Sheldon; Farabee, David; Hall, Betsy; Khalilifard, Farinaz; Leake, Barbara

    2015-01-01

    Background Although hepatitis A virus (HAV) and hepatitis B virus (HBV) infections are vaccine-preventable diseases, few homeless parolees coming out of prisons and jails have received the hepatitis A and B vaccination series. Objectives The study focused on completion of the HAV and HBV vaccine series among homeless men on parole. The efficacy of three levels of peer coaching and nurse-delivered interventions was compared at 12-month follow up: (a) intensive peer coaching and nurse case management (PC-NCM); (b) intensive peer coaching (PC) intervention condition, with minimal nurse involvement; and a (c) usual care (UC) intervention condition, which included minimal PC and nurse involvement. Further, we assessed predictors of vaccine completion among this targeted sample. Methods A randomized control trial was conducted with 600 recently paroled men to assess the impact of the three intervention conditions (PC-NCM vs. PC vs. UC) on reducing drug use and recidivism; of these, 345 seronegative, vaccine-eligible subjects were included in this analysis of completion of the Twinrix HAV/HAB vaccine. Logistic regression was added to assess predictors of completion of the HAV/HBV vaccine series and chi-squared analysis to compare completion rates across the three levels of intervention. Results Vaccine completion rate for the intervention conditions were 75.4% (PC-NCM), 71.8% (PC), and 71.9% (UC) (p =. 78). Predictors of vaccine noncompletion included being Asian and Pacific Islander, experiencing high levels of hostility, positive social support, reporting a history of injection drug use, being released early from California prisons, and being admitted for psychiatric illness. Predictors of vaccine series completion included reporting six or more friends, recent cocaine use, and staying in drug treatment for at least 90 days. Discussion Findings allow greater understanding of factors affecting vaccination completion in order to design more effective programs among the

  3. Lack of evidence of sexual transmission of hepatitis C virus in a prospective cohort study of men who have sex with men.

    PubMed

    Alary, Michel; Joly, Jean R; Vincelette, Jean; Lavoie, René; Turmel, Bruno; Remis, Robert S

    2005-03-01

    We studied the prevalence and incidence of hepatitis C virus (HCV) infection in the ongoing Omega Cohort Study of men who have sex with men (MSM). From January to September 2001, consenting men (n = 1085) attending a follow-up visit to the ongoing Omega Cohort Study were tested for HCV. If the test results were positive for HCV, we compared them with test results from previous serum samples collected from the time of entry into the original cohort study to determine the time of infection. HCV prevalence at entry was 2.9% and was strongly associated with injection drug use (32.9% vs 0.3%, P<.0001). Only 1 seroconversion was identified in 2653 person-years of follow-up (incidence rate = 0.038 per 100 person-years). The seroconverter was an active injection drug user who reported needle sharing. Sexual transmission of HCV among MSM appears to be rare.

  4. Lack of Evidence of Sexual Transmission of Hepatitis C Virus in a Prospective Cohort Study of Men Who Have Sex With Men

    PubMed Central

    Alary, Michel; Joly, Jean R.; Vincelette, Jean; Lavoie, René; Turmel, Bruno; Remis, Robert S.

    2005-01-01

    Objectives. We studied the prevalence and incidence of hepatitis C virus (HCV) infection in the ongoing Omega Cohort Study of men who have sex with men (MSM). Methods. From January to September 2001, consenting men (n = 1085) attending a follow-up visit to the ongoing Omega Cohort Study were tested for HCV. If the test results were positive for HCV, we compared them with test results from previous serum samples collected from the time of entry into the original cohort study to determine the time of infection. Results. HCV prevalence at entry was 2.9% and was strongly associated with injection drug use (32.9% vs 0.3%, P<.0001). Only 1 seroconversion was identified in 2653 person-years of follow-up (incidence rate = 0.038 per 100 person-years). The seroconverter was an active injection drug user who reported needle sharing. Conclusions. Sexual transmission of HCV among MSM appears to be rare. PMID:15727984

  5. Hepatitis

    MedlinePlus

    ... CPR: A Real Lifesaver Kids Talk About: Coaches Hepatitis KidsHealth > For Kids > Hepatitis Print A A A ... have liver damage because of it. What Is Hepatitis? Hepatitis is an inflammation (say: in-fluh-MAY- ...

  6. [HIV infection and syphilis prevalence among men who have sex with men receiving voluntary counseling and testing appointed through a web-based registering system and related factors].

    PubMed

    Wu, Qiongmiao; Cheng, Weibin; Zhong, Fei; Xu, Huifang; Liu, Qi; Lin, Peng

    2015-05-01

    To understand the human immunodeficiency virus (HIV) infection status and syphilis prevalence among men who have sex with men (MSM) receiving voluntary counseling and testing appointed through a web-based registering system and related factors. The MSM receiving web appointed HIV counseling and testing from 2011 to 2012 in Guangzhou were recruited and a questionnaire survey was conduct among them to obtain the information about their demographic characteristics and sexual behavior. Binary and multivariate logistic regression model were used to identify the factors associated with HIV infection or syphilis prevalence. A total of 4,904 MSM were enrolled in the study, the average age of the MSM was (28.77±7.24) years, and 70.3% of them had high education level; the unmarried MSM accounted for 72.7%. The HIV infection rate and syphilis prevalence were 8.7% and 4.4% respectively. The co-infection rate of HIV and Treponema pallidum was 1.2% (59/4 904). About one in three MSM did not use condom at latest homosexual behavior, 43.5% did not use condoms at each homosexual behavior in the past three months. Lower education level, occupation (worker or farmer), non-consistent condom use at each sex with men in the past three months, receiving HIV test or not and Treponema pallidum infection were associated with HIV infection. Age≥40 years, lower education level, multi male sex partners in the past three months and HIV infection were associated with Treponema pallidum infection. MSM receiving web appointed HIV counseling and testing had high prevalence of risk behaviors and high HIV infection rate, but had low previous HIV testing rate. It is necessary to strengthen the promotion of HIV test through web based appointment and conduct target behavior intervention in older MSM with lower education level.

  7. HIV Prevention Services Received at Health Care and HIV Test Providers by Young Men who Have Sex with Men: An Examination of Racial Disparities

    PubMed Central

    MacKellar, Duncan A.; Valleroy, Linda A.; Secura, Gina M.; Bingham, Trista; Celentano, David D.; Koblin, Beryl A.; LaLota, Marlene; Shehan, Douglas; Torian, Lucia V.

    2008-01-01

    We investigated whether there were racial/ethnic differences among young men who have sex with men (MSM) in their use of, perceived importance of, receipt of, and satisfaction with HIV prevention services received at health care providers (HCP) and HIV test providers (HTP) that explain racial disparities in HIV prevalence. Young men, aged 23 to 29 years, were interviewed and tested for HIV at randomly sampled MSM-identified venues in six U.S. cities from 1998 through 2000. Analyses were restricted to five U.S. cities that enrolled 50 or more black or Hispanic MSM. Among the 2,424 MSM enrolled, 1,522 (63%) reported using a HCP, and 1,268 (52%) reported having had an HIV test in the year prior to our interview. No racial/ethnic differences were found in using a HCP or testing for HIV. Compared with white MSM, black and Hispanic MSM were more likely to believe that HIV prevention services are important [respectively, AOR, 95% confidence interval (CI): 3.0, 1.97 to 4.51 and AOR, 95% CI: 2.7, 1.89 to 3.79], and were more likely to receive prevention services at their HCP (AOR, 95% CI: 2.5, 1.72 to 3.71 and AOR, 95% CI: 1.7, 1.18 to 2.41) and as likely to receive counseling services at their HTP. Blacks were more likely to be satisfied with the prevention services received at their HCP (AOR, 95% CI: 1.7, 1.14 to 2.65). Compared to white MSM, black and Hispanic MSM had equal or greater use of, perceived importance of, receipt of, and satisfaction with HIV prevention services. Differential experience with HIV prevention services does not explain the higher HIV prevalence among black and Hispanic MSM. PMID:18622708

  8. HIV prevention services received at health care and HIV test providers by young men who have sex with men: an examination of racial disparities.

    PubMed

    Behel, Stephanie K; MacKellar, Duncan A; Valleroy, Linda A; Secura, Gina M; Bingham, Trista; Celentano, David D; Koblin, Beryl A; Lalota, Marlene; Shehan, Douglas; Torian, Lucia V

    2008-09-01

    We investigated whether there were racial/ethnic differences among young men who have sex with men (MSM) in their use of, perceived importance of, receipt of, and satisfaction with HIV prevention services received at health care providers (HCP) and HIV test providers (HTP) that explain racial disparities in HIV prevalence. Young men, aged 23 to 29 years, were interviewed and tested for HIV at randomly sampled MSM-identified venues in six U.S. cities from 1998 through 2000. Analyses were restricted to five U.S. cities that enrolled 50 or more black or Hispanic MSM. Among the 2,424 MSM enrolled, 1,522 (63%) reported using a HCP, and 1,268 (52%) reported having had an HIV test in the year prior to our interview. No racial/ethnic differences were found in using a HCP or testing for HIV. Compared with white MSM, black and Hispanic MSM were more likely to believe that HIV prevention services are important [respectively, AOR, 95% confidence interval (CI): 3.0, 1.97 to 4.51 and AOR, 95% CI: 2.7, 1.89 to 3.79], and were more likely to receive prevention services at their HCP (AOR, 95% CI: 2.5, 1.72 to 3.71 and AOR, 95% CI: 1.7, 1.18 to 2.41) and as likely to receive counseling services at their HTP. Blacks were more likely to be satisfied with the prevention services received at their HCP (AOR, 95% CI: 1.7, 1.14 to 2.65). Compared to white MSM, black and Hispanic MSM had equal or greater use of, perceived importance of, receipt of, and satisfaction with HIV prevention services. Differential experience with HIV prevention services does not explain the higher HIV prevalence among black and Hispanic MSM.

  9. Ribozyme-independent replication of a defective hepatitis D virus RNA derived from hepatitis B/D patients receiving antiviral therapy.

    PubMed

    Hsu, Chao-Wei; Yeh, Chau-Ting

    2014-07-18

    Novel hepatitis D virus (HDV) RNA mutants carrying large fragment deletions were identified in the serum samples of two hepatitis B/D patients receiving antiviral therapy. Sequence analysis revealed that the deleted regions encompassed both ribozyme domains. The mutant persisted in the serum samples for at least 2 and 10 months, respectively in the two patients, raising the question of whether such mutants could replicate in the absence of ribozyme domains. Thirty anti-HDV antibody-positive serum samples derived from 17 patients receiving antiviral therapy were submitted for RT-PCR detection of HDV RNA deletion mutants. Large fragment HDV RNA deletions were found in 4 patients. Of them, two had liver biopsy samples available. Northern blot analysis revealed high molecular weight HDV RNA replication intermediates, genomic and anti-genomic senses, in the liver tissues. Transfection of an in vitro transcribed HDV RNA deletion mutant (1.28 kb) into Huh7 and HepG2 cells also resulted in generation of high molecular weight HDV RNA species in the hepatoma cells (>6.5 kb) with secretion of a 6.5 kb HDV RNA species into the medium. In conclusion, we discovered novel large fragment deletion mutants of HDV RNA in hepatitis B/D patients receiving antiviral therapy. Such mutants did not contain ribozyme domains but could replicate in the liver cells to generate high molecular weight but not unit-length HDV RNA. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Using health-system-wide data to understand hepatitis B virus prophylaxis and reactivation outcomes in patients receiving rituximab

    PubMed Central

    Schmajuk, Gabriela; Tonner, Chris; Trupin, Laura; Li, Jing; Sarkar, Urmimala; Ludwig, Dana; Shiboski, Stephen; Sirota, Marina; Dudley, R. Adams; Murray, Sara; Yazdany, Jinoos

    2017-01-01

    Abstract Hepatitis B virus (HBV) reactivation in the setting of rituximab use is a potentially fatal but preventable safety event. The rate of HBV screening and proportion of patients at risk who receive antiviral prophylaxis in patients initiating rituximab is unknown. We analyzed electronic health record (EHR) data from 2 health systems, a university center and a safety net health system, including diagnosis grouper codes, problem lists, medications, laboratory results, procedures codes, clinical encounter notes, and scanned documents. We identified all patients who received rituximab between 6/1/2012 and 1/1/2016. We calculated the proportion of rituximab users with inadequate screening for HBV according to the Centers for Disease Control guidelines for detecting latent HBV infection before their first rituximab infusion during the study period. We also assessed the proportion of patients with positive hepatitis B screening tests who were prescribed antiviral prophylaxis. Finally, we characterized safety failures and adverse events. We included 926 patients from the university and 132 patients from the safety net health system. Sixty-one percent of patients from the university had adequate screening for HBV compared with 90% from the safety net. Among patients at risk for reactivation based on results of HBV testing, 66% and 92% received antiviral prophylaxis at the university and safety net, respectively. We found wide variations in hepatitis B screening practices among patients receiving rituximab, resulting in unnecessary risks to patients. Interventions should be developed to improve patient safety procedures in this high-risk patient population. PMID:28353614

  11. Liver Fibrosis during an Outbreak of Acute Hepatitis C Virus Infection in HIV-Infected Men: A Prospective Cohort Study

    PubMed Central

    Fierer, Daniel S.; Uriel, Alison J.; Carriero, Damaris C.; Klepper, Arielle; Dieterich, Douglas T.; Mullen, Michael P.; Thung, Swan N.; Fiel, M. Isabel; Branch, Andrea D.

    2015-01-01

    Outbreaks of acute hepatitis C virus (HCV) infection are occurring in HIV-infected men who have sex with men. We evaluated risk factors and liver histopathology in 11 consecutively enrolled men with newly acquired HCV infection that was diagnosed on the basis of antibody seroconversion, new elevations in alanine aminotransferase level, and wide fluctuations in HCV RNA level. Ten patients reported unprotected anal intercourse, and 7 reported “club-drug” use, including methamphetamine. Liver biopsy showed moderately advanced fibrosis (Scheuer stage 2) in 9 patients (82%). No cause of liver damage other than acute HCV infection was identified. The specific pathways leading to periportal fibrosis in HIV-infected men with newly acquired HCV infection require investigation. PMID:18627270

  12. Fulminant hepatitis and fatal toxic epidermal necrolysis (Lyell disease) coincident with clarithromycin administration in an alcoholic patient receiving disulfiram therapy.

    PubMed

    Masiá, Mar; Gutiérrez, Félix; Jimeno, Araceli; Navarro, Andrés; Borrás, Joaquín; Matarredona, Jaime; Martín-Hidalgo, Alberto

    2002-02-25

    Disulfiram is widely used in the treatment of chronic alcoholism. Adverse drug reactions with fatal outcome following disulfiram therapy are infrequent, and hepatic failure accounts for most of them. Since disulfiram is a cytochrome P450 (CYP450) enzyme system inhibitor, numerous interactions with several drugs metabolized in the liver have been reported. Like disulfiram, clarithromycin inhibits a CYP450 isoenzyme, but, despite its widespread use for the treatment of respiratory tract infections, no interactions with disulfiram have been described as yet. We report a case of fatal toxic epidermal necrolysis (Lyell disease) and fulminant hepatitis shortly after starting treatment with clarithromycin in a patient who was receiving disulfiram. This is the first case of such a severe dermatosis in a patient receiving either disulfiram or clarithromycin therapy. The temporal relationship between drug administration and clinical symptoms in this case suggests a probable interaction between the 2 drugs.

  13. Fatal fulminant hepatitis in a chimpanzee (Pan troglodytes) receiving cyproterone acetate.

    PubMed

    Roe, Wendi D; Geschke, Katja; Pease, Chris

    2009-12-01

    Cyproterone acetate is a steroidal anti-androgen that has been used in human medicine for contraceptive purposes as well as treatment of medical conditions responsive to suppression of testosterone production. While serious side effects are considered to be rare, sporadic cases of severe hepatitis have been reported, including several fatal cases. This report describes a case of fatal fulminant hepatitis in one of four male chimpanzees (Pan troglodytes) that were undergoing trial treatment with cyproterone acetate to decrease inter-male aggression.

  14. Evaluation of knowledge and practice of hairdressers in men's beauty salons in Isfahan about hepatitis B, hepatitis C, and AIDS in 2010 and 2011.

    PubMed

    Ataei, Behrooz; Shirani, Kiana

    2012-01-01

    Blood-borne viruses such as hepatitis B, hepatitis C, and human immunodeficiency virus (HIV) have infected millions of people worldwide. During haircut or shaving, barbers may accidentally expose to their clients' blood, transmit their own infection to them, or transmit the infection from one client to another. So the knowledge of barbers toward topics related to AIDS, hepatitis B, and C are of great importance. This cross-sectional descriptive study was performed in 2010-2011 in men's beauty salons in Isfahan town. A multistage sampling was performed. The knowledge assessment questionnaire and the checklist of practice regarding hepatitis B, C, and AIDS were completed by trained interviewers. In our study, 240 hairdressers participated. There was a statistically significant relationship between the education level and knowledge score of the hairdressers (P = 0.048). We found a statistically significant relationship between the knowledge level and the working history of hairdressers according to the Pearson's correlation coefficient (P = 0.02). The results show significant relationship between the education level and the practice scores (P = 0.005). Also the working history of hairdressers and their practice score had a significant relationship (P = 0.005). The results did not show significant relationship between the age of the hairdressers and the practice scores (P = 0.12). We obtained promising results about the knowledge and practice levels of the staff of men's beauty shop in Isfahan about AIDS, hepatitis B, and C. However, but because of the important role of barbers in virus transmission, we should provide the best program for control, evaluation, continuous teaching programs.

  15. Evaluation of knowledge and practice of hairdressers in men's beauty salons in Isfahan about hepatitis B, hepatitis C, and AIDS in 2010 and 2011

    PubMed Central

    Ataei, Behrooz; Shirani, Kiana

    2012-01-01

    Background: Blood-borne viruses such as hepatitis B, hepatitis C, and human immunodeficiency virus (HIV) have infected millions of people worldwide. During haircut or shaving, barbers may accidentally expose to their clients’ blood, transmit their own infection to them, or transmit the infection from one client to another. So the knowledge of barbers toward topics related to AIDS, hepatitis B, and C are of great importance. Materials and Methods: This cross-sectional descriptive study was performed in 2010–2011 in men's beauty salons in Isfahan town. A multistage sampling was performed. The knowledge assessment questionnaire and the checklist of practice regarding hepatitis B, C, and AIDS were completed by trained interviewers. Results: In our study, 240 hairdressers participated. There was a statistically significant relationship between the education level and knowledge score of the hairdressers (P = 0.048). We found a statistically significant relationship between the knowledge level and the working history of hairdressers according to the Pearson's correlation coefficient (P = 0.02). The results show significant relationship between the education level and the practice scores (P = 0.005). Also the working history of hairdressers and their practice score had a significant relationship (P = 0.005). The results did not show significant relationship between the age of the hairdressers and the practice scores (P = 0.12). Conclusions: We obtained promising results about the knowledge and practice levels of the staff of men's beauty shop in Isfahan about AIDS, hepatitis B, and C. However, but because of the important role of barbers in virus transmission, we should provide the best program for control, evaluation, continuous teaching programs. PMID:23326805

  16. Effect of zoledronic Acid on bone mineral density in men with prostate cancer receiving gonadotropin-releasing hormone analog.

    PubMed

    Kapoor, Anoop; Gupta, Ankur; Desai, Nilay; Ahn, Hongshik

    2011-01-01

    Background. Loss of bone density with androgen deprivation therapy for prostate cancer is well recognized. We assessed the effects of quarterly infusion of zoledronic acid on bone mineral density (BMD) and markers of bone turnover over a one-year period in men receiving gonadotropin-releasing hormone analog (GnRH-a) for prostate cancer. Methods. 41 subjects were randomly assigned to treatment with zoledronic acid (4 mg) IV infusion or placebo every 3 months. The primary endpoint was the change in the lumbar spine BMD after 12 months of treatment. Results. The change in vertebral BMD in the zoledronic acid group (+7.93 ± 1.4%) was significantly (P < .05) greater than the change in the placebo group (+0.82 ± 1.7%) as was the change in left femoral neck BMD (+5.05 ± 1.4% for the zoledronic acid group versus -0.48 ± 1.4% for the placebo group). The decrease in biochemical markers of bone turnover was significantly (P < .05) greater in the zoledronic acid group compared to the placebo group. Conclusion. Quarterly infusion of zoledronic acid for 1 year improved vertebral and left femoral neck BMD with a decrease in bone turnover markers in men on GnRH-a treatment. Zoledronic acid treatment appears to be promising in men with low BMD receiving GnRH-a treatment.

  17. Short Report: Lack of Evidence of Hepatitis C and HIV Co-Infection among Men Who Have Sex with Men in Peru

    PubMed Central

    Lama, Javier R.; Lucchetti, Aldo; Cabezas, Cesar; Suarez-Ognio, Luis; Sanchez, Jorge

    2012-01-01

    Hepatitis C virus (HCV) infection occurs among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) because of shared routes of transmission. To assess the association between HCV and HIV infection among MSM in Peru, we conducted a matched case-control study (162 HIV-positive cases and 324 HIV-negative controls) among participants of an HIV sentinel surveillance survey in six urban cities. The HCV infection was initially screened using anti-HCV ELISA and immunoblot assay, and thereafter confirmed by the HCV RNA qualitative assay. Among cases, no confirmed HCV infection was found while among controls, only two confirmed HCV infections were reported (0.62%). This matched case-control reports a very low probability of association between HCV and HIV co-infection and suggests a very low prevalence of HCV infection among MSM in Peru. PMID:19556587

  18. Diagnostic accuracy of serum biochemical fibrosis markers in children with chronic hepatitis B evaluated by receiver operating characteristics analysis

    PubMed Central

    Lebensztejn, Dariusz Marek; Skiba, Elżbieta; Tobolczyk, Jolanta; Sobaniec-Lotowska, Maria Elżbieta; Kaczmarski, Maciej

    2005-01-01

    AIM: To investigate the diagnostic accuracy of potent serum biochemical fibrosis markers in children with chronic hepatitis B evaluated by receiver operating characteristics (ROC) analysis. METHODS: We determined the serum level of apolipoprotein A-I (APO A-I), haptoglobin (HPT) and a-2 macroglobulin (A2M) with an automatic nephelometer in 63 children (age range 4-17 years, mean 10 years) with biopsy-verified chronic HBeAg-positive hepatitis B. Fibrosis stage and inflammation grade were assessed in a blinded fashion according to Batts and Ludwig. We defined mild liver fibrosis as a score ≤2 and advanced fibrosis as a score equal to 3. ROC analysis was used to calculate the power of the assays to detect advanced liver fibrosis (AccuROC, Canada). RESULTS: Serum concentrations of APO A-I, HPT and A2M were not significantly different in patients with chronic hepatitis B compared to controls. However, APO A-I level of 1.19 ng/L had a sensitivity of 85.7% and a specificity of 60.7% (AUC = 0.7117, P = 0.035) to predict advanced fibrosis. All other serum biochemical markers and their combination did not allow a useful prediction. None of these markers was a good predictor of histologic inflammation. CONCLUSION: Apolipoprotein A-I may be a suitable serum marker to predict advanced liver fibrosis in children with chronic hepatitis B. PMID:16437671

  19. Diagnostic accuracy of serum biochemical fibrosis markers in children with chronic hepatitis B evaluated by receiver operating characteristics analysis.

    PubMed

    Lebensztejn, Dariusz Marek; Skiba, Elzbieta; Tobolczyk, Jolanta; Sobaniec-Lotowska, Maria Elzbieta; Kaczmarski, Maciej

    2005-12-07

    To investigate the diagnostic accuracy of potent serum biochemical fibrosis markers in children with chronic hepatitis B evaluated by receiver operating characteristics (ROC) analysis. We determined the serum level of apolipoprotein A-I (APO A-I), haptoglobin (HPT) and a-2 macroglobulin (A2M) with an automatic nephelometer in 63 children (age range 4-17 years, mean 10 years) with biopsy-verified chronic HBeAg-positive hepatitis B. Fibrosis stage and inflammation grade were assessed in a blinded fashion according to Batts and Ludwig. We defined mild liver fibrosis as a score < or =2 and advanced fibrosis as a score equal to 3. ROC analysis was used to calculate the power of the assays to detect advanced liver fibrosis (AccuROC, Canada). Serum concentrations of APO A-I, HPT and A2M were not significantly different in patients with chronic hepatitis B compared to controls. However, APO A-I level of 1.19 ng/L had a sensitivity of 85.7% and a specificity of 60.7% (AUC = 0.7117, P = 0.035) to predict advanced fibrosis. All other serum biochemical markers and their combination did not allow a useful prediction. None of these markers was a good predictor of histologic inflammation. Apolipoprotein A-I may be a suitable serum marker to predict advanced liver fibrosis in children with chronic hepatitis B.

  20. Hepatitis A vaccine should receive priority in National Immunization Schedule in India.

    PubMed

    Verma, Ramesh; Khanna, Pardeep

    2012-08-01

    Hepatitis A is an acute, usually self-limiting infection of the liver caused by a virus known as hepatitis A virus (HAV). Humans are the only reservoir of the virus; transmission occurs primarily through the fecal-oral route and is closely associated with poor sanitary conditions. The virus has a worldwide distribution and causes about 1.5 million cases of clinical hepatitis each year. The risk of developing symptomatic illness following HAV infection is directly correlated with age. As many 85% of children below 2 y and 50% of those between 2-5 y infected with HAV are anicteric, and among older children and adults, infection usually causes clinical disease, with jaundice occurring in more than 70% of cases. The infection is usually self-limiting with occasional fulminant hepatic failure and mortality. In most developing countries in Asia and Africa, hepatitis A is highly endemic such that a large proportion of the population acquires immunity through asymptomatic infection early in life. HAV is endemic in India; most of the population is infected asymptomatically in early childhood with life-long immunity. Several outbreaks of hepatitis A in various parts of India have been recorded in the past decade such that anti-HAV positivity varied from 26 to 85%. Almost 50% of children of ages 1-5 y were found to be susceptible to HAV. Any one of the licensed vaccines may be used since all have nearly similar efficacy and safety profiles (except for post-exposure prophylaxis / immunocompromised patients, where only inactivated vaccines may be used). Two doses 6 mo apart are recommended for all vaccines. All Hepatitis A vaccines are licensed for use in children aged 1 y or older. However in the Indian scenario, it is preferable to administer the vaccines at age 18 mo or more when maternal antibodies have completely declined. Vaccination at this age is preferable to later since it is easier to integrate with the existing schedule, protects those who have no antibodies, and

  1. Drug-Induced Subacute Cutaneous Lupus Erythematosus in a Patient Receiving Therapy for Chronic Hepatitis C.

    PubMed

    Reyes, Hans A; Cativo, Eder H; Sy, Alexander M

    Hepatitis C infection and its treatment have been associated with extrahepatic manifestations, including different skin conditions. Over the past decades, a greater number of drugs have been implicated as triggers for drug-induced subacute cutaneous lupus erythematosus. We report a case of a 42-year-old Hispanic man who developed a forehead violaceous rash during treatment with pegylated interferon alpha-2a as part of his therapy against hepatitis C infection that subsequently resulted to be subacute cutaneous lupus erythematosus. The skin lesion improved with discontinuation of medication and some topic therapy.

  2. Patterns and predictors of HIV/STI risk among Latino migrant men in a new receiving community.

    PubMed

    Kissinger, Patricia; Kovacs, Stephanie; Anderson-Smits, Colin; Schmidt, Norine; Salinas, Oscar; Hembling, John; Beaulieu, Allyson; Longfellow, Lisa; Liddon, Nicole; Rice, Janet; Shedlin, Michele

    2012-01-01

    The purpose of this study was to examine patterns and predictors of HIV/STI risk over time among Latino migrant men in a new receiving community. Latino men (N = 125) were interviewed quarterly for 18 months and HIV/STI tested annually. Selected individual, environmental and cultural factors by partner type and condom use were explored longitudinally and in a cross-section. Sex with female sex workers (FSWs) and multiple partners decreased, sex with main partners and abstinence increased, while the number of casual partners remained stable. Consistent condom use was highest with FSWs, lowest with main partners and midrange with casual partners with no trends over time. STI morbidity was low; no HIV was detected. Drug use and high mobility were associated with inconsistent condom use with FSW, whereas having family in the household was protective. HIV/STI prevention efforts should focus on drug using Latino migrants who are highly mobile and should foster healthy social connections.

  3. Hepatitis

    MedlinePlus

    ... clotting problems or chronic liver disease. previous continue Hepatitis B and Hepatitis C Although hep A is a ... does — through direct contact with infected body fluids. Hepatitis B and C are even more easily passed in ...

  4. Hepatitis

    MedlinePlus

    ... A if they've been vaccinated against it. Hepatitis B Hepatitis B is a more serious infection. It may lead ... of which cause severe illness and even death. Hepatitis B virus (HBV) is transmitted from person to person ...

  5. Hepatitis

    MedlinePlus

    ... a problem with the liver itself What Is Hepatitis A? Hepatitis A virus (HAV) is contagious, usually spreading to others ... objects contaminated by feces (poop) containing HAV. The hepatitis A vaccine has helped to make the infection rare ...

  6. Immunogenicity and immunologic memory after hepatitis B virus booster vaccination in HIV-infected children receiving highly active antiretroviral therapy.

    PubMed

    Abzug, Mark J; Warshaw, Meredith; Rosenblatt, Howard M; Levin, Myron J; Nachman, Sharon A; Pelton, Stephen I; Borkowsky, William; Fenton, Terence

    2009-09-15

    Hepatitis B virus (HBV) is an important cause of comorbidity in human immunodeficiency virus (HIV)-infected individuals. The immunogenicity of HBV vaccination in children receiving highly active antiretroviral therapy (HAART) was investigated. HIV-infected children receiving HAART who had low to moderate HIV loads and who had previously received 3 doses of HBV vaccine were given an HBV vaccine booster. Concentrations of antibody to hepatitis B surface antigen (anti-HBs) were determined before vaccination and at weeks 8, 48, and 96. A subset of subjects was administered a subsequent dose, and anti-HBs was measured before and 1 and 4 weeks later. At entry, 24% of 204 subjects were seropositive. Vaccine response occurred in 46% on the basis of seropositivity 8 weeks after vaccination and in 37% on the basis of a 4-fold rise in antibody concentration. Of 69 subjects given another vaccination 4-5 years later, immunologic memory was exhibited by 45% on the basis of seropositivity 1 week after vaccination and by 29% on the basis of a 4-fold rise in antibody concentration at 1 week. Predictors of response and memory included higher nadir and current CD4 cell percentage, higher CD19 cell percentage, and undetectable HIV load. HIV-infected children frequently lack protective levels of anti-HBs after previous HBV vaccination, and a significant proportion of them do not respond to booster vaccination or demonstrate memory despite receiving HAART, leaving this population insufficiently protected from infection with HBV.

  7. Evidence for dual control mechanism regulating hepatic glucose output in nondiabetic men

    SciTech Connect

    Clore, J.N.; Glickman, P.S.; Helm, S.T.; Nestler, J.E.; Blackard, W.G. )

    1991-08-01

    The authors previously reported a fall in hepatic glucose output (HGO) during sleep accompanied by reductions in glucose utilization (Rd) and free fatty acids (FFAs). This study was undertaken to determine the potential role of changes in Rd and FFA on HGO in nondiabetic men. To determine if the fall in HGO during sleep could be reversed by FFA elevation, seven nondiabetic men underwent (3-3H)glucose infusions from 2200 to 0800, with heparin (90 mU.kg-1.min-1) added at 0200. Glucose appearance (Ra) fell from 11.7 {plus minus} 1.1 at 2430 to 8.9 {plus minus} 0.8 mumol.kg-1.min-1 (P less than 0.05) at 0200. The fall in Ra was associated with decreases in FFA (0.57 {plus minus} 0.10 to 0.48 {plus minus} 0.07 mM) and glycerol (0.08 {plus minus} 0.01 to 0.06 {plus minus} 0.01 mM). Infusion of heparin significantly increased FFA and glycerol (1.09 {plus minus} 0.21 and 0.11 {plus minus} 0.01 mM, respectively, P less than 0.01) and resulted in a significant fall in plasma alanine, suggesting that gluconeogenesis had been increased. However, rates of glucose turnover were indistinguishable from overnight studies without heparin. In additional studies (n = 6), intralipid and heparin-induced FFA elevation (from 0.61 {plus minus} 0.07 to 0.95 {plus minus} 0.05 mM, P less than 0.01) stimulated gluconeogenesis ((U-14C)alanine to glucose) twofold (188 {plus minus} 22% increase compared to 114 {plus minus} 6% in saline control studies, P less than 0.01). However, despite increasing gluconeogenesis, overall HGO did not change (10.6 {plus minus} 0.5 vs. 10.7 {plus minus} 0.6 mumol.kg-1.min-1) during lipid infusion.

  8. Behavioural predictors of subsequent hepatitis C diagnosis in a UK clinic sample of HIV positive men who have sex with men.

    PubMed

    Turner, J M; Rider, A T; Imrie, J; Copas, A J; Edwards, S G; Dodds, J P; Stephenson, J M

    2006-08-01

    To explore the associations between self reported high risk sexual behaviours and subsequent diagnosis with hepatitis C virus (HCV) infection. The Sex, Health and Anti-Retrovirals Project (SHARP) was a cross sectional study of sexual behaviour in HIV positive, men who have sex with men (MSM) attending a London outpatient clinic. From July 1999 to August 2000 participants completed a computer assisted self interview questionnaire (CASI) on recent sexual behaviour, recreational drug use, and detailed reporting of the last two sexual episodes involving different partners. Results were combined with routine clinic data and subsequent testing for HCV up to 21 April 2005. A new HCV diagnosis was defined as anti-HCV antibody seroconversion or positive HCV RNA following a previous negative. Incident rate ratios (IRR) were calculated using Poisson regression in Stata (version 9). Men contributed time at risk from interview until either their diagnosis or their last negative test result. Of the 422 men who completed questionnaires, 308 (73%) had sufficient clinical and HCV testing data available for analysis. Incident HCV infection was identified in 11 men. Unprotected anal intercourse, more than 30 sex partners in the past year, higher numbers of new anal sex partners, rimming (oro-anal sex), fisting, use of sex toys, and intranasal recreational drug use were associated with HCV. In multivariate analysis only fisting remained associated with HCV (adjusted IRR 6.27, p = 0.005). In this study of HIV positive MSM, fisting is strongly associated with HCV infection. Where individuals report high risk sexual behaviours, clinicians should offer appropriate testing for HCV infection.

  9. Contraceptive use among HIV-infected women and men receiving antiretroviral therapy in Lusaka, Zambia: a cross-sectional survey.

    PubMed

    Hancock, Nancy L; Chibwesha, Carla J; Bosomprah, Samuel; Newman, Jonathan; Mubiana-Mbewe, Mwangelwa; Sitali, Elizabeth Siyama; Bolton-Moore, Carolyn; Mbwili-Muleya, Clara; Chi, Benjamin H

    2016-05-12

    Family planning (FP) is an essential health service and an important part of comprehensive HIV care. However, there is limited information about the contraceptive needs of people living with HIV in sub-Saharan Africa, which in turn has hampered efforts to expand and integrate FP services into existing HIV programs. We performed a cross-sectional survey to determine FP prevalence and predictors among HIV-positive women and men attending 18 public antiretroviral therapy (ART) clinics in Lusaka, Zambia. Trained peer counselors administered the 10-question survey to those seeking care for five days at each of the target sites. From February to April 2014, we surveyed 7,046 HIV-infected patients receiving routine HIV services. Use of modern contraception was reported by 69 % of female ART patients and 79 % of male ART patients. However, highly effective contraceptive use and dual method use were low among women (38 and 25 %, respectively) and men (19 and 14 %, respectively). HIV disclosure status (adjusted odds ratio (AOR) = 4.91, 95 % confidence interval (CI) = 3.32-7.24 for women, AOR = 3.58, 95 % CI = 2.39-5.38 for men) and sexual activity in the last 6 months (AOR = 5.80, 95 % CI = 4.51-7.47 for women, AOR = 6.24, 95 % CI = 3.51-11.08 for men) were associated with modern contraceptive use in multivariable regression. Most respondents said they would access FP services if made available within ART clinic. While FP-ART integration may be a promising strategy for increasing FP service uptake, such services must focus on assessing sexual activity and advocating for dual method use to increase effective contraceptive use and prevent unintended pregnancies.

  10. Evaluation of sexual function in hypertensive men receiving treatment: a review of current guidelines recommendation.

    PubMed

    Karavitakis, Markos; Komninos, Christos; Theodorakis, Pavlos N; Politis, Vasilios; Lefakis, Georgios; Mitsios, Kostas; Koritsiadis, Sotirios; Doumanis, Grigorios

    2011-09-01

    It has been suggested that some classes of antihypertensive drugs may induce or exacerbate sexual and/or erectile dysfunction (ED) more than others. Sexually related side effects of antihypertensive treatment may compromise patient's and partner's quality of life. Often, these side effects can lead to withdrawal or poor compliance with therapy resulting in abnormal blood pressure and associated morbidity. The aim of this study was to evaluate whether hypertension clinical practice guidelines (CPGs) address ED and/or other sexual issues as either an adverse outcome of chosen therapy or as a factor to consider in treatment decision. Hypertension CPGs were identified by searching PubMed (from 2000 to current), the World Wide Web, bibliographies of retrieved guidelines, and official home pages of major medical societies. The main outcome measures used for this study were guidelines assessment using a set of author-determined survey questions. Twelve CPGs were identified and analyzed. From these 12, only three emphasized the importance of assessing sexual function prior to initiation and/or follow-up of antihypertensive therapy; only five described potential sexual side effects associated with some drugs; only two provided specific management recommendations on commencing antihypertensive therapy in sexually active men or those with preexisting ED and address the timeline of the potential drug-induced impairment of sexual function. Only a minority of CPGs for the treatment of hypertension consider ED or other sexual issues as either an adverse outcome or as a factor to consider in treatment. Sexual function is an important aspect of quality of life for both the individual and his partner. It is therefore imperative to select therapy with the least possible potential for causing sexual sequelae and enable the best achievable balance between therapeutic efficacy, quality of life, and therapeutic compliance. Based on these results, our proposed algorithm attempts to

  11. HIV, hepatitis B/C and syphilis prevalence and risk behaviors among gay, transsexuals and men who have sex with men, Dominican Republic.

    PubMed

    Johnston, L G; Vaillant, T C; Dolores, Y; Vales, H M

    2013-04-01

    This study investigated HIV, hepatitis B (HBV) and C (HCV) and syphilis prevalence and associated behavioural correlates to HIV infection among gay, transsexuals and men who have sex with men (GTMSM) in the Dominican Republic using respondent-driven sampling. Eligible men were aged ≥15 years, reported engaging in anal/oral sex with another man within the past six months and living in one of the four cities sampled. GTMSM were recruited in Santo Domingo (n = 510), Barahona (n = 281), La Altagracia (n = 270) and Santiago (n = 327). HIV seroprevalence ranged from 5.1% to 7.6%. HBV ranged from 0.6% to 3.5%, HCV from 0.8% to 6.9% and syphilis from 3.5% to 6.9%. GTM practice numerous risky sexual behaviours including having multiple sex partners and practising inconsistent condom use with male and female, including transactional, sex partners. Although we found lower HIV prevalence compared with previous studies, the high level of extremely risky sexual behaviours practised by GTM in the Dominican Republic will most likely result in increases in HIV and other infections if action is not taken to scale-up effective prevention programmes for this population.

  12. Prevalence of hepatitis C in a Swiss sample of men who have sex with men: whom to screen for HCV infection?

    PubMed Central

    2014-01-01

    Background While the numbers of hepatitis-C-virus (HCV) infections among men who have sex with men (MSM) who are co-infected with the human immunodeficiency virus (HIV) are on the rise, with vast evidence for sexual transmission of HCV in this population, concerns have also been raised regarding sexual HCV-transmission among MSM without HIV infection. Therefore, the aim of this study was to estimate the prevalence of hepatitis C among MSM without HIV diagnosis in Zurich (Switzerland). Methods Participants were recruited from a gay health centre and various locations such as dark rooms, saunas and cruising areas in Zurich. Participants self-completed a questionnaire assessing known and suspected risk factors for HCV-infection, and provided a blood sample for detection of past (antibodies) and present (core antigen, RNA) infections with HCV. Results In total, 840 MSM aged 17-79 (median: 33 years) underwent HCV-testing and completed the questionnaire, among whom 19 reported living with HIV. Overall, seven tested positive for HCV-antibodies, and two were also positive for HCV core antigen and HCV-RNA–these two were immigrants, one from a country where HCV is endemic. None of the seven were aware of their infection. The seroprevalence of hepatitis C among the 821 non-HIV-diagnosed MSM was 0.37% (95%-CI: 0.12-1.69%), and one man harboured replicating virus (0.12%; 0.02-0.69%), resulting in a number needed to test of 821 to detect one active infection. Significant univariable associations of lifetime HCV-infection were found with known HIV-diagnosis (OR=72.7), being tattooed (OR=10.4), non-injection use of cocaine/amphetamines (OR=8.8), and non-Swiss origin (OR=8.5). For MSM without HIV-diagnosis, the only variable marginally associated with positive HCV-serostatus was being tattooed (OR=8.3). No significant associations were observed with reported injection drug use, unprotected anal intercourse, sexual practices that may lead to mucosal trauma, or proxy measures for

  13. Chronic hepatitis C in Swedish subjects receiving opiate substitution therapy--factors associated with advanced fibrosis.

    PubMed

    Jerkeman, Anna; Westin, Johan; Lagging, Martin; Norkrans, Gunnar; Lidman, Christer; Frimand, Jan; Simonsberg, Christian; Kakko, Johan; Widell, Anders; Björkman, Per

    2014-05-01

    Opiate substitution therapy (OST) reduces the risk of death from directly drug-related causes in heroin users, allowing other chronic health problems to emerge. People who inject drugs (PWID) are exposed to hepatitis C virus (HCV), with an associated risk of chronic liver disease. We investigated HCV prevalence and liver-related morbidity in a cohort of OST recipients, and analyzed factors associated with significant hepatic fibrosis. All patients registered on 1 April 2008 in 4 clinics providing OST in the 3 largest cities in Sweden were eligible for inclusion. HCV viremic subjects were evaluated for fibrosis stage by liver biopsy, transient elastometry (TE), and/or a biochemical fibrosis index (Göteborg University Cirrhosis Index; GUCI). Factors associated with severity of fibrosis were determined by logistic regression analysis. Out of 524 eligible patients, 277 consented to enrolment. Two hundred and thirty-six subjects (88%) were anti-HCV-positive, and 162 of these were viremic (69%). Significant liver fibrosis (defined as Ishak stages F3-F6, TE value ≥ 8.85 kPa, or GUCI > 0.33) was found in 69 out of 103 (67%) tested viremic patients, and was associated with alcohol intake (p = 0.03), higher body mass index (BMI; p = 0.04), and the presence of anti-HBc antibodies (indicating exposure to hepatitis B virus (HBV); p = 0.02). Significant liver fibrosis was detected in two-thirds of HCV viremic OST recipients in this cohort, and was associated with alcohol use, high BMI, and exposure to HBV. These findings indicate that the management of HCV and associated risk factors should be emphasized in Swedish OST programs.

  14. Dynamics of hepatitis B virus quasispecies heterogeneity and virologic response in patients receiving low-to-moderate genetic barrier nucleoside analogs.

    PubMed

    Peveling-Oberhag, J; Herrmann, E; Kronenberger, B; Farnik, H; Susser, S; Sarrazin, C; Zeuzem, S; Hofmann, W-P

    2013-04-01

    We characterized the early dynamics of hepatitis B virus (HBV) quasispecies evolution during the first weeks of antiviral therapy with low-to-moderate genetic barrier antiviral drugs and associated these data with antiviral response patterns. Fifteen chronic hepatitis B patients (men, 10; mean age, 34; HBeAg positive, 6) who received lamivudine or telbivudine for at least 52 weeks were included. HBV DNA was extracted from serum, and a 910-bp fragment covering domains A-F of the reverse transcriptase region was amplified, cloned and sequenced. Parameters of quasispecies heterogeneity, genetic diversity and complexity were calculated and were correlated with complete virologic response, defined as undetectable HBV DNA at week 52. Nine patients achieved complete virologic response during the observational period. While baseline HBV DNA levels and HBeAg status were associated with virologic response, baseline quasispecies complexity and diversity of responders showed no significant difference to those of nonresponders (P > 0.05). However, at week 4, quasispecies complexity of nonresponders was significantly higher compared with that of responders on the nucleotide level (P = 0.01) and the aa level (P = 0.04). The number of synonymous substitutions per synonymous site dropped significantly in responders at week 4 (P = 0.04), while there was no difference in nonresponders. The HBV quasispecies complexity at the early stage of antiviral therapy (week 4) with the low-to-moderate genetic barrier nucleoside analogs lamivudine or telbivudine was associated with subsequent virologic response. Further studies are needed to confirm HBV quasispecies evolution as additional predictive marker for beneficial treatment outcome.

  15. Reducing rectal injury in men receiving prostate cancer radiation therapy: current perspectives

    PubMed Central

    Serrano, Nicholas A; Kalman, Noah S; Anscher, Mitchell S

    2017-01-01

    Dose escalation is now the standard of care for the treatment of prostate cancer with radiation therapy. However, the rectum tends to be the dose-limiting structure when treating prostate cancer, given its close proximity. Early and late toxicities can occur when the rectum receives large doses of radiation therapy. New technologies allow for prevention of these toxicities. In this review, we examine the evidence that supports various dose constraints employed to prevent these rectal injuries from occurring. We also examine the use of intensity-modulated radiation therapy and how this compares to older radiation therapy techniques that allow for further sparing of the rectum during a radiation therapy course. We then review the literature on endorectal balloons and the effects of their daily use throughout a radiation therapy course. Tissue spacers are now being investigated in greater detail; these devices are injected into the rectoprostatic fascia to physically increase the distance between the prostate and the anterior rectal wall. Last, we review the use of systemic drugs, specifically statin medications and antihypertensives, as well as their impact on rectal toxicity. PMID:28814898

  16. Suppression of hepatic fatty acid oxidation and food intake in men.

    PubMed

    Kahler, A; Zimmermann, M; Langhans, W

    1999-01-01

    We investigated the effects of the fatty acid oxidation inhibitor etomoxir (ETO) on food intake and on fat and carbohydrate metabolism in two double-blind crossover studies in male, normal-weight subjects. In study 1, ETO (75 mg [+]-racemate) or placebo was given orally 30 min after completion of a standardized, fat-enriched (total energy: 2698 kJ, 40% from fat) lunch. The subjects (n = 15) were isolated from external time cues and free to choose when to eat dinner from an oversized serving (total energy: 6656 kJ, 60% from fat). In study 2, subjects (n = 13) were selected for habitually high fat intake (mean: 44% of energy intake). ETO (150 mg) or placebo was given after an overnight fast, 2.5 h before offering an oversized high fat breakfast (6960 kJ, 72% from fat). In both studies, blood samples were taken and the respiratory quotient (RQ) was measured several times during each test period. In study 1, ETO (75 mg) did not affect the timing and size of the dinner or subjective feelings of hunger and satiety. Although ETO (75 mg) did not affect the RQ, it decreased plasma beta-hydroxybutyrate (BHB) and increased plasma lactate compared with placebo. Plasma triacylglycerols (TG), free fatty acids (FFA), glucose, and insulin were not affected by ETO. In study 2, ETO (150 mg) enhanced hunger feelings and increased the size of the breakfast by 22.7%. ETO did not affect the RQ, but baseline RQ was lower in study 2 than in study 1 (0.83 versus 0.89, P < 0.01). Compared with placebo, ETO (150 mg) decreased plasma BHB and increased plasma FFA and plasma lactate. Baseline plasma concentrations of BHB, FFA, and lactate were higher in study 2 than in study 1 (BHB: 242 versus 81 mumol/L, P < 0.001; FFA: 0.674 versus 0.406 mmol/L, P < 0.01; lactate: 1.08 versus 0.74 mmol/L, P < 0.05). Plasma concentrations of TG, glucose, and insulin were not affected by ETO. The results suggest that inhibition of hepatic fatty acid oxidation stimulates eating in men when baseline fatty acid

  17. Immunogenicity and Immunologic Memory after Hepatitis B Virus Booster Vaccination in HIV-Infected Children Receiving Highly Active Antiretroviral Therapy

    PubMed Central

    Abzug, Mark J.; Warshaw, Meredith; Rosenblatt, Howard M.; Levin, Myron J.; Nachman, Sharon A.; Pelton, Stephen I.; Borkowsky, William; Fenton, Terence

    2010-01-01

    Background Hepatitis B virus (HBV) is an important cause of comorbidity in human immunodeficiency virus (HIV)–infected individuals. The immunogenicity of HBV vaccination in children receiving highly active antiretroviral therapy (HAART) was investigated. Methods HIV-infected children receiving HAART who had low to moderate HIV loads and who had previously received ≥3 doses of HBV vaccine were given an HBV vaccine booster. Concentrations of antibody to hepatitis B surface antigen (anti-HBs) were determined before vaccination and at weeks 8, 48, and 96. A subset of subjects was administered a subsequent dose, and anti-HBs was measured before and 1 and 4 weeks later. Results At entry, 24% of 204 subjects were seropositive. Vaccine response occurred in 46% on the basis of seropositivity 8 weeks after vaccination and in 37% on the basis of a ≥4-fold rise in antibody concentration. Of 69 subjects given another vaccination 4–5 years later, immunologic memory was exhibited by 45% on the basis of seropositivity 1 week after vaccination and by 29% on the basis of a ≥4-fold rise in antibody concentration at 1 week. Predictors of response and memory included higher nadir and current CD4 cell percentage, higher CD19 cell percentage, and undetectable HIV load. Conclusions HIV-infected children frequently lack protective levels of anti-HBs after previous HBV vaccination, and a significant proportion of them do not respond to booster vaccination or demonstrate memory despite receiving HAART, leaving this population insufficiently protected from infection with HBV. PMID:19663708

  18. Mixed muscle and hepatic derived plasma protein metabolism is differentially regulated in older and younger men following resistance exercise.

    PubMed

    Sheffield-Moore, M; Paddon-Jones, D; Sanford, A P; Rosenblatt, J I; Matlock, A G; Cree, M G; Wolfe, R R

    2005-05-01

    We sought to determine whether exercise-induced muscle protein turnover alters the subsequent production of hepatically derived acute-phase plasma proteins, and whether age affects how these proteins are regulated. We measured arteriovenous (a-v) balance and the synthesis of mixed muscle protein, albumin (A) and fibrinogen (F) before exercise (REST) and from the beginning of exercise to 10, 60, and 180 min following a single bout of moderate-intensity leg extension exercise (POST-EX) in postabsorptive untrained older (n = 6) and younger (n = 6) men using L-[ring-2H5]phenylalanine (Phe). Subjects performed 6 sets of 8 repetitions of leg extension at 80% of their 1-RM (one-repetition maximum). All data are presented as the difference from REST (Delta from REST at 10, 60, and 180 min POST-EX). Mixed muscle fractional synthesis rate (FSR-M) increased significantly from the beginning of exercise until 10 min POST-EX in the older men (DeltaFSR-M: 0.044%/h), whereas FSR-M in the younger men was not elevated until 180 min POST-EX (DeltaFSR-M: 0.030%/h). FSR-A and FSR-F increased at all POST-EX periods in the older men (DeltaFSR-A = 10 min: 1.90%/day; 60 min: 2.72%/day; 180 min: 2.78%/day; DeltaFSR-F = 10 min: 1.00%/day; 60 min: 3.01%/day; 180 min: 3.73%/day). No change occurred in FSR-A in the younger men, but FSR-F was elevated from the beginning of exercise until 10 and 180 min POST-EX (10 min: 3.07%/day and 180 min: 3.96%/day). Net balance of Phe was positive in the older men in the immediate POST-EX period. Our data indicate that mixed muscle and hepatic derived protein synthesis is differentially regulated in younger and older men in response to a single bout of moderate-intensity leg extension exercise. Moreover, our data suggest that with age may come a greater need to salvage or make available amino acids from exercise-induced muscle protein breakdown to mount an acute-phase response.

  19. Hepatitis C virus transmission among human immunodeficiency virus-infected men who have sex with men: Modeling the effect of behavioral and treatment interventions.

    PubMed

    Salazar-Vizcaya, Luisa; Kouyos, Roger D; Zahnd, Cindy; Wandeler, Gilles; Battegay, Manuel; Darling, Katharine Elizabeth Anna; Bernasconi, Enos; Calmy, Alexandra; Vernazza, Pietro; Furrer, Hansjakob; Egger, Matthias; Keiser, Olivia; Rauch, Andri

    2016-12-01

    The incidence of hepatitis C virus (HCV) infections among human immunodeficiency virus (HIV)-infected men who have sex with men has increased in recent years and is associated with high-risk sexual behavior. Behavioral interventions that target high-risk behavior associated with HCV transmission and treatment with direct-acting antivirals may prevent further HCV infections. We predicted the effect of behavioral and treatment interventions on HCV incidence and prevalence among HIV-infected men who have sex with men up to 2030 using a HCV transmission model parameterized with data from the Swiss HIV Cohort Study. We assessed behavioral interventions associated with further increase, stabilization, and decrease in the size of the population with high-risk behavior. Treatment interventions included increase in treatment uptake and use of direct-acting antivirals. If we assumed that without behavioral interventions high-risk behavior spread further according to the trends observed over the last decade and that the treatment practice did not change, HCV incidence converged to 10.7/100 person-years. All assessed behavioral interventions alone resulted in reduced HCV transmissions. Stabilization of high-risk behavior combined with increased treatment uptake and the use of direct-acting antivirals reduced incidence by 77% (from 2.2 in 2015 to 0.5/100 person-years) and prevalence by 81% (from 4.8% in 2015 to 0.9%) over the next 15 years. Increasing treatment uptake was more effective than increasing treatment efficacy to reduce HCV incidence and prevalence. A decrease in high-risk behavior led to a rapid decline in HCV incidence, independent of treatment interventions. Treatment interventions to curb the HCV epidemic among HIV-infected men who have sex with men are effective if high-risk behavior does not increase as it has during the last decade; reducing high-risk behavior associated with HCV transmission would be the most effective intervention for controlling the HCV

  20. Hepatitis C virus transmission among human immunodeficiency virus‐infected men who have sex with men: Modeling the effect of behavioral and treatment interventions

    PubMed Central

    Salazar‐Vizcaya, Luisa; Kouyos, Roger D.; Zahnd, Cindy; Wandeler, Gilles; Battegay, Manuel; Darling, Katharine Elizabeth Anna; Bernasconi, Enos; Calmy, Alexandra; Vernazza, Pietro; Furrer, Hansjakob; Egger, Matthias; Rauch, Andri

    2016-01-01

    The incidence of hepatitis C virus (HCV) infections among human immunodeficiency virus (HIV)‐infected men who have sex with men has increased in recent years and is associated with high‐risk sexual behavior. Behavioral interventions that target high‐risk behavior associated with HCV transmission and treatment with direct‐acting antivirals may prevent further HCV infections. We predicted the effect of behavioral and treatment interventions on HCV incidence and prevalence among HIV‐infected men who have sex with men up to 2030 using a HCV transmission model parameterized with data from the Swiss HIV Cohort Study. We assessed behavioral interventions associated with further increase, stabilization, and decrease in the size of the population with high‐risk behavior. Treatment interventions included increase in treatment uptake and use of direct‐acting antivirals. If we assumed that without behavioral interventions high‐risk behavior spread further according to the trends observed over the last decade and that the treatment practice did not change, HCV incidence converged to 10.7/100 person‐years. All assessed behavioral interventions alone resulted in reduced HCV transmissions. Stabilization of high‐risk behavior combined with increased treatment uptake and the use of direct‐acting antivirals reduced incidence by 77% (from 2.2 in 2015 to 0.5/100 person‐years) and prevalence by 81% (from 4.8% in 2015 to 0.9%) over the next 15 years. Increasing treatment uptake was more effective than increasing treatment efficacy to reduce HCV incidence and prevalence. A decrease in high‐risk behavior led to a rapid decline in HCV incidence, independent of treatment interventions. Conclusion: Treatment interventions to curb the HCV epidemic among HIV‐infected men who have sex with men are effective if high‐risk behavior does not increase as it has during the last decade; reducing high‐risk behavior associated with HCV transmission would be the most

  1. Hepatitis B

    MedlinePlus

    ... receive the hepatitis B vaccine. Since then, the rate of new hepatitis B infections has gone down ... 1 Asian Americans and African Americans have higher rates of chronic hepatitis B. 2 Many people in ...

  2. A phase III clinical trial of exercise modalities on treatment side-effects in men receiving therapy for prostate cancer.

    PubMed

    Newton, Robert U; Taaffe, Dennis R; Spry, Nigel; Gardiner, Robert A; Levin, Gregory; Wall, Bradley; Joseph, David; Chambers, Suzanne K; Galvão, Daniel A

    2009-06-29

    Androgen deprivation therapy (ADT) is accompanied by a number of adverse side effects including reduced bone mass and increased risk for fracture, reduced lean mass and muscle strength, mood disturbance and increased fat mass compromising physical functioning, independence, and quality of life. The purpose of this investigation is to examine the effects of long term exercise on reversing musculoskeletal-related side effects, and cardiovascular and diabetes risk factors in men receiving androgen deprivation for their prostate cancer. Specifically, we aim to investigate the effects of a 12-month exercise program designed to load the musculoskeletal system and reduce cardiovascular and diabetes disease progression on the following primary endpoints: 1) bone mineral density; 2) cardiorespiratory function and maximal oxygen capacity; 3) body composition (lean mass and fat mass); 4) blood pressure and cardiovascular function; 5) lipids and glycemic control; and 6) quality of life and psychological distress. Multi-site randomized controlled trial of 195 men (65 subjects per arm) undergoing treatment for prostate cancer involving ADT in the cities of Perth and Brisbane in Australia. Participants will be randomized to (1) resistance/impact loading exercise, (2) resistance/cardiovascular exercise groups and (3) usual care/delayed exercise. Participants will then undergo progressive training for 12 months. Measurements for primary and secondary endpoints will take place at baseline, 6 and 12 months (end of the intervention). The principal outcome of this project will be the determination of the strength of effect of exercise on the well established musculoskeletal, cardiovascular and insulin metabolism side effects of androgen deprivation in prostate cancer patients. As this project is much longer term than previous investigations in the area of exercise and cancer, we will gain knowledge as to the continuing effects of exercise in this patient population specifically

  3. Responder Analysis of the Effects of Denosumab on Bone Mineral Density in Men Receiving Androgen Deprivation Therapy for Prostate Cancer

    PubMed Central

    Egerdie, Blair; Saad, Fred; Smith, Matthew R; Tammela, Teuvo LJ; Heracek, Jiri; Sieber, Paul; Ke, Chunlei; Leder, Benjamin; Dansey, Roger; Goessl, Carsten

    2013-01-01

    Background Men with prostate cancer are at risk of experiencing accelerated bone loss and fractures as a result of androgen deprivation therapy (ADT). Objective We evaluated the effects of denosumab, a fully human monoclonal antibody against RANKL, on preservation of BMD at 3 key skeletal sites (lumbar spine [LS], femoral neck [FN], and total hip [TH]) and the distal radius at 36 months both by responder category and individual responses in a waterfall plot analysis. Design, Setting, and Participants This phase 3, randomized, double-blind study of men with non-metastatic prostate cancer receiving ADT investigated the effects of denosumab on bone mineral density (BMD) and fractures. Patients were treated for 36 months. Intervention Subcutaneous denosumab 60 mg (n=734) or placebo (n=734) every 6 months for up to 36 months. Patients were instructed to take supplemental Calcium and vitamin D. Measurements Primary outcome measure: The percentage change from baseline to month 36 in LS, FN, and TH BMD was measured by dual energy x-ray absorptiometry. BMD at the distal 1/3 radius at 36 months was measured in a sub-study of 309 patients. Results and Limitations At 36 months, significantly more patients in the denosumab arm had increases of >3% BMD from baseline at each site studied compared with placebo (LS, 78% vs 17%; TH, 48% vs 6%; FN, 48% vs 13%; distal 1/3 radius, 40% vs 7%). The percentage of denosumab patients with bone loss at all 3 key BMD sites at month 36 was 1%, as opposed to 42% in placebo arm. At 36 months 69% of denosumab-treated patients had BMD increases at all three sites (LS, TH or FN) compared with 8% of placebo-treated patients. Lower baseline BMD was associated with higher magnitude lumbar spine, femoral neck, and total hip BMD responses to denosumab. Conclusions In men with prostate cancer receiving ADT significantly higher BMD response rates were observed with denosumab vs. placebo. Trial Registration This study is registered with Clinical

  4. A cluster of acute hepatitis C virus infection among men who have sex with men--results from contact tracing and public health implications.

    PubMed

    Götz, Hannelore M; van Doornum, Gerard; Niesters, Hubert Gm; den Hollander, Jan G; Thio, H Bing; de Zwart, Onno

    2005-06-10

    An acute hepatitis C virus (HCV) infection in an HIV-positive man who had sex with men (MSM) was notified. In the period of his seroconversion he was also diagnosed with a rectal lymphogranuloma venereum (LGV) infection, and was part of a cluster of 15 LGV cases in 2003. Our aim was to investigate HCV transmission and to search for potential spread among sexual contacts and known LGV patients. Our case series included the index, two recent contacts, and 14 LGV cases. They were interviewed about parenteral exposure for HCV, history of sexually transmitted diseases(STDs), sexual behaviour and drug use. Laboratory investigations included anti-HCV antibodies, HCV-polymerase chain reaction, and HCV genotyping. Seven out of 17 MSM recently seroconverted for HCV (41%). Three genotypes were found. Parenteral risk factors were excluded. Six out of seven had LGV proctitis coinciding with HCV seroconversion, six (86%) were HIV infected. Unprotected anal contact was practised by both HCV uninfected and infected cases. Unprotected active and passive fisting was reported by all seven HCV infected men, compared with two of nine uninfected men (P = 0.003). Non-intravenous drug use during sexual activities was common among all MSM. Numerous, often anonymous, sexual contacts in various European countries were reported. A cluster of acute HCV infection is reported among mostly HIV-positive MSM, with multiple partners throughout Europe. Sexual techniques potentially leading to mucosal damage (fisting), concomitant STDs such as LGV and drug use seem facilitating factors for spread. Extensive case finding and partner tracing is advocated as well as targeted prevention messages.

  5. Clinical Significance of Two Real-Time PCR Assays for Chronic Hepatitis C Patients Receiving Protease Inhibitor-Based Therapy

    PubMed Central

    Inoue, Takako; Hmwe, Su Su; Shimada, Noritomo; Kato, Keizo; Ide, Tatsuya; Torimura, Takuji; Kumada, Takashi; Toyoda, Hidenori; Tsubota, Akihito; Takaguchi, Koichi; Wakita, Takaji; Tanaka, Yasuhito

    2017-01-01

    The aim of this study was to determine the efficacy of two hepatitis C virus (HCV) real-time PCR assays, the COBAS AmpliPrep/COBAS TaqMan HCV test (CAP/CTM) and the Abbott RealTime HCV test (ART), for predicting the clinical outcomes of patients infected with HCV who received telaprevir (TVR)-based triple therapy or daclatasvir/asunaprevir (DCV/ASV) dual therapy. The rapid virological response rates in patients receiving TVR-based triple therapy were 92% (23/25) and 40% (10/25) for CAP/CTM and ART, respectively. The false omission rate (FOR) of ART was 93.3% (14/15), indicating that CAP/CTM could accurately predict clinical outcome in the early phase. In an independent examination of 20 patients receiving TVR-based triple therapy who developed viral breakthrough or relapse, the times to HCV disappearance by ART were longer than by CAP/CTM, whereas the times to HCV reappearance were similar. In an independent experiment of WHO standard HCV RNA serially diluted in serum containing TVR, the analytical sensitivities of CAP/CTM and ART were similar. However, cell cultures transfected with HCV and grown in medium containing TVR demonstrated that ART detected HCV RNA for a longer time than CAP/CTM. Similar results were found for 42 patients receiving DCV/ASV dual therapy. The FOR of ART was 73.3% (11/15) at week 8 after initiation of therapy, indicating that ART at week 8 could not accurately predict the clinical outcome. In conclusion, although CAP/CTM and ART detected HCV RNA with comparable analytical sensitivity, CAP/CTM might be preferable for predicting the clinical outcomes of patients receiving protease inhibitor-based therapy. PMID:28118381

  6. Association of SCARB1 Gene Polymorphisms with Virological Response in Chronic Hepatitis C Patients Receiving Pegylated Interferon plus Ribavirin Therapy

    PubMed Central

    Hsu, Ching-Sheng; Hsu, Shih-Jer; Liu, Wei-Liang; Chen, Ding-Shinn; Kao, Jia-Horng

    2016-01-01

    The scavenger receptor type B class I(SR-BI) is a receptor for high-density lipoproteins(HDL) and one of entry factors for hepatitis C virus(HCV). We examined the association of single nucleotide polymorphisms(SNPs) of the SCARB1 gene, which encodes SR-BI, with virologic responses to pegylated interferon-based treatment in Asian chronic hepatitis C(CHC) patients. Human genomic and clinical data were collected from 156 consecutive Taiwanese HCV genotype 1 or 2 patients who received pegylated interferon plus ribavirin therapy and 153 non-HCV healthy subjects. Three SNPs(rs10846744, rs5888, and rs3782287) of the SCARB1 gene that have been linked to humans diseases were investigated. rs10846744 rather than rs5888 or rs3782287 was associated with serum HCV RNA level and sustained virologic response(SVR) to pegylated interferon plus ribavirin therapy in CHC patients(GG vs. non-GG genotype, Adjusted Odds Ratio, 95% CI: 0.32, 0.11–0.95, P = 0.039). Among patients with IL28B rs8099917 non-TT genotypes, those with rs10846744 non-GG genotype had a higher SVR rate than those with GG genotypes. In addition, patients with GG genotype had a higher fasting blood glucose level than those with CC genotype. In conclusion, SCARB1 gene polymorphisms may serve as a potential predictor of treatment responses in CHC patients receiving interferon-based therapy. (ClinicalTrials.gov number, NCT02714712). PMID:27561198

  7. Quantitative Hepatitis B Core Antibody Level Is a New Predictor for Treatment Response In HBeAg-positive Chronic Hepatitis B Patients Receiving Peginterferon

    PubMed Central

    Hou, Feng-Qin; Song, Liu-Wei; Yuan, Quan; Fang, Lin-Lin; Ge, Sheng-Xiang; Zhang, Jun; Sheng, Ji-Fang; Xie, Dong-Ying; Shang, Jia; Wu, Shu-Huan; Sun, Yong-Tao; Wei, Shao-Feng; Wang, Mao-Rong; Wan, Mo-Bin; Jia, Ji-Dong; Luo, Guang-Han; Tang, Hong; Li, Shu-Chen; Niu, Jun-Qi; Zhou, Wei-dong; Sun, Li; Xia, Ning-Shao; Wang, Gui-Qiang

    2015-01-01

    A recent study revealed that quantitative hepatitis B core antibody (qAnti-HBc) level could serve as a novel marker for predicting treatment response. In the present study, we further investigated the predictive value of qAnti-HBc level in HBeAg-positive patients undergoing PEG-IFN therapy. A total of 140 HBeAg-positive patients who underwent PEG-IFN therapy for 48 weeks and follow-up for 24 weeks were enrolled in this study. Serum samples were taken every 12 weeks post-treatment. The predictive value of the baseline qAnti-HBc level for treatment response was evaluated. Patients were further divided into 2 groups according to the baseline qAnti-HBc level, and the response rate was compared. Additionally, the kinetics of the virological and biochemical parameters were analyzed. Patients who achieved response had a significantly higher baseline qAnti-HBc level (serological response [SR], 4.52±0.36 vs. 4.19±0.58, p=0.001; virological response [VR], 4.53±0.35 vs. 4.22±0.57, p=0.005; combined response [CR], 4.50±0.36 vs. 4.22±0.58, p=0.009)). Baseline qAnti-HBc was the only parameter that was independently correlated with SR (p=0.008), VR (p=0.010) and CR(p=0.019). Patients with baseline qAnti-HBc levels ≥30,000 IU/mL had significantly higher response rates, more HBV DNA suppression, and better hepatitis control in PEG-IFN treatment. In conclusion, qAnti-HBc level may be a novel biomarker for predicting treatment response in HBeAg-positive patients receiving PEG-IFN therapy. PMID:25553110

  8. Risk Factors for Sexual Transmission of Hepatitis C Virus Among Human Immunodeficiency Virus-Infected Men Who Have Sex With Men: A Case-Control Study.

    PubMed

    Vanhommerig, Joost W; Lambers, Femke A E; Schinkel, Janke; Geskus, Ronald B; Arends, Joop E; van de Laar, Thijs J W; Lauw, Fanny N; Brinkman, Kees; Gras, Luuk; Rijnders, Bart J A; van der Meer, Jan T M; Prins, Maria; van der Meer, J T M; Molenkamp, R; Mutschelknauss, M; Nobel, H E; Reesink, H W; Schinkel, J; van der Valk, M; van den Berk, G E L; Brinkman, K; Kwa, D; van der Meche, N; Toonen, A; Vos, D; van Broekhuizen, M; Lauw, F N; Mulder, J W; Arends, J E; van Kessel, A; de Kroon, I; Boonstra, A; van der Ende, M E; Hullegie, S; Rijnders, B J A; van de Laar, T J W; Gras, L; Smit, C; Lambers, F A E; Prins, M; Vanhommerig, J W; van der Veldt, W

    2015-09-01

    Background.  Since 2000, incidence of sexually acquired hepatitis C virus (HCV)-infection has increased among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). To date, few case-control and cohort studies evaluating HCV transmission risk factors were conducted in this population, and most of these studies were initially designed to study HIV-related risk behavior and characteristics. Methods.  From 2009 onwards, HIV-infected MSM with acute HCV infection and controls (HIV-monoinfected MSM) were prospectively included in the MOSAIC (MSM Observational Study of Acute Infection with hepatitis C) study at 5 large HIV outpatient clinics in the Netherlands. Written questionnaires were administered, covering sociodemographics, bloodborne risk factors for HCV infection, sexual behavior, and drug use. Clinical data were acquired through linkage with databases from the Dutch HIV Monitoring Foundation. For this study, determinants of HCV acquisition collected at the inclusion visit were analyzed using logistic regression. Results.  Two hundred thirteen HIV-infected MSM (82 MSM with acute HCV infection and 131 MSM without) were included with a median age of 45.7 years (interquartile range [IQR], 41.0-52.2). Receptive unprotected anal intercourse (adjusted odds ratio [aOR], 5.01; 95% confidence interval [CI], 1.63-15.4), sharing sex toys (aOR, 3.62; 95% CI, 1.04-12.5), unprotected fisting (aOR, 2.57; 95% CI, 1.02-6.44), injecting drugs (aOR, 15.62; 95% CI, 1.27-192.6), sharing straws when snorting drugs (aOR, 3.40; 95% CI, 1.39-8.32), lower CD4 cell count (aOR, 1.75 per cubic root; 95% CI, 1.19-2.58), and recent diagnosis of ulcerative sexually transmitted infection (aOR, 4.82; 95% CI, 1.60-14.53) had significant effects on HCV acquisition. Conclusions.  In this study, both sexual behavior and biological factors appear to independently increase the risk of HCV acquisition among HIV-infected MSM.

  9. Frequency of hepatic contour abnormalities and signs of portal hypertension at CT in patients receiving chemotherapy for breast cancer metastatic to the liver.

    PubMed

    Qayyum, Aliya; Lee, Gerard K; Yeh, Benjamin M; Allen, Jill N; Venook, Alan P; Coakley, Fergus V

    2007-01-01

    This study aimed to determine the frequency of hepatic contour abnormalities and signs of portal hypertension at serial CT in patients receiving chemotherapy for breast cancer metastatic to the liver. We retrospectively identified 91 women with breast cancer metastatic to the liver who received chemotherapy and underwent serial CT at our institution between 1998 and 2002. Two readers independently categorized hepatic contour abnormalities on the final CT examination as none, limited retraction, widespread retraction, or diffuse nodularity. Readers also recorded the development of hepatic atrophy or enlargement, ascites, portosystemic collateral veins, and splenomegaly. Interpretative discrepancies were resolved by consensus. Portal hypertension was defined as the presence of at least two of the following CT signs: simple ascites, portosystemic collateral veins, and splenomegaly. After a median follow-up interval of 15 months (range, 1-46), hepatic contour abnormalities were seen in 68 of 91 patients (75%) and consisted of limited retraction (n = 42), widespread retraction (n = 10), or diffuse nodularity (n = 16). Portal hypertension was found in 1 of 23 patients without contour abnormalities, in 1 of 42 patients with limited retraction, in none of 10 patients with widespread retraction, and in 6 of 16 patients with diffuse nodularity (P < .01). Hepatic contour abnormalities commonly develop at serial CT in patients undergoing chemotherapy for breast cancer metastatic to the liver and may be accompanied by signs of portal hypertension; the latter are particularly, but not exclusively, associated with the development of diffuse hepatic nodularity.

  10. Anticipated and Actual Reactions to Receiving HIV Positive Results Through Self-Testing Among Gay and Bisexual Men

    PubMed Central

    Carballo-Diéguez, Alex; Ibitoye, Mobolaji; Frasca, Timothy; Brown, William; Balan, Iván

    2014-01-01

    We explored anticipated and actual reactions to receiving HIV positive results through self-testing with a diverse group of 84 gay and bisexual men in New York City. Grounded Theory was used to investigate these reactions in a two-phase study, one hypothetical, followed by a practical phase in which self-tests were distributed and used. Three major themes emerged when participants were asked about their anticipated reactions to an HIV positive self-test result: managing emotional distress, obtaining HIV medical care, and postponing sexual activity. When participants were asked about their anticipated reactions to a partner’s HIV positive self-test result, five themes emerged: provide emotional support; refrain from engaging in sex with casual partner; avoid high-risk sexual activity with both main and casual partners; seek medical services; and obtain a confirmatory test result. Although none of the participants tested positive, seven of their partners did. Participants provided emotional support and linked their partners to support services. The availability of HIV self-testing kits offers potential opportunities to tackle HIV infection among individuals with high-risk practices. PMID:24858480

  11. Hepatic retinoid levels in seven fish species (teleosts) from a tropical coastal lagoon receiving effluents from iron-ore mining and processing.

    PubMed

    Pereira, Adriana A; van Hattum, Bert; Brouwer, Abraham

    2012-02-01

    The present study was undertaken to investigate the possible effects of Fe and trace element exposure on hepatic levels of retinoids in seven fish species. Concentrations of retinoids were measured in fish collected from a coastal lagoon in Brazil that receives effluents from an iron-ore mining and processing plant. Fish from nearby coastal lagoons were also included to assess possible differences related to chemical exposure. Results indicated considerable differences in hepatic retinoid composition among the various species investigated. The most striking differences were in retinol and derivative-specific profiles and in didehydro retinol and derivative-specific profiles. The Perciformes species Geophagus brasiliensis, Tilapia rendalli, Mugil liza, and Cichla ocellaris and the Characiforme Hoplias malabaricus were characterized as retinol and derivative-specific, while the Siluriformes species Hoplosternum littorale and Rhamdia quelen were didehydro retinol and derivative-specific fish species. A negative association was observed between Al, Pb, As, and Cd and hepatic didehydro retinoid levels. Fish with higher levels of hepatic Fe, Cu, and Zn showed unexpectedly significant positive correlations with increased hepatic retinol levels. This finding, associated with the positive relationships between retinol and retinyl palmitate with lipid peroxidation, may suggest that vitamin A is mobilized from other tissues to increase hepatic antioxidant levels for protection against oxidative damage. These data show significant but dissimilar associations between trace element exposure and hepatic retinoid levels in fish species exposed to iron-ore mining and processing effluents, without apparent major impacts on fish health and condition. Copyright © 2011 SETAC.

  12. Hepatitis C Virus Subtype and Evolution Characteristic Among Drug Users, Men Who Have Sex With Men, and the General Population in Beijing, China

    PubMed Central

    Jiao, Yang; Zhang, Xiaoxi; Wang, Chen; Li, Li; Liu, Jie; Bar, Katharine J.; Wei, Huamian; Hu, Yao; Huang, Ping; Zeng, Zhaoli; Jiang, Shulin; Du, Jialiang; Shao, Yiming; Metzger, David; Li, Shuming; Ma, Liying

    2016-01-01

    Abstract The aim of this study was to characterize the current molecular epidemiology of hepatitis C virus (HCV) infection and evaluate the evolutionary patterns of HCV subtypes in Beijing, China, among different subpopulations. The whole blood samples and behavioral data were collected from a total of 10,354 subjects, including drug users (DUs), men who have sex with men (MSM), and the general population, in Beijing from 2010 to 2011. Samples were tested for HCV infection using both enzyme-linked immunosorbent assay (ELISA) and real-time PCR. All viremic subjects were then sequenced by nested PCR over core/E1 and NS5B regions. Phylogenetic and phylogeographic analysis was performed by BEAST software. In total, 217 subjects (2.1%) were tested positive for HCV by antibody or vRNA-based testing. HCV prevalence rates for DUs, MSM, and the general population were 26.2%, 0.54%, and 0.37%, respectively. The 156 HCV RNA-positive samples were sequenced. Nine HCV genotypes, including 1a, 1b, 2a, 3a, 3b, 6a, 6n, 6u and 6v, were detected. The most prevalent subtypes were 3b (36.09%), 1b (32.54%), and 3a (16.57%). Bayesian evolutionary analysis estimated that the time of introduction of subtype 1b into Beijing was 2004 (95% CI: 1997.7, 2007.7), with subtypes 3a and 3b being introduced later in 2006. Evolutionary analyses further suggested that subtype 1b from Beijing and Shanghai were closely related, whereas subtype 3a sequences were more similar with sequences from Yunnan, Guangzhou, Hong Kong, and Jiangsu. Subtype 3b sequences were closely related to those from Yunnan, Guangdong, and Hong Kong. Thus, the current HCV epidemic in Beijing is complex, heavily affecting DUs, and involving multiple genotypes that likely spread from different regions in China with its large migrant population. PMID:26871798

  13. Emerging viral STIs among HIV-positive men who have sex with men: the era of hepatitis C virus and human papillomavirus.

    PubMed

    van de Laar, Thijs Jw; Richel, Olivier

    2017-08-01

    The number of infectious disease outbreaks and the number of unique pathogens responsible have significantly increased since the 1980s. HIV-positive men who have sex with men (MSM) are a vulnerable population with regards to the introduction, spread and clinical consequences of (newly introduced) STIs. After the introduction of combination antiretroviral treatment (cART), the incidence of sexually acquired hepatitis C virus (HCV) infection and human papillomavirus (HPV)-induced anal cancers have significantly increased among HIV-positive MSM. The introduction and expansion of HCV is the result of increased sexual risk behaviour and sexually acquired mucosal trauma within large interconnected networks of HIV-positive MSM in particular. With the availability of cART, postexposure and pre-exposure prophylaxis (PEP and PrEP) and direct-acting antivirals (DAAs) for HCV, less concern for HIV and HCV might require a new approach to develop effective behavioural intervention strategies among MSM. The marked rise in HPV-induced anal cancers can be ascribed to the long-term immunologic defects in an ageing population affected by HIV. More evidence with regards to effective treatment options for anal dysplastic lesions and the usefulness of anal malignancy screening programmes is urgently needed. Most anal cancers in the future generation of HIV-positive MSM could be prevented with the inclusion of boys in addition to girls in current HPV vaccination programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Widespread hepatitis B virus genotype G (HBV-G) infection during the early years of the HIV epidemic in the Netherlands among men who have sex with men.

    PubMed

    Cornelissen, Marion; Zorgdrager, Fokla; Bruisten, Sylvia M; Bakker, Margreet; Berkhout, Ben; van der Kuyl, Antoinette C

    2016-06-10

    Hepatitis B virus (HBV) variants belong to different genotypes, A-J, whose worldwide distribution is linked with geography, probably because viral spread was associated with ancient human migrations. HBV genotype G (HBV-G) is an aberrant genotype with little sequence divergence, suggesting a recent origin. HBV-G is strongly associated with certain risk groups such as intravenous drug users (IDUs) and men who have sex with men (MSM), but hardly with geography. The origin and epidemiology of HBV-G remain unresolved, as is the disease association. To estimate the prevalence and possible time of introduction of HBV-G into the MSM community in Amsterdam, the Netherlands, we have retrospectively analysed 226 blood serum samples from HBsAg positive MSM enrolled in the Amsterdam Cohort Studies (ACS) on HIV infection and AIDS dating from 1984 to 1999 using genotype-specific PCR assays. Of the 226 HBsAg-positive samples, 149 were HBV DNA positive. Of those, 104 were positive for HBV genotype A (HBV-A) and five for HBV-G, and 40 showed a dual infection with both HBV-A and HBV-G. Being HIV-infected was significantly associated with a reduced HBV DNA viral load in blood, but not with the prevalence of HBV-G. Early virus already contained stop codons in the precore region and a 36 bp insertion in the core gene which are the characteristics of HBV-G. HBV-G was introduced before 1985 into the Amsterdam MSM community. Early isolates show very limited sequence variation, confirming a low evolutionary rate. HBV-G acquisition was independent of HIV infection, but being HIV-infected was significantly associated with a reduced HBV viral load in blood, indicating a beneficial effect of early HIV infection in controlling HBV replication.

  15. Identification of Novel Recombinant Forms of Hepatitis B Virus Generated from Genotypes Ae and G in HIV-1-Positive Japanese Men Who Have Sex with Men

    PubMed Central

    Kawahata, Takuya; Mori, Haruyo; Furubayashi, Keiichi; Taniguchi, Yasushi; Itoda, Ichiro; Komano, Jun

    2015-01-01

    Abstract The rare hepatitis B virus (HBV) genotype G (HBV/G) coinfects HIV-1-positive individuals along with HBV/A and generates recombinants. However, the circulation of HBV A/G recombinants remains poorly understood. This molecular epidemiologic study examined HBV A/G recombinants in Japanese HIV-1-positive men who have sex with men (MSM). Initially, blood specimens submitted for confirmatory tests of HIV infection in Osaka and Tokyo, Japan, from 2006 to 2013 were examined for HIV-1, and HIV-1-positive specimens were screened for HBV. Among 817 specimens from HIV-1-positive individuals, HBsAg was detected in 59 specimens; of these, HBV/Ae (alternatively A2), a subgenotype of HBV/A prevalent in Europe and North America, was identified in 70.2%, HBV/C in 17.5%, and HBV/G in 10.5%, and HBV/E in 1.8% according to the core gene sequence. The full-length genome analysis of HBV was performed on HBV/G-positive specimens because some HBV A/G recombinants were historically overlooked by genotyping based on a partial genome analysis. It revealed that five of the specimens contained novel Ae/G recombinants, the core gene of which had a high sequence similarity to HBV/G. Detailed analyses showed that novel recombinants were coinfected with HBV/Ae in a recombinant-dominant fashion. No major drug-resistant mutations were found in the newly identified HBV Ae/G recombinants. Some of the individuals asymptomatically coinfected with HIV/HBV suffered mild liver injury. This study demonstrated that novel Ae/G HBV recombinants were identified in Japanese HIV-1-positive MSM. The pathogenicity of novel HBV Ae/G recombinants should be examined in a future longitudinal study. Surveillance of such viruses in HIV-1-positive individuals should be emphasized. PMID:25825936

  16. Higher risk of incident hepatitis C virus coinfection among men who have sex with men, in whom the HIV genetic bottleneck at transmission was wide.

    PubMed

    Kouyos, Roger D; Rauch, Andri; Braun, Dominique L; Yang, Wan-Lin; Böni, Jürg; Yerly, Sabine; Klimkait, Thomas; Aubert, Vincent; Shah, Cyril; Kovari, Helen; Calmy, Alexandra; Cavassini, Matthias; Battegay, Manuel; Vernazza, Pietro L; Bernasconi, Enos; Ledergerber, Bruno; Günthard, Huldrych F

    2014-11-15

    High-risk sexual behaviors have been suggested as drivers of the recent dramatic increase of sexually transmitted hepatitis C virus (HCV) among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). We assessed the association between the genetic bottleneck of HIV at transmission and the prevalence and incidence of HCV coinfection in HIV-infected MSM from the Swiss HIV Cohort Study (SHCS). As a proxy for the width of the transmission bottleneck, we used the fraction of ambiguous nucleotides detected by genotypic resistance tests sampled during early HIV infection. We defined a broad bottleneck as a fraction of ambiguous nucleotides exceeding a previously established threshold (0.5%). From the SHCS, we identified 671 MSM with available results of HCV serologic tests and with an HIV genotypic resistance test performed during early HIV infection. Of those, 161 (24.0%) exhibited a broad HIV transmission bottleneck, 38 (5.7%) had at least 1 positive HCV test result, and 26 (3.9%) had an incident HCV infection. Individuals with broad HIV transmission bottlenecks exhibited a 2-fold higher odds of having ever experienced an HCV coinfection (odds ratio, 2.2 [95% confidence interval {CI}, 1.1-4.3]) and a 3-fold higher hazard of having an incident HCV infection (hazard ratio, 3.0 [95% CI, 1.4-6.6]) than individuals with narrow HIV transmission bottlenecks. Our results indicate that the currently occurring sexual spread of HCV is focused on MSM who are prone to exhibit broad HIV transmission bottlenecks. This is consistent with an important role of high-risk behavior and mucosal barrier impairment in the transmission of HCV among MSM. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  17. Evidence of a large, international network of international hepatitis C virus transmission in HIV-positive men who have sex with men

    PubMed Central

    van de Laar, T; Pybus, O; Bruisten, S; Brown, D; Nelson, M; Bhagani, S; Vogel, M; Baumgarten, A; Chaix, ML; Fisher, M; Gőtz, H; Matthews, G; Neifer, S; White, P; Rawlinson, W; Pol, S; Rockstroh, J; Coutinho, R; Dore, G; Dusheiko, G; Danta, M

    2009-01-01

    Background Since 2000, there has been a marked rise in acute hepatitis C virus (HCV) in HIV-positive men who have sex with men (MSM). We conducted an international phylogenetic study to investigate the existence of an HCV transmission network among MSM. Methods HIV-positive MSM diagnosed with recent HCV (n=226) in England (107), Netherlands (58), France (12), Germany (25) and Australia (24) between 2000 and 2006 were enrolled into a molecular phylogenetic study. Using real-time PCR, the NS5B region of the HCV genome (436 bp) was amplified, sequenced and compared with unrelated NS5B sequences. Results NS5B sequences were obtained from 200 (89%) cases. Circulating HCV genotypes were 1a (59%); 4d (23%), 3a (11%), 1b (5%), and 2b/c (3%). Phylogenetic analysis revealed 156 (78%) sequences that formed 11 clusters (bootstrap value >70%) containing between 4 and 37 individual sequences. Country mixing was associated with larger cluster size (17 vs 4.5 sequences; p=0.03). ‘Molecular clock’ analysis indicated that the majority (85%) of transmissions occurred since 1996. Discussion Phylogenetic analysis revealed a large international network of HCV transmission among HIV-positive MSM. The rapid spread of HCV among neighboring countries is supported by the large proportion (74%) of European MSM infected with an HCV strain co-circulating in multiple European countries; the low evolutionary distances among HCV isolates from different countries; and the trend toward increased country mixing with increasing cluster size. Temporally, this epidemic coincides with the introduction of highly active anti-retroviral therapy and associated increases in sexual risk behaviors. International collaborative public health efforts are needed to mitigate HCV transmission among this population. PMID:19422083

  18. Identification of Novel Recombinant Forms of Hepatitis B Virus Generated from Genotypes Ae and G in HIV-1-Positive Japanese Men Who Have Sex with Men.

    PubMed

    Kojima, Yoko; Kawahata, Takuya; Mori, Haruyo; Furubayashi, Keiichi; Taniguchi, Yasushi; Itoda, Ichiro; Komano, Jun

    2015-07-01

    The rare hepatitis B virus (HBV) genotype G (HBV/G) coinfects HIV-1-positive individuals along with HBV/A and generates recombinants. However, the circulation of HBV A/G recombinants remains poorly understood. This molecular epidemiologic study examined HBV A/G recombinants in Japanese HIV-1-positive men who have sex with men (MSM). Initially, blood specimens submitted for confirmatory tests of HIV infection in Osaka and Tokyo, Japan, from 2006 to 2013 were examined for HIV-1, and HIV-1-positive specimens were screened for HBV. Among 817 specimens from HIV-1-positive individuals, HBsAg was detected in 59 specimens; of these, HBV/Ae (alternatively A2), a subgenotype of HBV/A prevalent in Europe and North America, was identified in 70.2%, HBV/C in 17.5%, and HBV/G in 10.5%, and HBV/E in 1.8% according to the core gene sequence. The full-length genome analysis of HBV was performed on HBV/G-positive specimens because some HBV A/G recombinants were historically overlooked by genotyping based on a partial genome analysis. It revealed that five of the specimens contained novel Ae/G recombinants, the core gene of which had a high sequence similarity to HBV/G. Detailed analyses showed that novel recombinants were coinfected with HBV/Ae in a recombinant-dominant fashion. No major drug-resistant mutations were found in the newly identified HBV Ae/G recombinants. Some of the individuals asymptomatically coinfected with HIV/HBV suffered mild liver injury. This study demonstrated that novel Ae/G HBV recombinants were identified in Japanese HIV-1-positive MSM. The pathogenicity of novel HBV Ae/G recombinants should be examined in a future longitudinal study. Surveillance of such viruses in HIV-1-positive individuals should be emphasized.

  19. HIV-Infected Men Who Have Sex with Men Who Identify Themselves as Belonging to Subcultures Are at Increased Risk for Hepatitis C Infection

    PubMed Central

    Matser, Amy; Vanhommerig, Joost; Schim van der Loeff, Maarten F.; Geskus, Ronald B.; de Vries, Henry J. C.; Prins, Jan M.; Prins, Maria; Bruisten, Sylvia M.

    2013-01-01

    Background Hepatitis C virus (HCV) emerged as sexually transmitted infection among HIV-infected men who have sex with men (MSM). We studied whether HCV circulated in identifiable high-risk MSM subcultures and performed phylogenetic analysis. Methods HIV-infected MSM were recruited at the sexually transmitted infections (STI) outpatient clinic and a university HIV clinic in Amsterdam, the Netherlands, 2008–2009. Participants completed a detailed questionnaire and were tested for HCV antibodies and RNA, with NS5B regions sequenced for analysis of clusters. Results Among 786 participants, the median age was 43 (IQR 37–48) years, and 93 (11.8%) were HCV-positive. Seropositivity was associated with belonging to subcultures identified as leather (aOR 2.60; 95% CI 1.56–4.33), rubber/lycra (aOR 2.15; 95% CI 1.10–4.21), or jeans (aOR 2.23; 95% CI 1.41–3.54). The two largest HCV-RNA monophyletic clusters were compared; MSM in cluster I (genotype 1a, n = 13) reported more partners (P = 0.037) than MSM in cluster II (genotype 4d, n = 14), but demographics, subculture characteristics and other risk behaviors did not differ significantly between the two clusters. Discussion HCV infection is associated with identifiable groups of leather/rubber/lycra/jeans subcultures among HIV-infected MSM. Separate epidemiological HCV transmission networks were not revealed. Active HCV screening and treatment within specific subcultures may reduce HCV spread among all MSM. PMID:23469226

  20. Two simultaneous hepatitis B virus epidemics among injecting drug users and men who have sex with men in Buenos Aires, Argentina: characterization of the first D/A recombinant from the American continent.

    PubMed

    Trinks, J; Cuestas, M L; Tanaka, Y; Mathet, V L; Minassian, M L; Rivero, C W; Benetucci, J A; Gímenez, E D; Segura, M; Bobillo, M C; Corach, D; Ghiringhelli, P D; Sánchez, D O; Avila, M M; Peralta, L A M; Kurbanov, F; Weissenbacher, M C; Simmonds, P; Mizokami, M; Oubiña, J R

    2008-11-01

    Previous studies have revealed that hepatitis B virus (HBV)/D and HBV/F predominate among blood donors from Buenos Aires, Argentina. In the present study, blood samples from two high-risk groups were analysed: 160 corresponding to street- and hospital-recruited injecting drug users [81.2% showing the 'anti-hepatitis B core antigen (anti-HBc) only' serological pattern] and 20 to hepatitis B surface antigen (HBsAg)(+)/anti-HBc(+) men who have sex with men. HBV genotypes were assigned by polymerase chain reaction amplification followed by restriction fragment length polymorphism and confirmed by nucleotide sequencing of two different coding regions. HBV DNA was detected in 27 injecting drug users (16.9%, occult infection prevalence: 7.7%), and 14 men who have sex with men (70%). HBV/A prevailed among injecting drug users (81.8%) while HBV/F was predominant among men who have sex with men (57.1%). The high predominance of HBV/A among injecting drug users is in sharp contrast to its low prevalence among blood donors (P = 0.0006) and men who have sex with men (P = 0.0137). Interestingly, all HBV/A S gene sequences obtained from street-recruited injecting drug users encoded the rare serotype ayw1 and failed to cluster within any of the known A subgenotypes. Moreover, one of the HBV strains from a hospital-recruited injecting drug user was fully sequenced and found to be the first completely characterized D/A recombinant genome from the American continent. Data suggest that two simultaneous and independent HBV epidemics took place in Buenos Aires: one spreading among injecting drug users and another one sexually transmitted among the homosexual and heterosexual population.

  1. The effect of total starvation and very low energy diet in lean men on kinetics of whole body protein and five hepatic secretory proteins.

    USDA-ARS?s Scientific Manuscript database

    It is unclear whether the rate of weight loss, independent of magnitude, affects whole body protein metabolism and the synthesis and plasma concentrations of specific hepatic secretory proteins. We examined 1) whether lean men losing weight rapidly (starvation) show greater changes in whole body pro...

  2. Risk of Late Toxicity in Men Receiving Dose-Escalated Hypofractionated Intensity Modulated Prostate Radiation Therapy: Results From a Randomized Trial

    SciTech Connect

    Hoffman, Karen E. Voong, K. Ranh; Pugh, Thomas J.; Skinner, Heath; Levy, Lawrence B.; Takiar, Vinita; Choi, Seungtaek; Du, Weiliang; Frank, Steven J.; Johnson, Jennifer; Kanke, James; Kudchadker, Rajat J.; Lee, Andrew K.; Mahmood, Usama; McGuire, Sean E.; Kuban, Deborah A.

    2014-04-01

    Objective: To report late toxicity outcomes from a randomized trial comparing conventional and hypofractionated prostate radiation therapy and to identify dosimetric and clinical parameters associated with late toxicity after hypofractionated treatment. Methods and Materials: Men with localized prostate cancer were enrolled in a trial that randomized men to either conventionally fractionated intensity modulated radiation therapy (CIMRT, 75.6 Gy in 1.8-Gy fractions) or to dose-escalated hypofractionated IMRT (HIMRT, 72 Gy in 2.4-Gy fractions). Late (≥90 days after completion of radiation therapy) genitourinary (GU) and gastrointestinal (GI) toxicity were prospectively evaluated and scored according to modified Radiation Therapy Oncology Group criteria. Results: 101 men received CIMRT and 102 men received HIMRT. The median age was 68, and the median follow-up time was 6.0 years. Twenty-eight percent had low-risk, 71% had intermediate-risk, and 1% had high-risk disease. There was no difference in late GU toxicity in men treated with CIMRT and HIMRT. The actuarial 5-year grade ≥2 GU toxicity was 16.5% after CIMRT and 15.8% after HIMRT (P=.97). There was a nonsignificant numeric increase in late GI toxicity in men treated with HIMRT compared with men treated with CIMRT. The actuarial 5-year grade ≥2 GI toxicity was 5.1% after CIMRT and 10.0% after HIMRT (P=.11). In men receiving HIMRT, the proportion of rectum receiving 36.9 Gy, 46.2 Gy, 64.6 Gy, and 73.9 Gy was associated with the development of late GI toxicity (P<.05). The 5-year actuarial grade ≥2 GI toxicity was 27.3% in men with R64.6Gy ≥ 20% but only 6.0% in men with R64.6Gy < 20% (P=.016). Conclusions: Dose-escalated IMRT using a moderate hypofractionation regimen (72 Gy in 2.4-Gy fractions) can be delivered safely with limited grade 2 or 3 late toxicity. Minimizing the proportion of rectum that receives moderate and high dose decreases the risk of late rectal toxicity after this

  3. Factors Associated With Persistent Increase in Level of Alanine Aminotransferase in Patients With Chronic Hepatitis B Receiving Oral Antiviral Therapy.

    PubMed

    Jacobson, Ira M; Washington, Mary K; Buti, Maria; Thompson, Alexander; Afdhal, Nezam; Flisiak, Robert; Akarca, Ulus Salih; Tchernev, Konstantin G; Flaherty, John F; Aguilar Schall, Raul; Myers, Robert P; Subramanian, G Mani; McHutchison, John G; Younossi, Zobair; Marcellin, Patrick; Patel, Keyur

    2017-07-01

    Despite complete suppression of viral DNA with antiviral agents, in some patients with chronic hepatitis B (CHB), serum levels of alanine aminotransferase (ALT) do not normalize. We investigated factors associated with persistent increases in ALT level in patients with CHB given long-term tenofovir disoproxil fumarate. We analyzed data from 471 hepatitis B e antigen (HBeAg)-positive and HBeAg-negative patients with CHB participating in 2 phase 3 trials. We identified patients with an increased level of ALT (above the upper limit of normal range) after 5 years (240 weeks) of tenofovir disoproxil fumarate therapy. We analyzed findings from liver biopsy specimens collected from 467 patients (99%) at baseline and 339 patients (72%) at year 5 of treatment; biopsy specimens were evaluated by an independent pathologist. We performed stepwise, forward, multivariate regression analyses of specified baseline characteristics and on-treatment response parameters to identify factors associated with persistent increases in ALT level. Of the 471 patients, 87 (18%) still had an increased ALT level at year 5 of treatment. Factors associated significantly with a persistent increase in ALT level were a steatosis score of 5% or greater (grade 1 or more) at baseline (odds ratio [OR], 2.236; 95% confidence interval [CI], 1.031-4.852; P = .042) and at year 5 (OR, 3.392; 95% CI, 1.560 ≥ 7.375; P = .002), HBeAg seropositivity at baseline (OR, 3.297; 95% CI, 1.653-6.576; P < .001), and age 40 years or older (OR, 2.099; 95% CI, 1.014-4.342; P = .046). Of the 42 HBeAg-positive patients with steatosis at baseline, 21 (50%) had an increased ALT level at year 5 of treatment. Patients with persistent increases in ALT level were more likely to have an increase in steatosis at year 5 than those with a normal ALT level. HBeAg seropositivity and hepatic steatosis contribute to persistent increases in ALT level in patients with CHB receiving suppressive antiviral treatment. Clinical

  4. Willingness to Receive Treatment for Hepatitis C among Injecting Drug Users on Methadone Program: Implications for Education and Treatment

    PubMed Central

    Alam-Mehrjerdi, Zahra; Moradi, Afsaneh; Xu, Fenglian; Zarghami, Mehran; Salehi-Fadardi, Javad; Dolan, Kate

    2016-01-01

    Background Hepatitis C virus (HCV) is common among people who inject drugs (PWID) on methadoneprogram in Iran (Persia). However, a few PWID on methadone program report willingness to receive HCVtreatment. This study aimed to assess the factors which were associated with willingness to receive HCVtreatment in a group of PWID on methadone program in Iran. Methods We surveyed 187 PWID at seven drops in centers in Tehran, Iran. Details of demographiccharacteristics, drug use, injection, HCV, and drug treatment history were collected using a 25-itemquestionnaire. Participants were serologically tested for the current status of HCV. Findings The study found that 28.3% of the participants were HCV seropositive. In total, 49.1% of theparticipants reported unwillingness to receive HCV treatment. Awareness of current HCV status [odds ratio(OR) = 3.43; 95% confidence interval (CI): 1.33-7.26; P < 0.050]; adequate knowledge of HCV treatmentcenters in the community (OR = 3.9; 95% CI: 1.24-5.38; P < 0.050); participation in an educational programon HCV (OR = 2.9; 95% CI: 2.33-8.56; P < 0.001) and recent participation in the meetings of self-helpgroups (OR = 4.6; 95% CI: 3.43-9.33; P < 0.001) were significantly associated with current willingness toreceive HCV treatment. Conclusion The study results indicate that awareness of HCV status and the provision of adequate HCVeducation via different information centers can be associated with an increased willingness for HCVtreatment among PWID on methadone program. Conducting more research is suggested to assess theefficacy of educational programs and self-help groups in facilitating HCV treatment among PWID onmethadone program. PMID:27882206

  5. Quantification of Transfusion Recipients at Risk of Receiving Hepatitis B Virus-Contaminated Blood Components: A Korean Study.

    PubMed

    Lee, Kunsei; Kim, Hyeongsu; Chang, Sounghoon; Hur, Mina; Kim, Vitna; Jeong, Hyoseon; Seo, Dong Hee; Lee, SangWon; Kim, Eun Jung; Shin, Eunyoung; Kim, Young Tack

    2016-09-01

    Although there are lots of studies about the risk for the hepatitis B virus infection such as the residual risk for donated blood, there is no research on the risk of HBV infection, from the viewpoint of recipients in Korea. Using the data about HBsAg status of donated blood in 2008 and 2009, the distribution of blood components from the claim data of health insurance in 2009, the distribution of HBsAg and HBsAb of recipients, and some assumptions, we quantified the number of recipients in Korea that might be expected to receive HBV-contaminated blood components, as a proxy index for HBV infection by transfusion in 2009. Of the 376,211 recipients, the number who might be expected to receive blood components with HBV in 2009 was 23.2 (95 % CI 13.6, 36.8) in the basic model, 43.2 (95 % CI 25.4, 68.7) in extended model I, 55.2 (95 % CI 32.5, 87.7) in extended model II and 101.6 (95 % CI 59.8, 161.4) in extended model III. The number of HBV-positive samples per 100,000 transfused units was 0.6 in the basic model (95 % CI 0.3, 0.9), 1.1 in extended model I (95 % CI 0.6, 1.8), 1.4 in extended model II (95 % CI 0.8, 2.2), and 2.6 in extended model III (95 % CI 1.5, 4.1). This study showed that a few recipients might receive HBV-contaminated blood component by transfusion. These results could be used as a scientific evidence for health policy on HBV transfusion infection.

  6. Hepatitis C Treatment Uptake among Patients Who Have Received Opioid Substitution Treatment: A Population-Based Study.

    PubMed

    Midgard, Håvard; Bramness, Jørgen G; Skurtveit, Svetlana; Haukeland, John W; Dalgard, Olav

    2016-01-01

    There is limited data on hepatitis C (HCV) treatment uptake among people who inject drugs including individuals receiving opioid substitution treatment (OST). We aimed to calculate cumulative HCV treatment uptake, estimate annual treatment rates, and identify factors associated with HCV treatment among individuals who have received OST in Norway. This observational study was based on linked data from The Norwegian Prescription Database and The Norwegian Surveillance System for Communicable Diseases between 2004 and 2013. Both registries have national coverage. From a total of 9919 individuals who had been dispensed OST (methadone, buprenorphine or buprenorphine-naloxone), we included 3755 individuals who had been notified with HCV infection. In this population, dispensions of HCV treatment (pegylated interferon and ribavirin), benzodiazepines, selective serotonin reuptake inhibitors and antipsychotics were studied. Among 3755 OST patients notified with HCV infection, 539 (14%) had received HCV treatment during the study period. Annual HCV treatment rates during OST ranged between 1.3% (95% confidence interval [CI] 0.7-2.2) in 2005 and 2.6% (95% CI 1.9-3.5) in 2008 with no significant changes over time. HCV treatment uptake was not associated with age or gender, but associated with duration of active OST (adjusted odds ratio [aOR] 1.11 per year; 95% CI 1.07-1.15), high (> 80%) OST continuity (aOR 1.62; 95% CI 1.17-2.25), and heavy benzodiazepine use (aOR 0.65; 95% CI 0.49-0.87). Cumulative HCV treatment uptake among OST patients notified with HCV infection in Norway between 2004 and 2013 was 14%. Annual treatment rates during OST remained unchanged below 3% per year. High continuity of OST over time and absence of heavy benzodiazepine use predicted HCV treatment uptake. Increased awareness for HCV among OST patients is needed as tolerable and efficient directly acting antiviral treatment is being introduced.

  7. Multiple strategies are required to address the information and support needs of gay and bisexual men with hepatitis C in Australia.

    PubMed

    Hopwood, Max; Lea, Toby; Aggleton, Peter

    2016-03-01

    Hepatitis C virus (HCV) infection is increasingly reported among gay and bisexual men. However, little is known about the personal and social dimensions of HCV-related experience among these men in Australia. An online survey of 474 Australian gay and bisexual men was conducted from August to December 2013. A subsample of 48 HCV mono-infected and HIV/HCV co-infected men was analysed to explore HCV knowledge, sources of information, unmet information needs and use of HCV-related services. More than half of respondents in the subsample were unaware that HIV infection increases the risk of sexually acquired HCV and most wanted information about how to prevent the sexual transmission of HCV. A majority of respondents requested gay-specific HCV services, and approximately similar proportions of men indicated that they would like these services delivered by a hepatitis organization, a lesbian, gay, bisexual, transgender and intersex (LGBTI) organization and a HIV organization. Men in receipt of HIV antiretroviral treatments were most likely to request that gay-specific HCV information and support services be delivered by a LGBTI or HIV organization (OR = 8.63). These findings suggest that a variety of organizations are required to address the information and support needs of Australian gay and bisexual men with HCV. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Hepatitis

    MedlinePlus

    ... low because of routine testing of donated blood. Sexual transmission and transmission among family members through close contact ... associated with drinking contaminated water. Hepatitis Viruses ... B Blood, needles, sexual 10% of older children develop chronic infection. 90% ...

  9. Work productivity among treatment-naïve patients with genotype 1 chronic hepatitis C infection receiving telaprevir combination treatment.

    PubMed

    Aggarwal, J; Vera-Llonch, M; Donepudi, M; Suthoff, E; Younossi, Z; Goss, T F

    2015-01-01

    Work productivity is impacted in hepatitis C virus (HCV)-infected patients and has been linked to treatment. In two Phase 3 trials, ADVANCE and ILLUMINATE, treatment-naïve genotype 1 chronic HCV-infected patients received 12-week telaprevir (T) with 24 (T12PR24)- or 48 (T12PR48)-week peginterferon alfa-2a/ribavirin. The objective of this analysis was to examine the impact of chronic HCV infection and its treatment with combination therapy on work productivity. The 5-item, self-reported work productivity questionnaire (WPQ) was administered in Phase 3 trials to assess unemployment status, days unable to work due to HCV/treatment, reduced hours worked and impact on productivity in prior 4 weeks. Descriptive statistics and multivariate regression analyses were employed in analyses of pooled trial data. About 1147 patients were included; 22% (n = 255) were unemployed at baseline, with 8% being unemployed due to health reasons. At week 12, there were no differences by treatment regimen in the number of days unable to work. At week 48, improvements were observed earlier among patients receiving the shorter duration of T combination treatment. Mean (95% CI) change from baseline in days unable to work was -0.48 (-0.85, -0.11) days for T12PR24, 1.43 (0.63, 2.24) days for T12PR48 and 1.24 (0.18, 2.30) days for PR48 with placebo. Predictors of days unable to work were identified and include demographic characteristics, pretreatment and on-treatment levels of fatigue, as well regional variation. In post hoc analyses of the ADVANCE and ILLUMINATE trials, work productivity decreased during the initial 12 weeks regardless of treatment group. © 2014 John Wiley & Sons Ltd.

  10. Modelling CD4 T Cell Recovery in Hepatitis C and HIV Co-infected Children Receiving Antiretroviral Therapy

    PubMed Central

    Thorne, Claire; Malyuta, Ruslan; Volokha, Alla; Callard, Robin E.; Klein, Nigel J.; Lewis, Joanna

    2017-01-01

    Background: The effect of hepatitis C virus (HCV) coinfection on CD4+ T cell recovery in treated HIV-infected children is poorly understood. Objective: To compare CD4+ T cell recovery in HIV/HCV coinfected children with recovery in HIV monoinfected children. Method: We studied 355 HIV monoinfected and 46 HIV/HCV coinfected children receiving antiretroviral therapy (ART) during a median follow-up period of 4.2 years (interquartile range: 2.7–5.3 years). Our dataset came from the Ukraine pediatric HIV Cohort and the HIV/HCV coinfection study within the European Pregnancy and Paediatric HIV Cohort Collaboration. We fitted an asymptotic nonlinear mixed-effects model of CD4+ T cell reconstitution to age-standardized CD4 counts in all 401 children and investigated factors predicting the speed and extent of recovery. Results: We found no significant impact of HCV coinfection on either pre-ART or long-term age-adjusted CD4 counts (z scores). However, the rate of increase in CD4 z score was slower in HIV/HCV coinfected children when compared with their monoinfected counterparts (P < 0.001). Both monoinfected and coinfected children starting ART at younger ages had higher pre-ART (P < 0.001) and long-term (P < 0.001) CD4 z scores than those who started when they were older. Conclusions: HIV/HCV coinfected children receiving ART had slower CD4+ T cell recovery than HIV monoinfected children. HIV/HCV coinfection had no impact on pre-ART or long-term CD4 z scores. Early treatment of HIV/HCV coinfected children with ART should be encouraged. PMID:28403051

  11. Understanding Correlates of Hepatitis C Virus Infection among Homeless Recently Paroled Men

    PubMed Central

    Nyamathi, Adeline; Salem, Benissa E.; Marlow, Elizabeth; Zhang, Sheldon; Yadav, Kartik

    2013-01-01

    This cross-sectional study assessed predictors of Hepatitis C Virus (HCV) positivity with baseline data collected on recently-released male parolees (N=157) participating in a randomized trial focused on reduction of drug use, recidivism and risk for hepatitis and HIV infections. In this sample, the prevalence of HCV was 25%. The logistic regression analysis revealed that being an injection drug user (IDU) was significantly related to HCV infection. However, contrary to most of the current literature, being African American had significantly lower odds of contracting HCV than their Caucasian counterparts. Moreover, having lived on the streets, not being part of a close family in childhood and being older were also associated with HCV infection. These findings highlight the need for skilled assessments that target the vulnerabilities of homeless adults, especially those who have been incarcerated. Understanding drug use patterns, childhood networks, and family relationships, may assist in the design of interventions to reduce risky drug use and address behaviors derived from disadvantaged childhood. PMID:24158154

  12. When 'raw sex' turns to a 'raw deal' … taking the opportunity to think about sex? Interviews with HIV-positive gay men diagnosed with acute hepatitis C.

    PubMed

    Le Talec, Jean-Yves

    2013-01-01

    Since 2001, cases of hepatitis C virus (HCV) sexual transmission have been reported in France, among HIV-positive gay men who do not inject drugs. An earlier study focused on the incidence of acute hepatitis C and risk factors associated with HCV transmission. The present study, based on in-depth interviews, aimed to highlight the biography, the sexual practices and the experiences of gay men infected with HCV. Beyond an apparent uniformity, the group of interviewees illustrates a variety of situations, life stories and health pathways, depending on their age. These well-adjusted gay men were used to engaging in unprotected sexual practices, but before their diagnosis they largely ignored HCV-transmission risk, which was associated in their mind with a pejorative drug addict image. Once diagnosed with acute hepatitis C, they experienced a critical and emotional period during which they were open to discuss their sexual practices and reconsider risk-reduction procedures, without being willing to give up on their satisfying sex life. Health educators should consider labelling hepatitis C as an STI in order to disrupt its negative image and to help HIV-positive gay man raise their awareness of HCV-transmission risks and implement better risk-reduction strategies.

  13. Dose modifications in Asian cancer patients with hepatic dysfunction receiving weekly docetaxel: A prospective pharmacokinetic and safety study.

    PubMed

    Syn, Nicholas Li-Xun; Wang, Lingzhi; Wong, Andrea Li-Ann; Soe, Mu-Yar; Chuah, Benjamin; Chan, Daniel; Tan, Sing-Huang; Soo, Ross Andrew; Lee, Soo-Chin; Goh, Boon-Cher; Yong, Wei-Peng

    2016-02-01

    Hepatic dysfunction may modify the safety profile and pharmacokinetics of docetaxel in cancer patients, but no validated guideline exists to guide dose modification necessitated by this uncommon comorbidity. We carried out the first prospective study of a personalized dosage regimen for cancer patients with liver dysfunction treated with docetaxel. Weekly dosages were stratified by hepatic dysfunction classification as such: Category 1, normal; Category 2, mild--alkaline phosphatase, aspartate aminotransferase, and/or alanine aminotransferase ≤5× upper limit of normal (ULN), and total bilirubin within normal range; and Category 3, moderate--any alkaline phosphatase, and aspartate aminotransferase or alanine aminotransferase ≤5-10× ULN, and/or total bilirubin ≤1-1.5× ULN. Category 1, 2 and 3 patients received starting dosages of 40, 30, and 20 mg/m(2) docetaxel, respectively. Pharmacokinetics were evaluated on day 1 and 8 of the first treatment cycle, and entered into a multilevel model to delineate interindividual and interoccasion variability. Adverse event evaluation was carried out weekly for two treatment cycles. We found that docetaxel clearance was significantly different between patient categories (P < 0.001). Median clearance was 22.8, 16.4, and 11.3 L/h/m(2) in Categories 1, 2, and 3, respectively, representing 28% and 50% reduced clearance in mild and moderate liver dysfunction patients, respectively. However, docetaxel exposure (area under the concentration-time curve) and docetaxel-induced neutropenia (nadir and the maximum percentage decrease in neutrophil count) were not significantly different between categories. Median area under the concentration-time curve was 1.74, 1.83, and 1.77 mg·h/L in Categories 1, 2, and 3, respectively. The most common Grade 3/4 toxicity was neutropenia (30.0%). An unplanned comparison with the Child-Pugh and National Cancer Institute Organ Dysfunction Working Group grouping systems suggests that the proposed

  14. Serum 17-hydroxyprogesterone strongly correlates with intratesticular testosterone in gonadotropin-suppressed normal men receiving various dosages of human chorionic gonadotropin

    PubMed Central

    Amory, John K.; Coviello, Andrea D.; Page, Stephanie T.; Anawalt, Bradley D.; Matsumoto, Alvin M.; Bremner, William J.

    2009-01-01

    Objective: To determine if serum concentrations of testosterone precursors would correlate with intratesticular testosterone (ITT) concentration measured directly by testicular aspiration and allow for a less invasive means of inferring ITT. Design: Controlled clinical study. Setting: Healthy volunteers in an academic research environment. Patients: Twenty-nine normal men. Intervention: We determined ITT concentration by testicular aspiration before and after treatment in men receiving exogenous testosterone to block endogenous gonadotropin production and randomly assigned to one of four doses of human chorionic gonadotropin (hCG) (0, 125 IU, 250 IU, 500 IU every other day) for 3 weeks. Outcome measures: The association between serum 17-hydroxyprogesterone, androstenedione and dihydroepiandrosterone (DHEA) and ITT. Results: With testosterone administration alone, serum 17-hydroxyprogesterone decreased significantly and increased significantly when 500 IU hCG was administered. End-of-treatment ITT strongly correlated with serum 17-hydroxyprogesterone. Moreover, serum 17-hydroxyprogesterone, but not androstenedione or DHEA, was independently associated with end-of-treatment ITT by multivariate linear regression. Conclusion: Serum 17-hydroxyprogesterone is highly correlated with ITT in gonadotropin suppressed normal men receiving testosterone and stimulated with hCG. Serum 17-hydroxyprogesterone is a surrogate biomarker of ITT and may be useful in research and in men receiving gonadotropin therapy for infertility. PMID:17462643

  15. Serum 17-hydroxyprogesterone strongly correlates with intratesticular testosterone in gonadotropin-suppressed normal men receiving various dosages of human chorionic gonadotropin.

    PubMed

    Amory, John K; Coviello, Andrea D; Page, Stephanie T; Anawalt, Bradley D; Matsumoto, Alvin M; Bremner, William J

    2008-02-01

    To determine if serum concentrations of testosterone precursors would correlate with intratesticular testosterone (ITT) concentration measured directly by testicular aspiration and allow for a less invasive means of inferring ITT. Controlled clinical study. Healthy volunteers in an academic research environment. Twenty-nine normal men. We determined ITT concentration by testicular aspiration before and after treatment in men receiving exogenous T to block endogenous gonadotropin production and randomly assigned to one of four doses of hCG (0, 125 IU, 250 IU, or 500 IU every other day) for 3 weeks. The association between serum 17-hydroxyprogesterone (17OH-P), androstenedione, and DHEA and ITT. With T administration alone, serum 17OH-P decreased significantly and increased significantly when 500 IU hCG was administered. End-of-treatment ITT strongly correlated with serum 17OH-P. Moreover, serum 17OH-P, but not androstenedione or DHEA, was independently associated with end-of-treatment ITT by multivariate linear regression. Serum 17OH-P is highly correlated with ITT in gonadotropin-suppressed normal men receiving T and stimulated with hCG. Serum 17OH-P is a surrogate biomarker of ITT and may be useful in research and in men receiving gonadotropin therapy for infertility.

  16. Hepatitis C Treatment Uptake among Patients Who Have Received Opioid Substitution Treatment: A Population-Based Study

    PubMed Central

    Bramness, Jørgen G.; Skurtveit, Svetlana; Haukeland, John W.; Dalgard, Olav

    2016-01-01

    Background and Aims There is limited data on hepatitis C (HCV) treatment uptake among people who inject drugs including individuals receiving opioid substitution treatment (OST). We aimed to calculate cumulative HCV treatment uptake, estimate annual treatment rates, and identify factors associated with HCV treatment among individuals who have received OST in Norway. Methods This observational study was based on linked data from The Norwegian Prescription Database and The Norwegian Surveillance System for Communicable Diseases between 2004 and 2013. Both registries have national coverage. From a total of 9919 individuals who had been dispensed OST (methadone, buprenorphine or buprenorphine-naloxone), we included 3755 individuals who had been notified with HCV infection. In this population, dispensions of HCV treatment (pegylated interferon and ribavirin), benzodiazepines, selective serotonin reuptake inhibitors and antipsychotics were studied. Results Among 3755 OST patients notified with HCV infection, 539 (14%) had received HCV treatment during the study period. Annual HCV treatment rates during OST ranged between 1.3% (95% confidence interval [CI] 0.7–2.2) in 2005 and 2.6% (95% CI 1.9–3.5) in 2008 with no significant changes over time. HCV treatment uptake was not associated with age or gender, but associated with duration of active OST (adjusted odds ratio [aOR] 1.11 per year; 95% CI 1.07–1.15), high (> 80%) OST continuity (aOR 1.62; 95% CI 1.17–2.25), and heavy benzodiazepine use (aOR 0.65; 95% CI 0.49–0.87). Conclusions Cumulative HCV treatment uptake among OST patients notified with HCV infection in Norway between 2004 and 2013 was 14%. Annual treatment rates during OST remained unchanged below 3% per year. High continuity of OST over time and absence of heavy benzodiazepine use predicted HCV treatment uptake. Increased awareness for HCV among OST patients is needed as tolerable and efficient directly acting antiviral treatment is being introduced

  17. Severe Hepatic Sinusoidal Obstruction Syndrome in a Child Receiving Vincristine, Actinomycin-D, and Cyclophosphamide for Rhabdomyosarcoma: Successful Treatment with Defibrotide

    PubMed Central

    Choi, Aery; Kang, Young Kyung; Lim, Sewon; Kim, Dong Ho; Lim, Jung Sub; Lee, Jun Ah

    2016-01-01

    Hepatic sinusoidal obstruction syndrome (SOS) is a life-threatening syndrome that generally occurs as a complication after hematopoietic stem cell transplantation or, less commonly, after conventional chemotherapy. Regarding SOS in rhabdomyosarcoma patients who received conventional chemotherapy, the doses of chemotherapeutic agents are associated with the development of SOS. Several cases of SOS in rhabdomyosarcoma patients after receiving chemotherapy with escalated doses of cyclophosphamide have been reported. Here, we report on a 9-year-old female with rhabdomyosarcoma who developed severe SOS after receiving chemotherapy consisting of vincristine, actinomycin-D, and a moderate dose of cyclophosphamide. She was treated successfully with defibrotide without sequelae to the liver. PMID:27034141

  18. Patients receiving opioid maintenance treatment in primary care: successful chronic hepatitis C care in a real world setting

    PubMed Central

    2013-01-01

    Background Injection drug users (IDUs) represent a significant proportion of patients with chronic hepatitis C (CHC). The low treatment uptake among these patients results in a low treatment effectiveness and a limited public health impact. We hypothesised that a general practitioner (GP) providing an opioid maintenance treatment (OMT) for addicted patients can achieve CHC treatment and sustained virological response rates (SVR) comparable to patients without drug dependency. Methods Retrospective patient record analysis of 85 CHC patients who received OMT for more than 3 months in a single-handed general practice in Zurich from January 1, 2002 through May 31, 2008. CHC treatment was based on a combination with pegylated interferon and ribavirin. Treatment uptake and SVR (undetectable HCV RNA 6 months after end of treatment) were assessed. The association between treatment uptake and patient characteristics was investigated by multiple logistic regression. Results In 35 out of 85 CHC patients (52 males) with a median (IQR) age of 38.8 (35.0-44.4) years, antiviral therapy was started (41.2%). Median duration (IQR) of OMT in the treatment group was 55.0 (35.0-110.1) months compared to the group without therapy 24.0 (9.8-46.3) months (p<0.001). OMT duration remained a significant determinant for treatment uptake when controlled for potential confounding. SVR was achieved in 25 out of 35 patients (71%). Conclusion In addicted patients a high CHC treatment and viral eradication rate in a primary care setting in Switzerland is feasible. Opioid substitution seems a beneficial framework for CHC care in this “difficult to treat” population. PMID:23298178

  19. Undergraduate Origins of Women and Men 1970-1982 Graduates Who Received Doctorates between 1970-1986.

    ERIC Educational Resources Information Center

    Fuller, Carol H.

    Data from a study of the undergraduate origins of Ph.D.s are presented. Baccalaureate origins of doctorate recipients were analyzed for total and proportional productivity for each of the U.S. institutions whose graduates between 1970 and 1982 had earned at least one doctorate between 1970 and 1986. The numbers of baccalaureate degrees for men and…

  20. Undergraduate Origins of Women and Men 1970-1982 Graduates Who Received Doctorates between 1970-1986.

    ERIC Educational Resources Information Center

    Fuller, Carol H.

    Data from a study of the undergraduate origins of Ph.D.s are presented. Baccalaureate origins of doctorate recipients were analyzed for total and proportional productivity for each of the U.S. institutions whose graduates between 1970 and 1982 had earned at least one doctorate between 1970 and 1986. The numbers of baccalaureate degrees for men and…

  1. Rising Syphilis Infection among Rural HIV-Infected Men who Routinely Received Risk-Reduction Counseling: New Challenges to HIV Prevention in Clinical Care

    PubMed Central

    Mathur, Poonam; Zurlo, John; Albright, Patsi; Crook, Tonya; Whitener, Cynthia; Du, Ping

    2015-01-01

    Objective Syphilis incidence has been steadily increasing among HIV-infected men in the United States, representing an important public health challenge to HIV prevention. Clinic-based HIV prevention interventions are available but may need to be revisited in response to syphilis epidemic. We wanted to better understand the current epidemiology of syphilis in rural HIV-infected men who routinely received HIV risk-reduction counseling in order to plan more effective HIV prevention strategies in clinical care. Methods We conducted a retrospective cohort study to examine factors associated with syphilis infections in rural HIV-infected men who received sexually transmitted disease screening and HIV risk-reduction counseling during HIV primary care from January 2008 to June 2013. We assessed patients’ demographic, clinical, behavioral and psychosocial characteristics and performed a multivariable exact logistic regression to identify factors related to syphilis. Results Despite routine risk screening and HIV risk-reduction counseling, a total of 51 syphilis infections were diagnosed among 702 HIV-infected men (5 patients were diagnosed ≥ 2 episodes). The majority of the study participants was sexually active and reported at least one unsafe sexual behavior, mainly inconsistent condom use. Younger age (<35 years, adjusted odds ratio (aOR)=3.09), higher educational attainment (some college or above, aOR=3.72), and perception that the partner may have sex with other people (aOR=3.10) were significantly associated with syphilis infection. Non-injection drug use was related to syphilis in HIV-infected men who have sex with men (aOR=2.86). Discussion Some HIV-infected men, especially young, educated men, or those who perceived that their partners may have sex with other people, continue to have high-risk behaviors that increase their own risks of acquiring syphilis and may also facilitate HIV transmission. New strategies need to be developed for HIV primary care

  2. The Serum Anti-HBs Level Among Children Who Received Routine Hepatitis B Vaccination During Infancy in Mianyang City, China: A Cross-Sectional Study.

    PubMed

    He, Fang; Ma, Yuan-ji; Zhou, Tao-you; Duan, Jin-chao; Wang, Jun-feng; Ji, Yu-lin; Li, Hong; Zhang, Ju-ying; Tang, Hong

    2016-01-01

    Hepatitis B virus (HBV) prevalence has declined remarkably in children due to nationwide universal vaccination program for HBV in China. However, the persistence of immune response against HBV infection and the optimal time point when a booster vaccination should be performed remain to be elucidated. To assess the persistence and level of antibody against hepatitis B surface antigen (anti-HBs) in a representative population of age 15 and younger who received routine hepatitis B vaccination in Mianyang City, China. A cross-sectional study was conducted in 2011. One thousand five hundred twenty-six children of age 15 and younger who received three doses of 5 μg hepatitis B vaccine series during infancy but did not receive a booster vaccination later were enrolled. Of the 1,526 children, the mean age was 8.2 ± 4.1 and 739 children were male. The median anti-HBs level was 23.0 mIU/mL, and the total percentage of anti-HBs levels ≥10 mIU/mL was 60.9%. With an increase of age, median anti-HBs level, percentage of anti-HBs levels ≥10 mIU/mL, and percentage of anti-HBs levels ≥100 mIU/mL declined remarkably in the early period and reached the lowest level at the age of 3 and then remained relatively stable. The median anti-HBs level, the percentage of anti-HBs levels ≥10 mIU/mL, and the percentage of anti-HBs levels ≥100 mIU/mL in 1- and 2-year-old children were much higher than that in children aged 3-15 (p < 0.05, respectively). Immunity against HBV infection gradually decreased in early ages of children of 15 and younger who received three doses of 5 μg hepatitis B vaccine series during infancy in China. Three dosages of 10 μg hepatitis B vaccine for infants and repeated vaccination or additional booster vaccination for some children at or before age 3 should be provided to get much more powerful immunity to HBV.

  3. Plasma metabolomics identifies lipid abnormalities linked to markers of inflammation, microbial translocation, and hepatic function in HIV patients receiving protease inhibitors

    PubMed Central

    2013-01-01

    Background Metabolic abnormalities are common in HIV-infected individuals on antiretroviral therapy (ART), but the biochemical details and underlying mechanisms of these disorders have not been defined. Methods Untargeted metabolomic profiling of plasma was performed for 32 HIV patients with low nadir CD4 counts (<300 cells/ul) on protease inhibitor (PI)-based ART and 20 healthy controls using liquid or gas chromatography and mass spectrometry. Effects of Hepatitis C (HCV) co-infection and relationships between altered lipid metabolites and markers of inflammation, microbial translocation, and hepatic function were examined. Unsupervised hierarchical clustering, principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA), Random forest, pathway mapping, and metabolite set enrichment analysis (MSEA) were performed using dChip, Metaboanalyst, and MSEA software. Results A 35-metabolite signature mapping to lipid, amino acid, and nucleotide metabolism distinguished HIV patients with advanced disease on PI-based ART from controls regardless of HCV serostatus (p<0.05, false discovery rate (FDR)<0.1). Many altered lipids, including bile acids, sulfated steroids, polyunsaturated fatty acids, and eicosanoids, were ligands of nuclear receptors that regulate metabolism and inflammation. Distinct clusters of altered lipids correlated with markers of inflammation (interferon-α and interleukin-6), microbial translocation (lipopolysaccharide (LPS) and LPS-binding protein), and hepatic function (bilirubin) (p<0.05). Lipid alterations showed substantial overlap with those reported in non-alcoholic fatty liver disease (NALFD). Increased bile acids were associated with noninvasive markers of hepatic fibrosis (FIB-4, APRI, and YKL-40) and correlated with acylcarnitines, a marker of mitochondrial dysfunction. Conclusions Lipid alterations in HIV patients receiving PI-based ART are linked to markers of inflammation, microbial translocation, and hepatic

  4. Is Non-Contrast CT Adequate for the Evaluation of Hepatic Metastasis in Patients Who Cannot Receive Iodinated Contrast Media?

    PubMed

    Jee, Han Bum; Park, Min Jung; Lee, Hye Sun; Park, Mi-Suk; Kim, Myeong-Jin; Chung, Yong Eun

    2015-01-01

    To evaluate the appropriateness of follow-up with only non-enhanced CT (NECT) in patients with gastrointestinal cancer. This retrospective study included 323 patients with colorectal and gastric cancer who underwent two consecutive CT examinations (CT1 and CT2), including non-contrast and portal venous phase CT images, with an interval of 1 year. Patients were divided into 2 groups: Group A included patients with no hepatic metastasis on CT1 and with or without newly developed metastasis on CT2 to evaluate the diagnostic performance of NECT for detecting newly developed hepatic metastasis; Group B included patients with known hepatic metastasis both on CT1 and CT2 to evaluate the accuracy of NECT for the assessment of hepatic metastasis based on RECIST criteria (version 1.1). Contrast-enhanced CT (CECT) images were considered as reference standards. Group A included 172 patients (M:F = 107:65; mean age, 62.6 years). Among them, 57 patients had 95 metastases (mean size, 2.2 ± 1.3 cm). Per patient and per lesion sensitivity for diagnosing newly developed hepatic metastasis was 56.1-66.7% and 52.6-56.8%, respectively. In terms of small metastases (<1.5 cm), per lesion sensitivity was significantly decreased to 28.1-34.4% (P < 0.05). Metastasis size measurements were significantly smaller on NECT (P < 0.001) compared with reference standards. In Group B, the accuracy of response evaluation based on RECIST criteria was 65.6-72.2%. NECT showed inadequate diagnostic performances in both detecting newly developed hepatic metastasis and evaluating the response of hepatic metastasis based on RECIST criteria.

  5. HLA and response to booster hepatitis B vaccination in anti-HBs-seronegative adolescents who had received primary infantile vaccination.

    PubMed

    Lin, Hans Hsienhong; Liao, Huei-Wen Chang; Lin, Sheng-Kai; Wang, Li-Yu

    2008-06-25

    To explore contemporarily genetic and non-genetic determinants of long-term immunological memory to hepatitis B (HB) vaccination, we conducted a case-control study nested in an adolescent cohort of booster recipients who had received primary infantile HB vaccination but with residual anti-HBs titers <10 mIU/mL at 15-18 years of age. High-resolution phenotypes of human leukocyte antigen (HLA)-A, -B, and -DRB1 loci were determined by sequence-specific oligonucleotide probe hybridization. After controlling for pre-booster anti-HBs levels, the absences of HLA-A*02 and -DRB1*08, simply expressed as A*02(-) and -DRB1*08(-), and the presence of B*15 were significantly associated with elevated risks of non-response (post-booster anti-HBs titers<10 mIU/mL) to booster vaccination. The adjusted odds ratios (ORs) were 3.85 (CI, 1.82-8.33), 4.55 (CI, 1.23-16.67), 3.59 (CI, 1.40-9.17), respectively. There was multiplicative synergism between A*02 and B*15 on the risk of non-response to booster vaccination. The multivariate-adjusted ORs for A*02(-)/B*15, A*02(-)/B*15(-), A*02/B*15, and A*02/B*15(-) haplotypes were 20.39 (p=0.0003), 3.29 (p=0.007), 1.32 (p>0.05), and 1.0, respectively. Recent cigarette smoking and/or betel-quid chewing was associated with a 12-fold risk of non-response to booster vaccination. Further comparisons between responders and adolescents who had undetectable post-booster anti-HBs titers (<0.1 mIU/mL) demonstrated similar results. Our results indicated that response to booster HB vaccination as well as long-term immunological responses to HB vaccination are closely related with host genetic factors, and probably modified by recent substance use.

  6. A Pilot Study of Brief Heart Rate Variability Biofeedback to Reduce Craving in Young Adult Men Receiving Inpatient Treatment for Substance Use Disorders

    PubMed Central

    Eddie, D.; Kim, C.; Lehrer, P.; Deneke, E.; Bates, M.E.

    2014-01-01

    The present pilot study investigated the implementation feasibility, and efficacy for reducing alcohol and drug craving, of a brief, 3-session heart rate variability biofeedback (HRV BFB) intervention added to a traditional 28-day substance abuse disorder (SUD) inpatient treatment program. Forty-eight young adult men received either treatment as usual (TAU) plus three sessions of HRV BFB training over three weeks, or TAU only. Participants receiving HRV BFB training were instructed to practice daily using a handheld HRV BFB device. HRV BFB training was well tolerated by participants and supported by treatment staff. Men receiving TAU + HRV BFB demonstrated a greater, medium effect size reduction in alcohol and drug craving compared to those receiving TAU only, although this difference did not reach statistical significance. In addition, an interaction effect was observed in analyses that accounted for baseline craving levels, wherein heart rate variability (HRV) levels at treatment entry were predictive of changes in craving in the TAU group only. Low baseline levels of HRV were associated with increases in craving, whereas higher baseline HRV levels were associated with greater decreases in craving from start to end of treatment. In the TAU + HRV BFB group, however, there was no such association. That is, HRV BFB appeared to dissociate individual differences in baseline HRV levels from changes in craving. Given that alcohol and drug craving often precipitates relapse, HRV BFB merits further study as an adjunct treatment to ameliorate craving experienced by persons with substance use disorders. PMID:25179673

  7. Evaluation of chronic hepatitis B virus (HBV) infection in coinfected patients receiving lamivudine as a component of anti-human immunodeficiency virus regimens.

    PubMed

    Hoff, J; Bani-Sadr, F; Gassin, M; Raffi, F

    2001-03-15

    The effect of lamivudine on chronic coinfection with hepatitis B virus (HBV) in human immunodeficiency virus (HIV)--infected patients was studied prospectively. Nineteen patients with HIV infection, who were receiving an anti-HIV regimen containing lamivudine (150 mg twice daily), and who had replicative chronic HBV infection, were followed for a median of 14 months. Twelve patients' regimens contained protease inhibitors. Serum HBV DNA became undetectable, by means of molecular hybridization, in 14. Seroconversion of hepatitis B e antigen to antibody occurred in 6 of 17 patients, and seroconversion of hepatitis B surface antigen to antibody occurred in 1 of 19. The median serum alanine aminotransferase concentration had decreased by the time of the final evaluation. The median CD4 cell count increased and plasma HIV RNA was undetectable in 10 of 19 patients. Five patients had recurrence of detectable serum HBV DNA despite good compliance with treatment, and 2 mutations related to the resistance of HBV were detected. These patients had a significantly longer duration of treatment (21 versus 13 months; P<.05). In conclusion, resistant strains of HBV emerge at high detectable levels while patients receive anti-HIV regimens containing lamivudine.

  8. Trouble with Bleeding: Risk Factors for Acute Hepatitis C among HIV-Positive Gay Men from Germany—A Case-Control Study

    PubMed Central

    Schmidt, Axel J.; Rockstroh, Jürgen K.; Vogel, Martin; An der Heiden, Matthias; Baillot, Armin; Krznaric, Ivanka; Radun, Doris

    2011-01-01

    Objectives To identify risk factors for hepatitis C among HIV-positive men who have sex with men (MSM), focusing on potential sexual, nosocomial, and other non-sexual determinants. Background Outbreaks of hepatitis C virus (HCV) infections among HIV-positive MSM have been reported by clinicians in post-industrialized countries since 2000. The sexual acquisition of HCV by gay men who are HIV positive is not, however, fully understood. Methods Between 2006 and 2008, a case-control study was embedded into a behavioural survey of MSM in Germany. Cases were HIV-positive and acutely HCV-co-infected, with no history of injection drug use. HIV-positive MSM without known HCV infection, matched for age group, served as controls. The HCV-serostatus of controls was assessed by serological testing of dried blood specimens. Univariable and multivariable regression analyses were used to identify factors independently associated with HCV-co-infection. Results 34 cases and 67 controls were included. Sex-associated rectal bleeding, receptive fisting and snorting cocaine/amphetamines, combined with group sex, were independently associated with case status. Among cases, surgical interventions overlapped with sex-associated rectal bleeding. Conclusions Sexual practices leading to rectal bleeding, and snorting drugs in settings of increased HCV-prevalence are risk factors for acute hepatitis C. We suggest that sharing snorting equipment as well as sharing sexual partners might be modes of sexual transmission. Condoms and gloves may not provide adequate protection if they are contaminated with blood. Public health interventions for HIV-positive gay men should address the role of blood in sexual risk behaviour. Further research is needed into the interplay of proctosurgery and sex-associated rectal bleeding. PMID:21408083

  9. Impact of the timing of hepatitis B virus identification and anti-hepatitis B virus therapy initiation on the risk of adverse liver outcomes for patients receiving cancer therapy.

    PubMed

    Hwang, Jessica P; Suarez-Almazor, Maria E; Cantor, Scott B; Barbo, Andrea; Lin, Heather Y; Ahmed, Sairah; Chavez-MacGregor, Mariana; Donato-Santana, Christian; Eng, Cathy; Ferrajoli, Alessandra; Fisch, Michael J; McLaughlin, Peter; Simon, George R; Rondon, Gabriela; Shpall, Elizabeth J; Lok, Anna S

    2017-09-01

    Data on the incidence of adverse liver outcomes are limited for cancer patients with chronic (hepatitis B surface antigen [HBsAg]-positive/hepatitis B core antibody [anti-HBc]-positive) or past (HBsAg-negative/anti-HBc-positive) hepatitis B virus (HBV) after chemotherapy. This study was aimed at determining the impact of test timing and anti-HBV therapy on adverse liver outcomes in these patients. Patients with solid or hematologic malignancies who received chemotherapy between 2004 and 2011 were retrospectively studied. HBV testing and anti-HBV therapy were defined as early at the initiation of cancer therapy and as late after initiation. Outcomes included hepatitis flares, hepatic impairment, liver failure, and death. Time-to-event analysis was used to determine incidence, and multivariate hazard models were used to determine predictors of outcomes. There were 18,688 study patients (80.4% with solid tumors). The prevalence of chronic HBV was 1.1% (52 of 4905), and the prevalence of past HBV was 7.1% (350 of 4905). Among patients with solid tumors, late identification of chronic HBV was associated with a higher risk of hepatitis flare (hazard ratio [HR], 4.02; 95% confidence interval [CI], 1.26-12.86), hepatic impairment (HR, 8.48; 95% CI, 1.86-38.66), liver failure (HR, 9.38; 95% CI, 1.50-58.86), and death (HR, 3.90; 95% CI, 1.19-12.83) in comparison with early identification. Among patients with hematologic malignancies and chronic HBV, the risk of death was 7.8 (95% CI, 1.73-35.27) times higher for persons with late initiation of anti-HBV therapy versus early initiation. Patients with late identification of chronic HBV had late or no anti-HBV therapy. Chronic HBV predicted liver failure in patients with solid or hematologic malignancies, whereas male sex and late identification were predictors for patients with solid tumors. Early identification correlates with early anti-HBV therapy and reduces the risk of liver failure and death in chronic HBV patients

  10. Add-on fesoterodine for residual storage symptoms suggestive of overactive bladder in men receiving α-blocker treatment for lower urinary tract symptoms.

    PubMed

    Kaplan, Steven A; Roehrborn, Claus G; Gong, Jason; Sun, Franklin; Guan, Zhonghong

    2012-06-01

    Study Type - Therapy (RCT) Level of Evidence 1b What's known on the subject? and What does the study add? Male lower urinary tract symptoms are often attributed to bladder outlet obstruction secondary to benign prostatic hyperplasia and treated with drugs targeting the prostate. However, many men with storage lower urinary tract symptoms may not respond adequately to these agents. Antimuscarinics, with or without an α-blocker, may be effective for the treatment of the storage symptoms of overactive bladder in some men. Flexible-dose fesoterodine as an add-on treatment significantly improved urinary frequency and symptom bother, but not urgency episodes (primary endpoint), versus add-on placebo and was well tolerated in men with persistent overactive bladder symptoms despite receiving α-blocker. • To evaluate flexible-dose fesoterodine vs placebo in men with persistent overactive bladder (OAB) symptoms despite receiving α-blocker treatment • This was a double-blind, 12-week, flexible-dose trial. • Men with persistent storage symptoms (≥ 8 micturitions and ≥ 3 urgency episodes per 24 h) after receiving an α-blocker for ≥ 6 weeks were randomized to add-on fesoterodine 4 mg or placebo, with optional dose escalation to 8 mg at week 4 and reduction back to 4 mg at week 8 (or matching placebo adjustments). • Subjects completed 3-day diaries, International Prostate Symptom Score (IPSS), Overactive Bladder Questionnaire (OAB-q), Patient Perception of Bladder Condition (PPBC), and Urgency Perception Scale (UPS) at baseline and weeks 4 and 12. • A total of 943 men were randomized and received at least one dose of study treatment (fesoterodine, n= 471; placebo, n= 472). • Among these, 251 (53%) in the fesoterodine group and 300 (64%) in the placebo group requested dose escalation at week 4 and 35 (7%) and 15 (3%) requested dose reduction at week 8. Changes from baseline to week 12 in urgency episodes (primary endpoint) in the fesoterodine (-3.2) and

  11. Use of abdominal ultrasound in the diagnosis of hepatic sinusoidal obstruction syndrome (SOS) in a patient receiving a hematopoietic-cell transplant.

    PubMed

    Abadía Barnó, Marta; Marín Serrano, Eva; Ruiz Fernández, Gloria

    2017-08-01

    The sinusoidal obstruction syndrome (SOS) is an uncommon form of portal hypertension that occurs in hematopoietic-cell transplant recipients who receive intense conditioning treatments. The diagnosis is clinical and it is usually delayed, because in these patients there are many causes that can damage the liver and can delay its detection. We present the case of a 47-year-old man, whose diagnosis was made with clinical and analytical data supported by ultrasound signs that showed hepatic congestion. After treatment with defibrotide the patient improved clinically and analytically. Hepatic vascularization and perfusion also improved. Therefore, abdominal doppler ultrasound is shown as a noninvasive exploration useful for the clinical management of SOS and as an early marker of good clinical evolution.

  12. One day of mixed meal overfeeding reduces hepatic insulin sensitivity and increases VLDL particle but not VLDL-triglyceride secretion in overweight and obese men.

    PubMed

    Smith, Gordon I; Magkos, Faidon; Reeds, Dominic N; Okunade, Adewole L; Patterson, Bruce W; Mittendorfer, Bettina

    2013-08-01

    The exact mechanisms responsible for increased plasma triglyceride (TG) concentration in obese people are unclear, and it is not known whether excess energy intake per se is involved in the pathophysiology of this abnormality. The purpose of our study was to examine how excess energy intake from a balanced diet for 1 day affects very-low-density lipoprotein (VLDL)-TG kinetics and its putative regulators hepatic insulin sensitivity and plasma free fatty acid availability. We used stable isotope-labeled tracer methods to evaluate glucose and lipid kinetics in 8 overweight and obese men (age, 38 ± 3 years; body mass index, 33.7 ± 1.7 kg/m(2); means ± SEM) on 2 occasions (randomized crossover design): once, the day after they consumed a balanced diet that provided an amount of energy that matched their energy expenditure, and another time, the day after they consumed a balanced diet that provided 30% excess calories. Eight healthy, lean men (34 ± 1 years; 22.5 ± 0.6 kg/m(2)) were studied under isocaloric conditions only to provide a reference for normal lipid kinetics. VLDL-TG and VLDL-apolipoprotein B-100 (apoB-100) concentrations and secretion rates were significantly greater (P < .01) in overweight/obese compared with lean men. Hypercaloric, compared with isocaloric, feeding in overweight/obese men increased glucose rate of appearance in plasma (904 ± 21 vs 873 ± 26 μmol/min), the hepatic insulin resistance index (10.9 ± 2.2 vs 8.3 ± 1.8), and VLDL-apoB-100 concentration and secretion rate (1.91 ± 0.24 vs. 1.53 ± 0.13 nmol/min), whereas VLDL-apoB-100 plasma clearance rate, VLDL-TG secretion and plasma clearance rates, and free fatty acid rate of appearance in plasma were not affected by overfeeding. One day of moderate overfeeding (30% excess energy intake) stimulates hepatic glucose and VLDL-apo B-100 secretion rates but has no effect on hepatic and adipose tissue fatty acid metabolism in overweight/obese men.

  13. High-Intensity Aerobic Exercise Improves Both Hepatic Fat Content and Stiffness in Sedentary Obese Men with Nonalcoholic Fatty Liver Disease

    PubMed Central

    Oh, Sechang; So, Rina; Shida, Takashi; Matsuo, Tomoaki; Kim, Bokun; Akiyama, Kentaro; Isobe, Tomonori; Okamoto, Yoshikazu; Tanaka, Kiyoji; Shoda, Junichi

    2017-01-01

    We compared the effects of 12-week programs of resistance training (RT), high-intensity interval aerobic training (HIAT), and moderate-intensity continuous aerobic training (MICT). The primary goal was to evaluate the therapeutic effects of the exercise modalities for the management of nonalcoholic fatty liver disease (NAFLD). A total of 61 sedentary obese men with NAFLD were randomized into one of the following exercise regimens (RT, HIAT, or MICT). Hepatic fat content was decreased to a similar extent in the RT, HIAT, and MICT groups (−14.3% vs. −13.7% vs. −14.3%) without significant changes in weight and visceral fat. The gene expression levels of fatty acid synthesis were significantly decreased in the subjects’ monocytes. Hepatic stiffness was decreased only in the HIAT group (−16.8%). The stiffness change was associated with restored Kupffer cell phagocytic function (+17.8%) and decreased levels of inflammation such as leptin (−13.2%) and ferritin (−14.1%). RT, HIAT, and MICT were equally effective in reducing hepatic fat content, but only HIAT was effective in improving hepatic stiffness and restoring Kupffer cell function. These benefits appeared to be independent of detectable weight and visceral fat reductions; the benefits were acquired through the modulation of in vivo fatty acid metabolism and obesity-related inflammatory conditions. PMID:28223710

  14. Hepatitis B virus reactivation in hepatitis B surface antigen seropositive patients with metastatic non-small cell lung cancer receiving cytotoxic chemotherapy: the efficacy of preemptive lamivudine and identification of risk factors.

    PubMed

    Lin, Gui-Nan; Peng, Jie-Wen; Xiao, Jian-jun; Liu, Dong-Ying; Xia, Zhong-Jun

    2014-08-01

    Little is known about the likelihood and degree of hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg) seropositive patients with disseminated non-small cell lung cancer (NSCLC) receiving chemotherapy. Between January 2003 and December 2013, all HBsAg seropositive patients with metastatic NSCLC receiving cytotoxic chemotherapy were retrospectively evaluated. The morbidity and mortality of HBV reactivation, risk factors associated with reactivation, as well as the efficacy of preemptive lamivudine were investigated. Of 258 patients who were eligible for the present study, 176 were treated without antiviral prophylaxis and 82 received preemptive lamivudine. Patients without lamivudine prophylaxis had a significantly higher prevalence of HBV reactivation (19.3 vs 6.1 %, p = 0.006) and severe hepatitis attributable to reactivation (11.8 vs 3.7 %, p = 0.034) than those with preemptive lamivudine. However, no significant difference in mortality due to reactivation was noted between patients with or without prophylactic lamivudine (0 vs 2.3 %, p = 0.310). Furthermore, patients who developed HBV reactivation were indentified to have a higher rate of HBeAg seropositivity (74.4 vs 43.4 %, p < 0.001), serum HBV-DNA level of 10(4) copies/ml or greater (76.9 vs 47.9 %, p = 0.001), coexisting liver metastasis (50.0 vs 40.6 %, p = 0.033) and treatment with more than 4 cycles of chemotherapy (56.4 vs 39.3 %, p = 0.046) than those who did not experienced reactivation. The current study has demonstrated that preemptive lamivudine significantly reduced the prevalence of HBV reactivation in HBsAg seropositive patients with metastatic NSCLC receiving systemic chemotherapy.

  15. Prevalence of, and risk factors for, HIV, hepatitis B and C infections among men who inject image and performance enhancing drugs: a cross-sectional study

    PubMed Central

    Hope, Vivian D; McVeigh, Jim; Marongiu, Andrea; Evans-Brown, Michael; Smith, Josie; Kimergård, Andreas; Croxford, Sara; Beynon, Caryl M; Parry, John V; Bellis, Mark A; Ncube, Fortune

    2013-01-01

    Objective To describe drug use, sexual risks and the prevalence of blood-borne viral infections among men who inject image and performance enhancing drugs (IPEDs). Design A voluntary unlinked-anonymous cross-sectional biobehavioural survey. Setting 19 needle and syringe programmes across England and Wales. Participants 395 men who had injected IPEDs. Results Of the participants (median age 28 years), 36% had used IPEDs for <5 years. Anabolic steroids (86%), growth hormone (32%) and human chorionic gonadotropin (16%) were most frequently injected, with 88% injecting intramuscularly and 39% subcutaneously. Two-thirds also used IPEDs orally. Recent psychoactive drug use was common (46% cocaine, 12% amphetamine), 5% had ever injected a psychoactive drug and 9% had shared injecting equipment. ‘Viagra/Cialis’ was used by 7%, with 89% reporting anal/vaginal sex in the preceding year (20% had 5+ female-partners, 3% male-partners) and 13% always using condoms. Overall, 1.5% had HIV, 9% had antibodies to the hepatitis B core antigen (anti-HBc) and 5% to hepatitis C (anti-HCV). In multivariate analysis, having HIV was associated with: seeking advice from a sexual health clinic; having had an injection site abscess/wound; and having male partners. After excluding those reporting male partners or injecting psychoactive drugs, 0.8% had HIV, 8% anti-HBc and 5% anti-HCV. Only 23% reported uptake of the hepatitis B vaccine, and diagnostic testing uptake was poor (31% for HIV, 22% for hepatitis C). Conclusions Previous prevalence studies had not found HIV among IPED injectors. HIV prevalence in this, the largest study of blood-borne viruses among IPED injectors, was similar to that among injectors of psychoactive drugs. Findings indicate a need for targeted interventions. PMID:24030866

  16. Effect of Aerobic and Resistance Exercise Training on Liver Enzymes and Hepatic Fat in Iranian Men With Nonalcoholic Fatty Liver Disease

    PubMed Central

    Shamsoddini, Alireza; Sobhani, Vahid; Ghamar Chehreh, Mohammad Ebrahim; Alavian, Seyed Moayed; Zaree, Ali

    2015-01-01

    Background: Nonalcoholic fatty liver disease (NAFLD) has different prevalence rates in various parts of the world and is a risk factor for diabetes and cardiovascular disease that could progress to nonalcoholic steatohepatitis, cirrhosis, and liver failure. Objectives: The current study aimed to investigate the effect of Aerobic Training (AT) and resistance training (RT) on hepatic fat content and liver enzyme levels in Iranian men. Patients and Methods: In a randomized clinical trial study, 30 men with clinically defined NAFLD were allocated into three groups (aerobic, resistance and control). An aerobic group program consisted of 45 minutes of aerobic exercise at 60% - 75% maximum heart rate intensity, a resistance group performed seven resistance exercises at intensity of 50% - 70% of 1 repetition maximum (1RM ) and the control group had no exercise training program during the study. Before and after training, anthropometry, insulin sensitivity, liver enzymes and hepatic fat were elevated. Results: After training, hepatic fat content was markedly reduced, to a similar extent, in both the aerobic and resistance exercise training groups (P ≤ 0.05). In the two exercise training groups, alanine amino transferase and aspartate amino transferase serum levels were significantly decreased compared to the control group (P = 0.002) and (P = 0.02), respectively. Moreover, body fat (%), fat mass (kg), homeostasis model assessment insulin resistance (HOMI-IR) were all improved in the AT and RT. These changes in the AT group were independent of weight loss. Conclusions: This study demonstrated that RT and AT are equally effective in reducing hepatic fat content and liver enzyme levels among patients with NAFLD. However, aerobic exercise specifically improves NAFLD independent of any change in body weight. PMID:26587039

  17. Prevalence of, and risk factors for, HIV, hepatitis B and C infections among men who inject image and performance enhancing drugs: a cross-sectional study.

    PubMed

    Hope, Vivian D; McVeigh, Jim; Marongiu, Andrea; Evans-Brown, Michael; Smith, Josie; Kimergård, Andreas; Croxford, Sara; Beynon, Caryl M; Parry, John V; Bellis, Mark A; Ncube, Fortune

    2013-09-12

    To describe drug use, sexual risks and the prevalence of blood-borne viral infections among men who inject image and performance enhancing drugs (IPEDs). A voluntary unlinked-anonymous cross-sectional biobehavioural survey. 19 needle and syringe programmes across England and Wales. 395 men who had injected IPEDs. Of the participants (median age 28 years), 36% had used IPEDs for <5 years. Anabolic steroids (86%), growth hormone (32%) and human chorionic gonadotropin (16%) were most frequently injected, with 88% injecting intramuscularly and 39% subcutaneously. Two-thirds also used IPEDs orally. Recent psychoactive drug use was common (46% cocaine, 12% amphetamine), 5% had ever injected a psychoactive drug and 9% had shared injecting equipment. 'Viagra/Cialis' was used by 7%, with 89% reporting anal/vaginal sex in the preceding year (20% had 5+ female-partners, 3% male-partners) and 13% always using condoms. Overall, 1.5% had HIV, 9% had antibodies to the hepatitis B core antigen (anti-HBc) and 5% to hepatitis C (anti-HCV). In multivariate analysis, having HIV was associated with: seeking advice from a sexual health clinic; having had an injection site abscess/wound; and having male partners. After excluding those reporting male partners or injecting psychoactive drugs, 0.8% had HIV, 8% anti-HBc and 5% anti-HCV. Only 23% reported uptake of the hepatitis B vaccine, and diagnostic testing uptake was poor (31% for HIV, 22% for hepatitis C). Previous prevalence studies had not found HIV among IPED injectors. HIV prevalence in this, the largest study of blood-borne viruses among IPED injectors, was similar to that among injectors of psychoactive drugs. Findings indicate a need for targeted interventions.

  18. Tenofovir-based rescue therapy for advanced liver disease in 6 patients coinfected with HIV and hepatitis B virus and receiving lamivudine.

    PubMed

    Gutiérrez, Sonia; Guillemi, Silvia; Jahnke, Natalie; Montessori, Valentina; Harrigan, P Richard; Montaner, Julio S G

    2008-02-01

    We summarize the clinical history and laboratory results following the introduction of tenofovir among 6 patients coinfected with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) who presented with severe liver disease while receiving lamivudine-based highly active antiretroviral therapy. In all cases, the introduction of tenofovir led to a sustained undetectable HBV and HIV loads, with marked clinical and laboratory improvement in liver function. We provide supporting evidence for the role of tenofovir in the management of advanced HBV infection in HIV-positive patients after the development of lamivudine resistance.

  19. The effect of total starvation and very low energy diet in lean men on kinetics of whole body protein and five hepatic secretory proteins.

    PubMed

    Afolabi, Paul R; Jahoor, Farook; Jackson, Alan A; Stubbs, James; Johnstone, Alexander M; Faber, Peter; Lobley, Gerald; Gibney, Eileen; Elia, Marinos

    2007-12-01

    It is unclear whether the rate of weight loss, independent of magnitude, affects whole body protein metabolism and the synthesis and plasma concentrations of specific hepatic secretory proteins. We examined 1) whether lean men losing weight rapidly (starvation) show greater changes in whole body protein kinetics, synthesis, and circulating concentrations of selected hepatic secretory proteins than those losing the same amount of weight more slowly [very low energy diet (VLED)]; and 2) whether plasma concentrations and synthetic rates of these proteins are related. Whole body protein kinetics were measured using [1-(13)C]leucine in 11 lean men (6 starvation, 5 VLED). Fractional and absolute synthetic rates of HDL-apolipoprotein A1 (apoA1), retinol binding protein, transthyretin, alpha(1)-antitrypsin (alpha(1)-AT), and transferrin were measured using a prime-constant intravenous infusion of [(13)C(2)]glycine. Compared with VLED group, the starvation group showed greater increases (at a 5% weight loss) in whole body protein oxidation (P < 0.05); fractional synthetic rates of HDL-apoA1 (25.3 vs. -1.52%; P = 0.003) and retinol binding protein (30.6 vs. 7.1%; P = 0.007); absolute synthetic rates of HDL-apoA1 (7.1 vs. -3.8 mg.kg(-1).day(-1); P = 0.003) and alpha(1)-AT (17.8 vs. 3.6 mg.kg(-1).day(-1); P = 0.02); and plasma concentration of alpha(1)-AT (P = 0.025). Relationships between synthetic rates and plasma concentrations varied between the secreted proteins. It is concluded that synthetic rates of hepatic secreted proteins in lean men are more closely related to the rate than the magnitude of weight loss. Changes in concentration of these secreted proteins can occur independently of changes in synthetic rates, and vice versa.

  20. Observed changes in cardiovascular risk factors among high-risk middle-aged men who received lifestyle counselling: a 5-year follow-up

    PubMed Central

    Siren, Reijo; Eriksson, Johan G.; Vanhanen, Hannu

    2016-01-01

    Objective To examine the long-term impact of health counselling among middle-aged men at high risk of CVD. Design An observational study with a 5-year follow-up. Setting and intervention All men aged 40 years in Helsinki have been invited to a visit to evaluate CVD risk from 2006 onwards. A modified version of the North Karelia project risk tool (CVD risk score) served to assess the risk. High-risk men received lifestyle counselling based on their individual risk profile in 2006 and were invited to a follow-up visit in 2011. Subjects Of the 389 originally high-risk men, 159 participated in the follow-up visits in 2011. Based on their follow-up in relation the further risk communication, we divided the participants into three groups: primary health care, occupational health care and no control visits. Main outcome measures Lifestyle and CVD risk score change. Results All groups showed improvements in lifestyles. The CVD risk score decreased the most in the group that continued the risk communication visits in their primary health care centre (6.1 to 4.8 [95% CI −1.6 to −0.6]) compared to those who continued risk communication visits in their occupational health care (6.0 to 5.4 [95% CI −1.3 to 0.3]), and to those with no risk communication visits (6.0 to 5.9 [95% CI −0.5 to 0.4]). Conclusions These findings indicate that individualized lifestyle counselling improves health behaviour and reduces total CVD risk among middle-aged men at high risk of CVD. Sustained improvement in risk factor status requires ongoing risk communication with health care providers. KEY POINTSStudies of short duration have shown that lifestyle changes reduce the risk of cardiovascular disease among high-risk individuals.Sustaining these lifestyle changes and maintaining the lower disease risk attained can prove challenging.Cardiovascular disease (CVD) risk assessment and individualized health counselling for high-risk men, when implemented in primary health care, have the potential

  1. Strategies for promoting HIV testing uptake: willingness to receive couple-based and collective HIV testing among a cross-sectional online sample of men who have sex with men in China.

    PubMed

    Wei, Chongyi; Muessig, Kathryn E; Bien, Cedric; Yang, Ligang; Meng, Roger; Han, Larry; Yang, Min; Tucker, Joseph D

    2014-09-01

    Low rates of HIV testing drive the rapidly growing HIV epidemic among men who have sex with men (MSM) in China. We examined the potential usefulness of couple-based and collective HIV testing strategies among Chinese MSM. A cross-sectional online survey was conducted among 1113 MSM in 2013. Multivariable logistic regression analyses were conducted to identify factors associated with willingness to receive couple-based and collective testing. Acceptability of couple-based testing was very high among participants (86.1%), with a moderate level of interest in collective testing (43.2%). Being 'out' to others about one's sexual identity (adjusted OR (AOR)=1.48, 95% CI 1.01 to 2.17) and having ever had an HIV test (AOR=3.05, 95% CI 2.10 to 4.33) were associated with willingness to receive couple-based testing. Having multiple male anal sex partners in the past 3 months was associated with willingness to participate in collective testing (AOR=1.43, 95% CI 1.03 to 1.99). Couple-based and collective HIV testing could help better control the HIV epidemic among Chinese MSM if implemented and promoted in a culturally competent manner. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Hepatitis C

    MedlinePlus

    ... a mother who had hepatitis C Received a tattoo or acupuncture with needles that were not disinfected ... is very low with practitioners who have a tattoo license or permit or an acupuncture license) Received ...

  3. Epidemiology of human immunodeficiency virus, viral hepatitis (B and C), treponema pallidum, and human T-cell lymphotropic I/II virus among men who have sex with men in Buenos Aires, Argentina.

    PubMed

    Pando, María A; Bautista, Christian T; Maulen, Sergio; Duranti, Ricardo; Marone, Ruben; Rey, Jorge; Vignoles, Moira; Eirin, Maria E; Biglione, Mirna M; Griemberg, Gloria; Montano, Silvia M; Carr, Jean K; Sanchez, José L; Avila, María M

    2006-05-01

    Human immunodeficiency virus (HIV) and sexually transmitted infections (STI) are prevalent among men who have sex with men (MSM). To estimate the prevalence of HIV and STIs in this group. A total of 694 MSM were tested for HIV, hepatitis B (HBV), hepatitis C (HCV), human T-cell lymphotropic (HTLV-I/II) viruses and Treponema pallidum infection. HIV, HBV, and T pallidum were detected in 13.8%, 37.7%, and 16.9% of subjects, respectively. Prevalences of 1.9% and 0.3% were detected for HCV and HTLV-I/II. A prior history of STI was the most predictor for HIV, HBV, and T pallidum. Use of illegal drugs, blood transfusion history, and multiple sexual partners were associated with HCV. The 2 most common co-infections were HBV/T pallidum and HIV/HBV. Infection with HIV, HBV, and T pallidum was elevated among MSM. Routine testing, education, vaccine-based prevention, and control programs need to be implemented in this high-risk population.

  4. Sexual Behavior of Heterosexual Men and Women Receiving Antiretroviral Pre-Exposure Prophylaxis for HIV Prevention: A Longitudinal Analysis

    PubMed Central

    Mugwanya, Kenneth K.; Donnell, Deborah; Celum, Connie; Thomas, Katherine K.; Ndase, Patrick; Mugo, Nelly; Katabira, Elly; Ngure, Kenneth; Baeten, Jared M.

    2013-01-01

    Background Limited data are available to assess sexual behavior by persons using antiretroviral pre-exposure prophylaxis (PrEP) for HIV prevention. Increased sexual risk taking by persons using effective HIV prevention strategies, like PrEP, could offset HIV prevention benefits. Methods The Partners PrEP Study, a randomized, placebo-controlled trial of daily oral PrEP among heterosexual HIV-uninfected members of HIV serodiscordant couples, publicly reported efficacy for HIV prevention in July 2011 and participants continued monthly follow-up thereafter. We used regression analyses to compare the frequency of sex unprotected by a condom during the 12 months after compared to before July 2011 to assess whether knowledge of PrEP efficacy for HIV prevention resulted in increased sexual risk behavior. Results We analyzed 56, 132 person-months from 3024 HIV-uninfected subjects (64% male). The average frequency of unprotected sex with the HIV-infected study partner was 59 per 100 person-months pre- versus 53 post-unblinding, reflecting no immediate change or change over time after July 2011 (p=0·66 and 0·25, respectively). There was a statistically significant increase in unprotected sex with outside partners over time after July 2011 but the effect was modest (average of 6.8 unprotected sex acts per year versus 6.2 acts in a predicted counterfactual scenario had unblinding not occurred, p=0·04). Compared to pre-July 2011, there was no significant increase in incident sexually transmitted infections or pregnancy after July 2011. Interpretation The transition from a blinded, placebo-controlled efficacy trial to all participants aware they were receiving active, efficacious PrEP in the Partners PrEP Study provided a “natural experiment” to evaluate sexual risk compensation. PrEP, provided as part of a comprehensive prevention package, may not result in substantial changes in risk-taking sexual behavior for heterosexual couples. PMID:24139639

  5. Perceptions of the PrePex Device Among Men Who Received or Refused PrePex Circumcision and People Accompanying Them

    PubMed Central

    Taruberekera, Noah; Martinson, Neil; Lebina, Limakatso

    2016-01-01

    Background: The PrePex medical male circumcision (MMC) device has been approved for MMC scale-up. However, the WHO has recommended that a country-specific situation analysis should be carried out before MMC device rollout. Method: A cross-sectional survey was conducted over 12 months in 3 MMC clinics, by trained nurses and researchers, to ascertain attitudes toward PrePex MMC in 3 groups: men consenting for PrePex MMC (PrePex recipients), people accompanying men, and adolescents coming for either PrePex or surgical circumcision (MMC escorts) and men refusing the PrePex device MMC (PrePex rejecters). All participants received information on surgical and the PrePex device MMC methods. Results: A total of 312 PrePex recipients, 117 MMC escorts, and 21 PrePex rejecters were recruited into the study. Ninety-nine percent of PrePex recipients thought that their expectations (safe, convenient, minimal pain) were met, and they were pleased with cosmetic outcome. Fifty-nine percent of PrePex rejecters opted for surgical circumcision because they perceived PrePex to be novel and risky. All 3 groups of participants were concerned about odor, dead skin, discomfort, healing time, and wound care. Ninety-eight percent of MMC escorts, 99% of PrePex recipient, and 81% of PrePex rejecters perceived PrePex circumcision as an acceptable option for South African MMC programmes. Conclusions: This acceptability study suggests that PrePex MMC is considered safe and convenient and could be incorporated into existing MMC programmes. Concerns about odor, pain, wound care, and healing time suggest that the need for more research to further optimize methods and that MMC clients should be counseled on available methods to enable them to choose among options based on their preferences. PMID:27331596

  6. Controlling behaviours and technology‐facilitated abuse perpetrated by men receiving substance use treatment in England and Brazil: Prevalence and risk factors

    PubMed Central

    Canfield, Martha; Radcliffe, Polly; D'Oliveira, Ana Flavia Pires Lucas

    2017-01-01

    Abstract Introduction and Aims Controlling behaviours are highly prevalent forms of non‐physical intimate partner violence (IPV). The prevalence of perpetrating controlling behaviours and technology‐facilitated abuse (TFA) was compared by men receiving substance use treatment in England (n = 223) and Brazil (n = 280). Factors associated with perpetrating these behaviours towards their current/most recent partner and their association with other types of IPV were explored. Design and Methods Secondary analysis from two cross‐sectional studies was performed. Data on socio‐demographic characteristics, infidelity, IPV perpetration and victimisation, adverse childhood experiences (ACE), attitudes towards gender relations and roles, substance use, depressive symptoms and anger expression were collected. Results Sixty‐four percent (143/223) and 33% (73/223) of participants in England and 65% (184/280) and 20% (57/280) in Brazil reported controlling behaviours and TFA, respectively, during their current/most recent relationship. Excluding IPV victimisation from the multivariate models; perpetrating controlling behaviours was associated with a higher number of ACE, higher anger expression (England) and severe physical IPV perpetration (Brazil), and perpetrating TFA was associated with younger age. Including both IPV victimisation and perpetration in the multivariate models; perpetrating controlling behaviour was associated with experiencing a higher number of ACE, higher anger expression (England), emotional IPV victimisation (England) and experiencing controlling behaviour from a partner (England). The perpetration of TFA was associated with younger age and experiencing TFA from a partner. Conclusions Technological progress provides opportunities for perpetrators to control and abuse their partners. Controlling behaviours and TFA should be addressed to reduce IPV perpetration by males in substance use treatment. [Gilchrist G, Canfield M,Radcliffe P, d

  7. Effect of different types of smoking and synergism with Hepatitis C virus on risk of hepatocellular carcinoma in American men and women: Case-control study

    PubMed Central

    Hassan, Manal M.; Spitz, Margaret R.; Thomas, Melanie B.; El-Deeb, Adel S.; Glover, Katrina Y.; Nguyen, Nga T.; Chan, Wenyaw; Kaseb, Ahmed; Curley, Steven A.; Vauthey, Jean-Nicolas; Ellis, Lee M.; Abdalla, Eddie; Lozano, Richard D.; Patt, Yehuda Z.; Brown, Thomas D.; Abbruzzese, James L.; Li, Donghui

    2009-01-01

    The International Agency for Research on Cancer has declared smoking to be a risk factor for hepatocellular carcinoma (HCC). However, passive exposure to cigarette smoke and use of noncigarette tobacco products on the risk of HCC has not been examined. Therefore, we evaluated the independent effects of different types of smoking exposure along with multiple risk factors for HCC and determined whether the magnitude of smoking was modified by other risk factors in men and women. We conducted a case-control study at The University of Texas M. D. Anderson Cancer Center where 319 HCC patients and 1,061 healthy control subjects were personally interviewed for several HCC risk factors. Multivariate logistic regression analysis was performed to estimate the adjusted odds ratio (AOR) and 95% confidence interval (CI) for each potential risk factor. Use of smokeless tobacco (chewing tobacco and snuff), cigars, pipes and passive smoking exposure were not related to HCC among noncigarette smokers. However, regular cigarette smoking was associated with HCC in men: AOR, 1.9 (95% CI, 1.1–3.1). Heavy alcohol consumption was associated with HCC in women: AOR, 7.7 (95% CI, 2.3–25.1). Cigarette smoking interacted synergistically with chronic infection of hepatitis C virus in men: AOR, 136.3 (95% CI, 43.2–429.6) and with heavy alcohol consumption in women: AOR, 13.7 (95% CI, 3.2–57.9). We conclude that sex differences were observed in HCC relationship with cigarette smoking and alcohol consumption. Controlling for smoking exposure might be a prudent approach to the prevention of HCC, especially in patients with chronic viral hepatitis infections. PMID:18688864

  8. Clinical course of chronic hepatitis B patients receiving nucleos(t)ide analogues after virological breakthrough during monotherapy with lamivudine.

    PubMed

    De Francesco, Maria Antonia; Gargiulo, Franco; Spinetti, Angiola; Zaltron, Serena; Giagulli, Cinzia; Caccuri, Francesca; Castelli, Francesco; Caruso, Arnaldo

    2015-01-01

    Little is known about the optimal management of patients with chronic hepatitis B (CHB) who develop drug resistance. The aim of this study was to investigate the effectiveness of different drug regimens in chronically HBV-infected patients. HBV viral load was determined using a bDNA assay and the substitutions in HBV-DNA were studied by polymerase sequencing test. The study involved 38 patients who experienced a therapeutic failure to lamivudine (LAM). The sequential treatments used were: LAM + adefovir (ADV), LAM + tenofovir (TDF), entecavir (ETV) monotherapy, ADV monotherapy and TDF monotherapy. Similar activity against HBV replication was observed with all drug regimens. Of the patients treated with LAM, 44% developed resistance mutations. The rt M204I mutation was observed more frequently. Sequential ADV add-on LAM and TDF therapy induced the appearance of resistance in 3/18 (16.6%) and in 1/8 (5.5%) treated patients, respectively. Genotype D was the most prevalent (78.9%), followed by genotype A (13%), genotype E (5.2%) and genotype C (2.6%). Our study showed that baseline serum HBV DNA is an important predictor of virologic response and that virologic breakthrough is significantly associated with the insurgence of genotypic resistance.

  9. Short-term response to a booster dose of hepatitis B vaccine in anti-HBs negative adolescents who had received primary vaccination 16 years ago.

    PubMed

    Wang, Li-Yu; Lin, Hans Hsienhong

    2007-10-10

    We conducted a revaccination study to investigate the short-term response to booster hepatitis B (HB) vaccination in seronegative adolescents who had received primary infantile HB vaccination. A booster dose of recombinant HB vaccine was administered to 395 adolescents 15-18 years of age whose serum titers of antibody against hepatitis B surface antigen (HBsAg) (anti-HBs) were <10 mIU/mL. Seventy-seven percent of the booster recipients converted to anti-HBs seropositivity (postbooster titers> or =10 mIU/mL). As compared with adolescents who had undetectable prebooster anti-HBs titers (<0.1 mIU/mL), the seropositive rates and geometric mean titers (GMTs) of 2-month and 1-year postbooster were significantly higher for those of prebooster titers of 0.1-0.9 and 1.0-9.9 mIU/mL (all p<0.0001). Postbooster titers declined significantly more rapidly for those with undetectable prebooster anti-HBs titers than for those with prebooster titers of 0.1-0.9 and 1.0-9.9 mIU/mL. Our observations indicate that a booster dose of HB vaccine maybe unable to induce sufficient immunological response in adolescents who had undetectable residual anti-HBs titers.

  10. Hepatitis B Reactivation in a HBsAg-Negative, HBcAb-Positive Patient Receiving Fludarabine for the Treatment of Chronic Lymphocytic Leukaemia.

    PubMed

    Toscanini, Federica; De Leo, Pasqualina; Calcagno, Giuseppe; Malfatti, Federica; Grasso, Alessandro; Anselmo, Marco

    2011-01-01

    Hepatitis B virus (HBV) reactivation is an increasingly recognized cause of morbidity and mortality in patients undergoing chemotherapy. In haematology, the risk of reactivation of B hepatitis among HBsAg-positive patients has been documented; therefore, use of lamivudine prophylaxis is recommended before starting chemotherapy. Differently, for HBsAg-negative patients with markers of previous HBV infection (i.e., presence of isolated anti-HBc positivity) (anticore patients) management strategies are not univocal. We describe a rare case of HBV reactivation in an anticore patient after fludarabine therapy for chronic lymphocytic leukaemia. The patient fully recovered after a 6-month course of lamivudine with persistent HBV-DNA clearance and loss of HBsAg. The most important feature of this case is that fludarabine alone infrequently determines HBV reactivation, especially in anticore patients. Therefore, we suggest that patients candidates to receive fludarabine therapy should be considered for lamivudine prophylaxis, not only if HBsAg-positive, but even if anticore-positive only.

  11. American Society of Clinical Oncology provisional clinical opinion: chronic hepatitis B virus infection screening in patients receiving cytotoxic chemotherapy for treatment of malignant diseases.

    PubMed

    Artz, Andrew S; Somerfield, Mark R; Feld, Jordan J; Giusti, Andrew F; Kramer, Barnett S; Sabichi, Anita L; Zon, Robin T; Wong, Sandra L

    2010-07-01

    PURPOSE An American Society of Clinical Oncology (ASCO) provisional clinical opinion (PCO) offers timely clinical direction to ASCO's membership following publication or presentation of potentially practice-changing information. This PCO addresses recommendations for chronic hepatitis B virus (HBV) infection screening in patients receiving cytotoxic or immunosuppressive chemotherapy for treatment of malignant diseases. The Centers for Disease Control and Prevention (CDC) issued Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection, recommending screening for hepatitis B infection (hepatitis B surface antigen [HBsAg], antihepatitis B core antigen [anti-HBc], and antibodies to HBsAg [anti-HBs]) for "persons receiving cytotoxic or immunosuppressive therapy (eg, chemotherapy for malignant diseases...)." The evidence is insufficient to determine the net benefits and harms of routine screening for chronic HBV infection in individuals with cancer who are about to receive cytotoxic or immunosuppressive therapy or who are already receiving therapy. Individuals with cancer who undergo certain cytotoxic or immunosuppressive therapies and have HBV infection or prior exposure to HBV may be at elevated risk of liver failure from HBV reactivation. As such, HBV screening requires clinical judgment. Physicians may consider screening patients belonging to groups at heightened risk for chronic HBV infection or if highly immunosuppressive therapy is planned. Highly immunosuppressive treatments include, but are not limited to, hematopoietic cell transplantation and regimens including rituximab. Screening based on a high risk of prior HBV exposure or risk of reactivation due to planned therapeutic regimens should include testing for HBsAg as a serologic marker for HBV infection. In some populations, testing for anti-HBc should also be considered. There is no evidence to support serologic testing for anti-HBs in this context

  12. Protective Immunity to Hepatitis B and Streptococcus Pneumoniae in Active Duty Women Versus Men: Prevalence and Responses to Preventive Immunization

    DTIC Science & Technology

    1996-04-01

    corticosteroids, autoimmune diseases such as systemic lupus erythematosus, prior hepatitis B infection or any active systemic infectious disease. Each study...19), and 23F (23) ( Danish classification system used worldwide with U.S. system notation in parentheses if different). Those subjects identified

  13. Hepatic steatosis in HIV-HCV coinfected patients receiving antiretroviral therapy is associated with HCV-related factors but not antiretrovirals.

    PubMed

    Martinez, Valrie; Ta, Thi Dieu Ngan; Mokhtari, Zahra; Guiguet, Marguerite; Miailhes, Patrick; Valantin, Marc-Antoine; Charlotte, Frderic; Bertheau, Philippe; Molina, Jean-Michel; Katlama, Christine; Caumes, Eric

    2012-07-09

    In HIV and hepatitis C virus (HCV) coinfected patients, the role of antiretroviral therapy (ART) on hepatic steatosis (HS) remains controversial. HIV/HCV coinfected patients receiving ART and previously untreated for HCV who underwent a liver biopsy were included. Cumulative duration of exposure to each antiretroviral was recorded up to liver biopsy date. Logistic regression analyses evaluated factors associated with steatosis and its severity. 184 patients were included: median age 41 years, 84% male, 89% Caucasian, 61% with a past history of intravenous drug use. HCV genotypes were 1 (55%), 2 (6%), 3 (26%), and 4 (13%). Median HCV-RNA was 6.18 log10 IU/ml. HIV-RNA was undetectable (<400 copies/ml) in 67% of patients. Median CD4 count was 321/mm3. All patients had been exposed to nucleoside reverse transcriptase inhibitors (median cumulative exposure 56 months); 126 received protease inhibitors (23 months), and 79 non-nucleoside reverse transcriptase inhibitors (16 months). HS was observed in 102 patients (55%): 41% grade 1; 5% grade 2, and 9% grade 3. In multivariate analysis, HCV genotype 3 and HCV viral load were moderately associated with mild steatosis but strongly with grade 2-3 steatosis. After adjustment for the period of biopsy, no association was detected between HS and exposure to any antiretroviral class or drug, or duration of ART globally or comparing genotype 3 to others. Among our ART-treated HIV-HCV cohort predominantly infected with genotype 1, 55% of patients had HS which was associated with HCV-related factors, but not ART class or duration of exposure.

  14. Risk Assessment of Hepatocellular Carcinoma Using Transient Elastography Vs. Liver Biopsy in Chronic Hepatitis B Patients Receiving Antiviral Therapy

    PubMed Central

    Seo, Yeon Seok; Kim, Mi Na; Kim, Seung Up; Kim, Sang Gyune; Um, Soon Ho; Han, Kwang-Hyub; Kim, Young Seok

    2016-01-01

    Abstract Liver stiffness (LS) assessed using transient elastography (TE) can assess the risk of developing hepatocellular carcinoma (HCC). We evaluated whether TE, when compared with histological data as a reference standard, can predict the risk of HCC development in chronic hepatitis B (CHB) patients starting antiviral therapy. Observational cohort database of 381 patients with CHB who underwent liver biopsy (LB) and TE were reviewed. All patients underwent surveillance for HCC development using ultrasonography and alpha-fetoprotein. During the median follow-up period of 48.1 (interquartile range 30.3–69.3) months, HCC developed in 34 (8.9%) patients. In patients with HCC development, age, proportion of diabetes mellitus, histological fibrosis stage, and LS value were significantly higher than those in patients without (all P <0.05). The cumulative incidence rates of HCC increased significantly in association with elevated LS value in 3 stratified groups (LS value <8, 8–13, and >13 kPa; log-rank test, P <0.001), and with higher histological fibrosis stage in 3 stratified groups (F0–2, F3, and F4; log-rank test, P <0.001). On multivariate analysis, along with age, LS value was an independent predictor of HCC development (hazard ratio 1.041, P <0.001), whereas histological staging was not (P >0.05). TE predicted HCC development independently in patients with CHB starting antiviral therapy. However, further investigation is needed to determine whether the current surveillance strategy can be optimized based on the LS value at the time of starting antiviral therapy. PMID:27015173

  15. Persistent Neurocognitive Decline in a Clinic Sample of Hepatitis C Virus-infected Persons Receiving Interferon and Ribavirin Treatment

    PubMed Central

    Cattie, Jordan E.; Letendre, Scott L.; Woods, Steven Paul; Barakat, Fatma; Perry, William; Cherner, Mariana; Umlauf, Anya; Franklin, Donald; Heaton, Robert K.; Hassanein, Tarek; Grant, Igor

    2015-01-01

    Treatment of Hepatitis C virus (HCV) with pegylated interferon and ribavirin (IFN/RBV) can be associated with neuropsychiatric side effects, which may necessitate dose reductions or treatment discontinuation. This study aimed to characterize the time course and predictors of cognitive and affective/mood symptoms after IFN/RBV treatment initiation. Forty individuals enrolled in a longitudinal project underwent comprehensive cognitive, medical, and psychiatric assessment at baseline and 10 weeks, 6 months, 12 months, and 18 months after treatment initiation. Analyses were conducted to determine the prevalence of neurocognitive impairment over time, explicate the relationship between neurocognitive impairment, neuropsychiatric symptoms, and liver disease at each time point, and identify predictors of neurocognitive decline as well as cognitive effects of viral clearance. By 10 weeks after initiating IFN/RBV, the prevalence of neurocognitive impairment rose from 22.5% to 47.4% (p < 0.05). Infection with Genotype 1 and premorbid depression were associated with more severe declines (p < 0.05). After 18 months, 42.5% remained neurocognitively impaired, independent of viral clearance, severity of liver disease, and current depressive symptoms. Undetectable viral load was not associated with improvement 18 months after initiating treatment (p > .10). Results of the current study indicate that IFN/RBV treatment-emergent neurocognitive declines are significant, prevalent, and may persist long after treatment cessation. Clinicians should monitor cognition throughout the course of treatment for HCV, noting that early declines may indicate individuals at elevated risk for persistent neurocognitive impairment. Longer-term studies are needed to determine whether lasting declines may remit over longer intervals. PMID:25326107

  16. Persistent neurocognitive decline in a clinic sample of hepatitis C virus-infected persons receiving interferon and ribavirin treatment.

    PubMed

    Cattie, Jordan E; Letendre, Scott L; Woods, Steven Paul; Barakat, Fatma; Perry, William; Cherner, Mariana; Umlauf, Anya; Franklin, Donald; Heaton, Robert K; Hassanein, Tarek; Grant, Igor

    2014-12-01

    Treatment of hepatitis C virus (HCV) with pegylated interferon and ribavirin (IFN/RBV) can be associated with neuropsychiatric side effects, which may necessitate dose reductions or treatment discontinuation. This study aimed to characterize the time course and predictors of cognitive and affective/mood symptoms after IFN/RBV treatment initiation. Forty individuals enrolled in a longitudinal project underwent comprehensive cognitive, medical, and psychiatric assessment at baseline and 10 weeks, 6 months, 12 months, and 18 months after treatment initiation. Analyses were conducted to determine the prevalence of neurocognitive impairment over time; explicate the relationship between neurocognitive impairment, neuropsychiatric symptoms, and liver disease at each time point; and identify predictors of neurocognitive decline as well as cognitive effects of viral clearance. By 10 weeks after initiating IFN/RBV, the prevalence of neurocognitive impairment rose from 22.5 to 47.4% (p < 0.05). Infection with genotype 1 and premorbid depression were associated with more severe declines (p < 0.05). After 18 months, 42.5% remained neurocognitively impaired, independent of viral clearance, severity of liver disease, and current depressive symptoms. Undetectable viral load was not associated with improvement 18 months after initiating treatment (p > 0.10). Results of the current study indicate that IFN/RBV treatment-emergent neurocognitive declines are significant, prevalent, and may persist long after treatment cessation. Clinicians should monitor cognition throughout the course of treatment for HCV, noting that early declines may indicate individuals at elevated risk for persistent neurocognitive impairment. Longer-term studies are needed to determine whether lasting declines may remit over longer intervals or with newer direct acting agents.

  17. Sexually transmitted diseases in men.

    PubMed

    Phillips, Kenneth D; Dudgeon, Wesley D; Becker, Joel; Bopp, Christopher M

    2004-06-01

    increased risk for contracting HIV. Another important consideration at the periodic screening examination is the vaccinations that are to be recommended. Men who have sex with men should receive hepatitis A and hepatitis B vaccine. Additionally, it is recommended that all adolescents should receive hepatitis B vaccine.

  18. Hepatitis C Screening Rate Among Underserved Adults With Serious Mental Illness Receiving Care in California Community Mental Health Centers.

    PubMed

    Trager, Evan; Khalili, Mandana; Masson, Carmen L; Vittinghoff, Eric; Creasman, Jennifer; Mangurian, Christina

    2016-04-01

    Although HCV is more prevalent among people with severe mental illness (SMI; e.g., schizophrenia, bipolar disorder) than in the general population (17% vs 1%), no large previous studies have examined HCV screening in this population. In this cross-sectional study, we examined administrative data for 57 170 California Medicaid enrollees with SMI to identify prevalence and predictors of HCV screening from October 2010 through September 2011. Only 4.7% (2674 of 57 170) received HCV screening, with strongest predictors being nonpsychiatric health care utilization and comorbid substance abuse.

  19. High Prevalence and High Incidence of Coinfection with Hepatitis B, Hepatitis C, and Syphilis and Low Rate of Effective Vaccination against Hepatitis B in HIV-Positive Men Who Have Sex with Men with Known Date of HIV Seroconversion in Germany

    PubMed Central

    Jansen, Klaus; Thamm, Michael; Bock, Claus-Thomas; Scheufele, Ramona; Kücherer, Claudia; Muenstermann, Dieter; Hagedorn, Hans-Jochen; Jessen, Heiko; Dupke, Stephan; Hamouda, Osamah; Gunsenheimer-Bartmeyer, Barbara; Meixenberger, Karolin

    2015-01-01

    Objectives Men who have sex with men (MSM) are at higher risk for coinfection with hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis than the general population. HIV infection and these coinfections accelerate disease progression reciprocally. This study evaluated the prevalence and incidence of these coinfections in HIV1-positive MSM in Germany. Materials and Methods As part of a nationwide, multicenter, prospective cohort study of HIV-infected MSM, plasma samples collected yearly were screened for HBsAg and antibodies to HBc, HBs, HCV, and syphilis. Samples with indications of active HBV or HCV infection were confirmed by polymerase chain reaction. Prevalence and incidence of each infection and incidence rates per study participant were calculated, and incidences over 4-year time intervals compared. Results This study screened 5,445 samples from 1,843 MSM. Median age at HIV seroconversion was 33 years. Prevalences of active, cleared, and occult HBV, and of active/cleared HCV were 1.7%, 27.1%, 0.2%, and 8.2%, respectively, and 47.5% had been effectively vaccinated against HBV. Prevalence of antibodies to Treponema pallidum and of triple or quadruple sexually transmitted infections (STIs) were 39.6% and 18.9%, respectively. Prevalence of STI, cleared HBV, HBV vaccination, and history of syphilis differed significantly among age groups. Incidences of HBV, HCV, and syphilis were 2.51, 1.54, and 4.06 per 100 person-years, respectively. Incidences of HCV and syphilis increased over time. HCV incidence was significantly higher in MSM coinfected with syphilis and living in Berlin, and syphilis incidence was significantly higher for MSM living in Berlin. Discussion Despite extensive HBV vaccination campaigns, fewer than 50% of screened MSM were effectively vaccinated, with a high proportion of HIV-positive MSM coinfected with HBV. High rates of STI coinfections in HIV-positive MSM and increasing incidences emphasize the need for better tailored campaigns for

  20. Controlling behaviours and technology-facilitated abuse perpetrated by men receiving substance use treatment in England and Brazil: Prevalence and risk factors.

    PubMed

    Gilchrist, Gail; Canfield, Martha; Radcliffe, Polly; D'Oliveira, Ana Flavia Pires Lucas

    2017-01-01

    Controlling behaviours are highly prevalent forms of non-physical intimate partner violence (IPV). The prevalence of perpetrating controlling behaviours and technology-facilitated abuse (TFA) was compared by men receiving substance use treatment in England (n = 223) and Brazil (n = 280). Factors associated with perpetrating these behaviours towards their current/most recent partner and their association with other types of IPV were explored. Secondary analysis from two cross-sectional studies was performed. Data on socio-demographic characteristics, infidelity, IPV perpetration and victimisation, adverse childhood experiences (ACE), attitudes towards gender relations and roles, substance use, depressive symptoms and anger expression were collected. Sixty-four percent (143/223) and 33% (73/223) of participants in England and 65% (184/280) and 20% (57/280) in Brazil reported controlling behaviours and TFA, respectively, during their current/most recent relationship. Excluding IPV victimisation from the multivariate models; perpetrating controlling behaviours was associated with a higher number of ACE, higher anger expression (England) and severe physical IPV perpetration (Brazil), and perpetrating TFA was associated with younger age. Including both IPV victimisation and perpetration in the multivariate models; perpetrating controlling behaviour was associated with experiencing a higher number of ACE, higher anger expression (England), emotional IPV victimisation (England) and experiencing controlling behaviour from a partner (England). The perpetration of TFA was associated with younger age and experiencing TFA from a partner. Technological progress provides opportunities for perpetrators to control and abuse their partners. Controlling behaviours and TFA should be addressed to reduce IPV perpetration by males in substance use treatment. [Gilchrist G, Canfield M,Radcliffe P, d'Oliveira AFPL. Controlling behaviours and technology-facilitated abuse perpetrated by

  1. Cognitive performance as a predictor of hepatic encephalopathy in pretransplant patients with cirrhosis receiving psychoactive medications: a prospective study.

    PubMed

    Bajaj, Jasmohan S; Thacker, Leroy R; Heuman, Douglas M; Sterling, Richard K; Stravitz, R Todd; Sanyal, Arun J; Luketic, Velimir; Fuchs, Michael; Gilles, Ho Chong S; Wade, James B

    2012-10-01

    Psychiatric disorders and medications may affect the cognitive performance of patients with cirrhosis and complicate the diagnosis and prediction of hepatic encephalopathy (HE). The aim of this study was to study the association of psychoactive medications with cognitive performance and their effects on the ability of tests to predict HE development in patients with cirrhosis referred for transplant evaluation. Cirrhosis details, psychiatric disorders, psychoactive medications, and any history of prior HE were recorded for patients with cirrhosis at 2 transplant centers. Patients were followed until the development of HE. Five cognitive tests--number connection test A (NCT-A), number connection test B, the digit symbol test (DST), the block design test, and the inhibitory control test (ICT)--were administered. A high lure score and a low ICT target score indicated poor performance. The cognitive performances of patients with psychiatric disorders/medications and patients without them were compared. A proportional hazards model was created with the time to HE as the outcome, and it was based on demographics, psychoactive medications, cirrhosis details, and individual cognitive scores. Patients with prior HE and patients without prior HE were then studied separately. One hundred fifty-five patients with a mean age of 57.5 ± 6.2 years and a mean Model for End-Stage Liver Disease (MELD) score of 15.1 ± 6.2 were included [prior HE, 48%; diabetes, 34%; selective serotonin reuptake inhibitors (SSRIs), 32%; opioids, 19%; and antipsychotics, 10%]. Prior HE and antipsychotics (but not opioids or diabetes) were associated with worse cognition. SSRI users had better NCT-A and DST performance. One hundred forty-eight patients were followed for a median of 182.5 days; 58 developed HE at a median of 99 days after inclusion. In the entire group, the model showed that prior HE (hazard ratio = 4.13), the MELD score (hazard ratio = 1.07), and a high lure score (hazard ratio = 1

  2. The prevalence and impact of thrombocytopenia, anaemia and leucopenia on sustained virological response in patients receiving hepatitis C therapy: evidence from a large 'real world' cohort.

    PubMed

    Wang, Huan; Innes, Hamish; Hutchinson, Sharon J; Goldberg, David J; Allen, Samuel; Barclay, Stephen T; Bramley, Peter; Fox, Raymond; Fraser, Andrew; Hayes, Peter C; Kennedy, Nicholas; Mills, Peter R; Dillon, John F

    2016-04-01

    The aim of the study was to explore the extent of thrombocytopenia (TCP), anaemia and leucopenia in patients with hepatitis C and evaluate how they impact the management of antiviral therapy, the attainment of sustained virological response (SVR), and some therapy-related adverse events. The Scottish Hepatitis C Clinical Database was used in this retrospective study. The prevalence of TCP, anaemia and leucopenia was evaluated. The impact of the three deficiencies on antiviral therapy management, serious adverse events and SVR attainment was assessed in patients who received therapy. The prevalence of TCP, anaemia and leucopenia was 18.5, 0.9 and 0.2% among 4907 treated patients at baseline, increasing to 72, 25.8 and 5.4% during treatment, respectively. Dose reduction occurred in 29.3% of the patients without TCP; this percentage was higher in those with baseline TCP (53%) and in those who acquired it during treatment (35%). Similar results were found for anaemia and leucopenia. Baseline TCP (odds ratio=0.67, P<0.001) and baseline anaemia (odds ratio=0.43, P=0.03) were identified as risk factors associated with lower SVR rate; acquired TCP and anaemia were not associated with reduced SVR. Baseline TCP or anaemia increased the risk of dose cessation. Patients who acquired TCP, anaemia or leucopenia during treatment did not exhibit compromised SVR rates, whereas patients with TCP or anaemia at baseline did. The potential benefit of growth factors in maintaining SVR rate is likely to be confined to those with baseline TCP or anaemia rather than to those who acquire it during therapy, where dose reduction does not appear to reduce the chance of SVR.

  3. T follicular helper cells and antibody response to Hepatitis B virus vaccine in HIV-1 infected children receiving ART.

    PubMed

    Bekele, Yonas; Yibeltal, Desalegn; Bobosha, Kidist; Andargie, Temesgen E; Lemma, Mahlet; Gebre, Meseret; Mekonnen, Eyasu; Habtewold, Abiy; Nilsson, Anna; Aseffa, Abraham; Howe, Rawleigh; Chiodi, Francesca

    2017-08-21

    HBV vaccine has 95% efficacy in children to prevent HBV infection and related cancer. We conducted a prospective study in HIV-1 infected children receiving ART (n = 49) and controls (n = 63) to assess humoral and cellular responses to HBV vaccine provided with three doses under an accelerated schedule of 4 weeks apart. At 1 month post-vaccination all children, except 4 HIV-1 infected, displayed protective antibody (ab) titers to HBV vaccine; ab titers were lower in infected children (P < 0.0001). Ab titers decreased (P < 0.0001) in both HIV-1 infected and control children at 6 months. The frequency of circulating Tfh (cTFh) cells was 20.3% for controls and 20.8% for infected children prior to vaccination and remained comparable post-vaccination. Cytokine expression by cTfh cells upon activation with HBV antigen was comparable in the two groups at baseline and 1 month post-vaccination. Higher plasma levels (P < 0.0001) of CXCL13 were found in infected children which correlated with cTfh cell frequency at baseline. In conclusion, a lower ab response to HBV vaccine was measured in HIV-1 infected children. The frequency and activation profile of cTfh cells was comparable in infected children and controls suggesting that cells other than Tfh cells are responsible for impaired ab response to HBV vaccine.

  4. Risk score model for the development of hepatocellular carcinoma in treatment-naïve patients receiving oral antiviral treatment for chronic hepatitis B.

    PubMed

    Sohn, Won; Cho, Ju-Yeon; Kim, Ji Hoon; Lee, Jung Il; Kim, Hyung Joon; Woo, Min-Ah; Jung, Sin-Ho; Paik, Yong-Han

    2017-06-01

    This study aimed to develop and validate a risk prediction model for the development of hepatocellular carcinoma (HCC) in treatment-naïve patients receiving oral antiviral treatment for chronic hepatitis B (CHB). We investigated 2,061 Korean treatment-naïve patients with CHB treated with entecavir as an initial therapy. A risk score model for HCC development was developed based on multivariable Cox regression model in a single center (n=990) and was validated using the time-dependent area under the receiver operating characteristic curve (AUROC) in three other centers (n=1,071). The difference of HCC development among risk groups (low, intermediate, and high) categorized by risk score was also investigated. The cumulative incidence rates of HCC at 5 years were 11.2% and 8.9% in the testing and validation cohorts, respectively. HCC-Risk Estimating Score in CHB patients Under Entecavir (HCC-RESCUE) is formulated as (age+15×gender [female=0 / male=1]+23×cirrhosis [absence=0 / presence=1]). The AUROCs at 1 year, 3 years, and 5 years were 0.82, 0.81, and 0.81, respectively, in the validation cohort. A significant difference of HCC development in each risk group was determined by the 5-year HCC risk score in the validation cohort (low risk group, 2.1%; intermediate risk group, 9.3%; high risk group, 41.2%, p<0.001). The study presents a new risk score model with a good ability to predict HCC development and determine high risk patients for HCC development consisting of readily available clinical factors in treatment-naïve CHB patients receiving entecavir.

  5. Early tumour response as a survival predictor in previously- treated patients receiving triplet hepatic artery infusion and intravenous cetuximab for unresectable liver metastases from wild-type KRAS colorectal cancer.

    PubMed

    Bouchahda, Mohamed; Boige, Valérie; Smith, Denis; Karaboué, Abdoulaye; Ducreux, Michel; Hebbar, Mohamed; Lepère, Céline; Focan, Christian; Guimbaud, Rosine; Innominato, Pasquale; Awad, Sameh; Carvalho, Carlos; Tumolo, Salvatore; Truant, Stephanie; De Baere, Thierry; Castaing, Denis; Rougier, Philippe; Morère, Jean-François; Taieb, Julien; Adam, René; Lévi, Francis

    2016-11-01

    Early tumour shrinkage has been associated with improved survival in patients receiving cetuximab-based systemic chemotherapy for liver metastases from colorectal cancer (LM-CRC). We tested this hypothesis for previously treated LM-CRC patients receiving cetuximab (500 mg/m(2)) and triplet hepatic artery infusion (HAI) within European trial OPTILIV. Irinotecan (180 mg/m(2)), 5-fluorouracil (2800 mg/m(2)) and oxaliplatin (85 mg/m(2)) were given as chronomodulated or conventional delivery. Patients were retrospectively categorised as early responders (complete or partial RECIST response after three courses) or non-early responders (late or no response). Prognostic factors were determined using multivariate logistic or Cox regression models. Response was assessed in 57 of 64 registered patients (89%), who had previously received one to three prior systemic chemotherapy protocols. An early response occurred at 6 weeks in 16 patients (28%; 9 men, 7 women), aged 33-76 years, with a median of 12 liver metastases (LMs) (2-50), involving five segments (1-8). Ten patients had a late response, and 31 patients had no response. Grade 3-4 fatigue selectively occurred in the non-early responders (0% versus 26%; p = 0.024). Early tumour response was jointly predicted by chronomodulation-odds ratio (OR): 6.0 (1.2-29.8; p = 0.029)-and LM diameter ≤57 mm-OR: 5.3 (1.1-25.0; p = 0.033). Early tumour response predicted for both R0-R1 liver resection-OR: 11.8 (1.4-100.2; p = 0.024) and overall survival-hazard ratio: 0.39 (0.17-0.88; p = 0.023) in multivariate analyses. Early tumour response on triplet HAI and systemic cetuximab predicted for complete macroscopic liver resection and prolonged survival for LM-CRC patients within a multicenter conversion-to-resection medicosurgical strategy. Confirmation is warranted for early response on HAI to guide decision making. Protocol numbers: EUDRACT 2007-004632-24 NCT00852228. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. The effect of 5α-reductase inhibitors on prostate growth in men receiving testosterone replacement therapy: a systematic review and meta-analysis.

    PubMed

    Cui, Yuanshan; Zong, Huantao; Yang, Chenchen; Yan, Huilei; Zhang, Yong

    2013-08-01

    Androgen replacement therapy is a widely accepted form of treatment worldwide for aging men with late-onset hypogonadism (LOH) syndrome. Urologists have been concerned with the use of androgen supplements due to the possibility of enhancing prostate growth. We performed a systematic review and meta-analysis to assess the effect of 5α-reductase inhibitors on prostate growth in men receiving testosterone replacement therapy. A literature review was performed to identify all published randomized placebo-controlled trials (RCT) that used exogenous testosterone combined with 5α-reductase inhibitor therapy for the treatment of hypogonadism. The search included the following databases: MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The reference lists of the retrieved studies were also investigated, and a systematic review and meta-analysis were conducted. Five publications involving a total of 250 patients were used in the analysis, including 4 RCTs that were short-term (≤6 mo) comparisons of testosterone plus a 5α-reductase inhibitor with testosterone plus placebo and 3 RCTs that were long-term (18-36 mo) comparisons of testosterone plus a 5α-reductase inhibitor with testosterone plus placebo. In our meta-analysis, we found that testosterone plus a 5α-reductase inhibitor may slow the progression of prostate growth. For the comparison of short-term testosterone plus 5α-reductase inhibitor treatment with testosterone plus placebo therapy, the prostate-specific antigen (PSA) level (the standardized mean difference (SMD) = -0.24, 95 % confidence interval (CI) = -0.45 to 0.04, p = 0.02)) and the prostate volume (SMD = -1.66, 95 % CI = -4.54 to 1.22, p = 0.26) indicated that, compared with testosterone plus placebo therapy, the testosterone plus 5α-reductase inhibitor may decrease the PSA level. For the comparison of long-term testosterone plus 5α-reductase inhibitor with testosterone plus placebo, the PSA level (SMD = -0.53, 95 % CI = -0.84 to 0

  7. Dose-response association between hepatitis B surface antigen levels and liver cancer risk in Chinese men and women.

    PubMed

    Yang, Yang; Gao, Jing; Li, Hong-Lan; Zheng, Wei; Yang, Gong; Zhang, Wei; Ma, Xiao; Tan, Yu-Ting; Rothman, Nathaniel; Gao, Yu-Tang; Chow, Wong-Ho; Shu, Xiao-Ou; Xiang, Yong-Bing

    2016-07-15

    We aimed at evaluating the risk of liver cancer in different levels of HBsAg among Chinese men and women. We carried out a nested case-control study including 363 cases and 3,511 controls in two population-based cohorts in Shanghai. Plasma samples collected at enrollment were quantified for HBsAg levels using the Architect QT assay. Conditional logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for liver cancer, with adjustment for potential confounders. HBsAg was detected in 6.29% of control subjects overall (7.02% in men and 4.98% in women). HBsAg levels were positively associated with liver cancer risk in a dose-response manner (ptrend  < 0.001). Such association showed a significant gender disparity. With increasing levels of HBsAg, liver cancer risks rose more steeply in men than in women. In men, the adjusted ORs increased from 7.27 (95% CI: 3.49-15.15) at the lowest detectable level of HBsAg (5-9 IU/ml) to 7.16 (95% CI: 3.21-15.96), 34.30 (95% CI: 16.94-69.44), and 47.33 (95% CI: 23.50-95.34) at the highest level of HBsAg (≥1,000 IU/ml) compared to those negative for HBsAg. The corresponding ORs were much lower for women, from 1.37 (95% CI: 0.25-7.47), 3.81 (95% CI: 1.09-13.28), 7.36 (95% CI: 2.41-22.46) and 16.86 (95% CI: 7.24-39.27), respectively. HBsAg quantification has potential to distinguish individuals at different risks of liver cancer. Men with the lowest detectable level of HBsAg should still pay attention to their liver cancer risks, but those with a higher level may be given a higher priority in future liver cancer surveillance program.

  8. Can Hepatitis C Virus (HCV) Direct-Acting Antiviral Treatment as Prevention Reverse the HCV Epidemic Among Men Who Have Sex With Men in the United Kingdom? Epidemiological and Modeling Insights

    PubMed Central

    Martin, Natasha K.; Thornton, Alicia; Hickman, Matthew; Sabin, Caroline; Nelson, Mark; Cooke, Graham S.; Martin, Thomas C. S.; Delpech, Valerie; Ruf, Murad; Price, Huw; Azad, Yusef; Thomson, Emma C.; Vickerman, Peter

    2016-01-01

    Background. We report on the hepatitis C virus (HCV) epidemic among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) in the United Kingdom and model its trajectory with or without scaled-up HCV direct-acting antivirals (DAAs). Methods. A dynamic HCV transmission model among HIV–diagnosed MSM in the United Kingdom was calibrated to HCV prevalence (antibody [Ab] or RNA positive), incidence, and treatment from 2004 to 2011 among HIV-diagnosed MSM in the UK Collaborative HIV Cohort (UK CHIC). The epidemic was projected with current or scaled-up HCV treatment, with or without a 20% behavioral risk reduction. Results. HCV prevalence among HIV-positive MSM in UK CHIC increased from 7.3% in 2004 to 9.9% in 2011, whereas primary incidence was flat (1.02–1.38 per 100 person-years). Over the next decade, modeling suggests 94% of infections are attributable to high-risk individuals, comprising 7% of the population. Without treatment, HCV chronic prevalence could have been 38% higher in 2015 (11.9% vs 8.6%). With current treatment and sustained virological response rates (status quo), chronic prevalence is likely to increase to 11% by 2025, but stabilize with DAA introduction in 2015. With DAA scale-up to 80% within 1 year of diagnosis (regardless of disease stage), and 20% per year thereafter, chronic prevalence could decline by 71% (to 3.2%) compared to status quo in 2025. With additional behavioral interventions, chronic prevalence could decline further to <2.5% by 2025. Conclusions. Epidemiological data and modeling suggest a continuing HCV epidemic among HIV-diagnosed MSM in the United Kingdom driven by high-risk individuals, despite high treatment rates. Substantial reductions in HCV transmission could be achieved through scale-up of DAAs and moderately effective behavioral interventions. PMID:26908813

  9. Spontaneous viral clearance of hepatitis C virus (HCV) infection among people who inject drugs (PWID) and HIV-positive men who have sex with men (HIV+ MSM): a systematic review and meta-analysis.

    PubMed

    Smith, Daniel J; Jordan, Ashly E; Frank, Mayu; Hagan, Holly

    2016-09-05

    Hepatitis C virus (HCV) infection causes significant morbidity and mortality among people who inject drugs (PWID) and HIV+ men who have sex with men (MSM). Characterizing spontaneous viral clearance of HCV infection among PWID and HIV+ MSM is important for assessing the burden of disease and treatment strategies in these populations. Electronic and other searches of medical literature were conducted. Reports were eligible if they presented original data from upper-middle- and high-income countries on laboratory-confirmed HCV infection and spontaneous viral clearance among PWID or HIV+ MSM. Pooled estimates of spontaneous viral clearance were generated using fixed-effect and random-effects models. Meta-regression examined potential predictors related to individual characteristics and research methodology. The meta-analysis estimated that spontaneous viral clearance occurs in 24.4 % of PWID and 15.4 % of HIV+ MSM. In univariate meta-regression among PWID, male sex and age were significantly associated with spontaneous viral clearance, and in multivariate analysis, male sex and HIV positivity were predictors of spontaneous viral clearance; among HIV+ MSM no variables were found to affect spontaneous viral clearance. The variability in estimates of spontaneous viral clearance between HIV+ MSM and PWID suggests the impact of HIV co-infection and HCV re-infection. Due to limited data on additional factors that may affect the natural history of HCV, more research is needed to further understand spontaneous viral clearance in these risk groups. The protocols for the PWID and HIV+ MSM research were registered with PROSPERO (CRD42014008805; CRD42013006462).

  10. Prevalence, Risk Behaviors, and Virological Characteristics of Hepatitis B Virus Infection in a Group of Men Who Have Sex with Men in Brazil: Results from a Respondent-Driven Sampling Survey

    PubMed Central

    Oliveira, Marina P.; Matos, Márcia A. D.; Silva, Ágabo M. C.; Lopes, Carmen L. R.; Teles, Sheila A.; Matos, Marcos A.; Spitz, Natália; Araujo, Natalia M.; Mota, Rosa M. S.; Kerr, Ligia R. F. S.; Martins, Regina M. B.

    2016-01-01

    Background Men who have sex with men (MSM) are at increased risk of exposure to hepatitis B virus (HBV) compared with the general population. This study aims to assess the epidemiological and virological characteristics of HBV infection in a sample of MSM in Brazil, where data are scarce. Methods A cross-sectional study was conducted among MSM in the City of Goiânia, Central Brazil, from March to November 2014, using Respondent-Driven Sampling (RDS). After signing the consent form, participants were interviewed and a blood sample collected. All samples were tested for HBV serological markers and HBV DNA. HBV nucleotide sequence analysis was also performed. Results A total of 522 MSM were recruited in the study. The prevalence of HBV infection (current or past [presence of anti-HBc marker]) was 15.4% (95% CI: 8.7–25.8) and the rate of HBsAg carriers was 0.6% (95% CI: 0.2–1.6). About 40% (95% CI: 32.3–48.8) of the participants had serological evidence of previous HBV vaccination (reactive for isolated anti-HBs). In addition, 44.3% (95% CI: 36.1–52.9) were seronegative for all HBV markers. Age over 25 years old, receptive anal intercourse, previous sex with women, and history of sexually transmitted infections (STIs) were factors associated with HBV infection. HBV DNA was detected only in HBsAg-positive individuals. HBV isolates were classified into genotype A (subgenotypes A1 and A2), and some mutations were identified throughout the genome. Therefore, occult HBV infection was not observed in the study population. Conclusions Public health strategies should be improved for the MSM population in order to prevent HBV and other STIs, as well as to provide appropriate management of patients with active infections. PMID:27508385

  11. C-reactive protein-to-albumin ratio is a predictor of hepatitis B virus related decompensated cirrhosis: time-dependent receiver operating characteristics and decision curve analysis.

    PubMed

    Huang, Si-Si; Xie, Dong-Mei; Cai, Yi-Jing; Wu, Jian-Min; Chen, Rui-Chong; Wang, Xiao-Dong; Song, Mei; Zheng, Ming-Hua; Wang, Yu-Qun; Lin, Zhuo; Shi, Ke-Qing

    2017-04-01

    Hepatitis B virus (HBV) infection remains a major health problem and HBV-related-decompensated cirrhosis (HBV-DC) usually leads to a poor prognosis. Our aim was to determine the utility of inflammatory biomarkers in predicting mortality of HBV-DC. A total of 329 HBV-DC patients were enrolled. Survival estimates for the entire study population were generated using the Kaplan-Meier method. The prognostic values for model for end-stage liver disease (MELD) score, Child-Pugh score, and inflammatory biomarkers neutrophil/lymphocyte ratio, C-reactive protein-to-albumin ratio (CAR), and lymphocyte-to-monocyte ratio (LMR) for HBV-DC were compared using time-dependent receiver operating characteristic curves and time-dependent decision curves. The survival time was 23.1±15.8 months. Multivariate analysis identified age, CAR, LMR, and platelet count as prognostic independent risk factors. Kaplan-Meier analysis indicated that CAR of at least 1.0 (hazard ratio, 7.19; 95% confidence interval, 4.69-11.03), and LMR less than 1.9 (hazard ratio, 2.40; 95% confidence interval, 1.69-3.41) were independently associated with mortality of HBV-DC. The time-dependent receiver operating characteristic indicated that CAR showed the best performance in predicting mortality of HBV-DC compared with LMR, MELD score, and Child-Pugh score. The results were also confirmed by time-dependent decision curves. CAR and LMR were associated with the prognosis of HBV-DC. CAR was superior to LMR, MELD score, and Child-Pugh score in HBV-DC mortality prediction.

  12. Long-term tracking of hepatitis B viral load and the relationship with risk for hepatocellular carcinoma in men.

    PubMed

    Wu, Chih-Feng; Yu, Ming-Whei; Lin, Chih-Lin; Liu, Chun-Jen; Shih, Wei-Liang; Tsai, Keh-Sung; Chen, Chien-Jen

    2008-01-01

    Little is known about the longitudinal course of hepatitis B virus (HBV) load and its relationship with the development of hepatocellular carcinoma (HCC). We conducted a case-cohort study nested within a cohort of 2874 HBV surface antigen-positive male Taiwanese government employees aged 30 years or older. HBV genotype and DNA levels (i.e. viral load) were tested using polymerase chain reaction-based assays on plasma samples from 112 cases and 1031 non-cases. Prediagnostic plasma levels of HBV DNA were measured in multiple samples collected from each man (total 7706 samples), taken over periods of up to 16 years before diagnosis. Baseline viral load influenced HBV genotype-specific HCC risks and predicted the persistence of high viral load (>/=4.39 log copies/ml) that can cause HCC. Moderate to high tracking of viral load was observed within 9 years. Hepatitis B e antigen (P < 0.0001), genotype C HBV infection (P = 0.0369) and longitudinal alanine aminotransferase (ALT) elevation (defined as ALT abnormality in >/=50% of the visits) (P = 0.0005) were positively related to longer duration of persistence for high viral load. After multivariate adjustment, HBV genotype C [odds ratio (OR) = 5.97, 95% confidence interval (CI) = 3.44-10.34], high viral load detected at >/=50% of the visits (compared with sustained low viral load: OR = 5.04, 95% CI = 2.31-11.00) and longitudinal ALT elevation (compared with sustained normal ALT levels: OR = 2.84, 95% CI = 1.46-5.51) accounted for 43.5, 57.2 and 24.9% of HCCs, respectively. The results suggest that maintenance of viral load <4.39 log copies/ml was associated with sustained normalization of ALT levels and decreased risk of HCC.

  13. Low rates of hepatitis screening and vaccination of HIV-infected MSM in HIV clinics.

    PubMed

    Hoover, Karen W; Butler, Mary; Workowski, Kimberly A; Follansbee, Stephen; Gratzer, Beau; Hare, C Bradley; Johnston, Barbara; Theodore, John L; Tao, Guoyu; Smith, Bryce D; Chorba, Terence; Kent, Charlotte K

    2012-05-01

    HIV-infected men who have sex with men (MSM) are at increased risk of viral hepatitis because of similar behavioral risk factors for acquisition of these infections. Our objective was to estimate adherence to HIV management guidelines that recommend screening HIV-infected persons for hepatitis A, B, and C infection, and vaccinating for hepatitis A and B if susceptible. We evaluated hepatitis prevention services received by a random sample of HIV-infected MSM in 8 HIV clinics in 6 US cities. We abstracted medical records of all visits made by the patients to the clinic during the period from 2004 to 2007, to estimate hepatitis screening and vaccination rates overall and by clinic site. Medical records of 1329 patients who had 14,831 visits from 2004 to 2006 were abstracted. Screening rates for hepatitis A, B, and C were 47%, 52%, and 54%, respectively. Among patients who were screened and found to be susceptible, 29% were vaccinated for hepatitis A and 25% for hepatitis B. The percentage of patients screened and vaccinated varied significantly by clinic. Awareness of hepatitis susceptibility and hepatitis coinfection status in HIV-infected patients is essential for optimal clinical management. Despite recommendations for hepatitis screening and vaccination of HIV-infected MSM, rates were suboptimal at all clinic sites. These low rates highlight the importance of routine review of adherence to recommended clinical services. Such reviews can prompt the development and implementation of simple and sustainable interventions to improve the quality of care.

  14. [CLINICAL AND PHARMACOECONOMIC RESULTS OF THE USAGE OF VARIOUS HIV REVERSE TRANSCRIPTASE INHIBITORS IN THE SCHEMES OF ANTIRETROVIRAL THERAPY OF PATIENT RECEIVING THERAPY FOR THE CHRONIC HEPATITIS C VIRUS].

    PubMed

    Moshkovich, G F; Minaeva, S V; Varlova, L W; Goryaeva, M P; Gulyaeva, S S; Tichonova, E V

    2016-01-01

    Efficacy, safety, and economical aspects of treatment with abacavir, zidovudine, stavudine, and phosphazide in the schemes of antiretroviral therapy of the HIV-infected patients receiving therapy for hepatitis C virus were tested. Clinical, immunological, and virologic efficacy of treatment and dynamics of hemoglobin, thrombocytes, and alanine aminotransferase as markers of common adverse events recorded at the start of the antiviral therapy of chronic hepatitis C and after 4, 8, 12, 24, 48 weeks of the treatment were evaluated. The usage of these drugs in the schemes of antiretroviral therapy exhibited efficacy, high tolerability and safety for all HIV reverse transcriptase inhibitors.

  15. An Observational, Multicenter, Cohort Study Evaluating the Antiviral Efficacy and Safety in Korean Patients With Chronic Hepatitis B Receiving Pegylated Interferon-alpha 2a (Pegasys)

    PubMed Central

    Chon, Young Eun; Kim, Dong Joon; Kim, Sang Gyune; Kim, In Hee; Bae, Si Hyun; Hwang, Seong Gyu; Heo, Jeong; Jang, Jeong Won; Lee, Byung Seok; Kim, Hyung Joon; Jun, Dae Won; Kim, Kang Mo; Chung, Woo Jin; Choi, Moon Seok; Jang, Jae Young; Yim, Hyung Joon; Tak, Won Young; Yoon, Ki Tae; Park, Jun Yong; Han, Kwang-Hyub; Suk, Ki Tae; Lee, Hyun Woong; Jang, Byoung Kuk; Ahn, Sang Hoon

    2016-01-01

    Abstract Currently, limited data are available regarding the efficacy and safety of pegylated interferon alpha-2a (PEG-IFN α-2a) in Korean patients with chronic hepatitis B (CHB), in whom hepatitis B virus (HBV) genotype C is the most common type. We collected data from 439 patients (HBeAg positive, n = 349; HBeAg negative, n = 90) with CHB who were treated with PEG-IFN α-2a as a first-line therapy from 18 institutions. Treatment responses at the end of treatment (ET) and at 6 months posttreatment (PT6) were compared between the patients who were treated for 24 weeks versus 48 weeks, and adverse events (AEs) were evaluated. In HBeAg-positive patients, those who received PEG-IFN α-2a for 48 weeks showed significantly higher HBV DNA suppression (HBV DNA < 2000 IU/mL) than those who were treated for 24 weeks (48 weeks vs 24 weeks; at ET, 44.4% vs 36.7%, P = 0.035; at PT6, 35.9% vs 13.3%, P = 0.035). The HBeAg seroconversion rate at ET was 18.1% in 48-week treatment group, which is significantly higher than the 2.2% (P < 0.001) that was seen in 24-week treatment group. This finding also continued at PT6 (29.0% vs 10.0%, P < 0.001). Following 48 weeks of treatment in HBeAg-negative patients, HBV DNA suppression at ET was higher than in HBeAg-positive patients (87.8% vs 44.4%). AEs were typical of those associated with PEG-IFN α-2a. In naïve Korean HBeAg-positive CHB patients treated with PEG-IFN α-2a, higher rates of HBV DNA suppression and HBeAg seroconversion were achieved in the 48-week treatment group than in the 24-week treatment group without additional risk of AEs. PMID:27057828

  16. Can hepatitis B virus DNA in semen be predicted by serum levels of hepatitis B virus DNA, HBeAg, and HBsAg in chronically infected men from infertile couples?

    PubMed

    Fei, Q J; Yang, X D; Ni, W H; Pan, C S; Huang, X F

    2015-05-01

    Hepatitis B virus (HBV) in semen is important for father-to-child transmission of HBV and has adverse effects on sperm quality. However, risk factors associated with HBV in semen remain unclear. Serum HBV DNA and hepatitis B e antigen (HBeAg) levels may pose a risk on HBV in semen. This study aims to examine whether serum HBV DNA, HBeAg, and hepatitis B surface antigen (HBsAg) level were associated with HBV DNA in semen. 151 male patients chronically infected with HBV from infertile couples were included. Serum HBsAg and HBeAg were determined using an electrochemiluminescence immune assay (ECLIA). Serum and seminal plasma HBV DNA were detected by the QIAGEN Real-Time HBV DNA assay. Of 151 patients, 143 (94.7%) were serum HBV DNA-positive and 65 (43.0%) were seminal plasma HBV DNA-positive. Serum HBV DNA and HBeAg level of seminal plasma HBV DNA-positive patients were significantly higher (p < 0.001) as compared with those of seminal plasma HBV DNA-negative patients, HBsAg level of seminal plasma HBV DNA-positive patients was significantly lower (p < 0.001) compared with that of seminal plasma HBV DNA-negative patients. The best serum HBV DNA, HBeAg, and HBsAg value for discriminating between seminal plasma HBV DNA-positive and HBV DNA-negative patients were ≥6.9 log10 IU/mL (sensitivity 100.0%, specificity 90.7%), >14.8 S/CO (sensitivity 96.9%, specificity 81.5%), and <1791.5 S/CO (sensitivity 81.5%, specificity 81.2%), respectively. The combination of serum HBV DNA and HBeAg had high diagnostic sensitivity (100.0%) and specificity (95.4%) for the presence of HBV DNA in semen. As such, these serum markers especially the combination of HBV DNA and HBeAg are useful predictors of the presence of HBV DNA in semen in HBV chronically infected men from infertile couples. © 2015 American Society of Andrology and European Academy of Andrology.

  17. Hepatitis B -- children

    MedlinePlus

    ... at birth: Newborn babies should receive their first hepatitis B vaccine and one dose of immunoglobulins (IG) within 12 hours. The baby should complete all hepatitis B vaccines as recommended during the first six months. Some ...

  18. Clove bud (Syzygium aromaticum) improved blood and hepatic antioxidant indices in laying hens receiving low n-6 to n-3 ratios.

    PubMed

    Rahman Alizadeh, M; Mahdavi, A H; Rahmani, H R; Jahanian, E

    2017-10-01

    This study was carried out to investigate the effects of different levels of clove bud (Syzygium aromaticum) powder and vitamin E on serum lipid profile, enzyme activities and antioxidant indices, as well as hepatic biochemical and histological alterations in laying hens receiving different n-6 to n-3 ratios. A total of 160 laying hens, 43 weeks of age, were allotted to 8 experimental diets with 5 cages of 4 birds each. Dietary treatments consisted of two ratios of n-6 to n-3 (16.71 and 2.35), three levels of clove bud (0.0, 2.0 and 4.0 g/kg) and a high vitamin E level (200 mg/kg, as a positive control in each level of n-6 to n-3 ratio) in a 2 × 4 factorial arrangement during 70 days of the experiment. Results showed that a decline in the n-6 to n-3 ratio led to a reduction in serum cholesterol concentration (p < 0.05) and an increase in serum HDL content (p < 0.05). Additionally, decreasing n-6 to n-3 ratio and increasing clove bud level caused a remarkable decline in serum aspartate aminotransferase (p < 0.05 and p < 0.001) and alanine aminotransferase (p < 0.05 and p < 0.05) enzyme activities. Furthermore, total antioxidant capacity (p < 0.05 and p < 0.001) as well as serum vitamin E concentration (p < 0.05 and p < 0.001) was decreased and enhanced by low n-6 to n-3 ratio diets (LRD) and clove bud powder respectively. Decreasing the n-6 to n-3 ratio lowered hepatic lipid (p < 0.05) and glycogen contents (p < 0.01) as well as tissue integrity (p < 0.05), and raised liver MDA concentration (p < 0.001), markedly. Nevertheless, increments in clove bud content led to a reduction (p < 0.01) in liver relative weight (p < 0.05) and hepatic fat vacuole numbers. In general, the best synergistic responses on modulating of blood lipids and serum enzyme activities were observed when the highest level of clove bud was supplemented in the diets with low n-6 to n-3 ratio. Likewise, antioxidant indices were improved by administration of

  19. Treatment patterns, health care resource utilization, and costs in U.S. patients diagnosed with chronic hepatitis C infection who received telaprevir or boceprevir.

    PubMed

    Le, T Kim; Kalsekar, Anupama; Macaulay, Dendy; Yuan, Yong; Sorg, Rachael A; Behrer, Christopher R; Wei, Jin; Wu, Eric Q

    2015-04-01

    Chronic hepatitis C (CHC) is associated with substantial morbidity and mortality, with the future burden of disease predicted to significantly increase. The recent addition of 2 direct-acting antiviral (DAA) protease inhibitors, telaprevir and boceprevir, to peginterferon alfa (PEG) and ribavirin (RBV) therapy has been shown to significantly improve sustained virologic response rates and thus has become standard of care. While the efficacy and safety of DAAs has been assessed in the clinical trial setting, less is known about real-world use of these new therapies. To (a) evaluate the treatment patterns, health care utilization, and costs of CHC patients receiving DAA-based therapies in the United States using a retrospective analysis of a large administrative claims database and (b) evaluate factors associated with therapy noncompletion using multivariable analyses. Adult patients with ≥ 1 claim for CHC and a prescription filled for boceprevir or telaprevir were selected from a de-identified U.S.-based claims database. The date of the first fill for a DAA after May 13, 2011 (date of first DAA availability) was defined as the index date, and patients were categorized into either the telaprevir or boceprevir cohort. Patients were required to have continuous eligibility and no claims for hepatitis B during the 6 months before (baseline) and 12 months following (study period) the index date. Baseline characteristics and study period treatment patterns, health care utilization, and costs were described. Factors associated with therapy noncompletion were examined using multivariable logistic regression, and adjusted health care costs were compared between the DAA cohorts using multivariable analyses. A total of 871 telaprevir and 284 boceprevir patients were identified. DAA patients were aged 54 years on average and more often were male (60%, n = 688). Approximately 25% (n = 216) of telaprevir and 18% (n = 52) of boceprevir patients had cirrhosis, and 9

  20. Relationship of chronic hepatitis C infection to rates of AIDS-defining illnesses in a Canadian cohort of HIV seropositive individuals receiving highly active antiretroviral therapy.

    PubMed

    Raboud, J; Anema, A; Su, D; Klein, M B; Zakaryan, A; Swan, T; Palmer, A; Hosein, S; Loutfy, M R; Machouf, N; Montaner, J S G; Rourke, S B; Tsoukas, C; Hogg, R S; Cooper, C

    2012-01-01

    The influence of chronic hepatitis C virus (HCV) infection on the risk, timing, and type of AIDS-defining illnesses (ADIs) is not well described. To this end, rates of ADIs were evaluated in a Canadian cohort of HIV seropositive individuals receiving highly active antiretroviral therapy (HAART). ADIs were classified into 6 Centers for Disease Control and Prevention (CDC)-defined etiological subgroups: non-Hodgkin lymphoma, viral infection, bacterial infection, HIV-related disease, protozoal infection, and mycotic infection. Generalized estimating equation (GEE) Poisson regression models were used to estimate the effect of HCV on rates of ADIs after adjusting for covariates. Among 2,706 HAART recipients, 768 (28%) were HCV coinfected. Rates of all ADIs combined and of bacterial infection, HIV-related disease, and mycotic infection were increased in HCV-coinfected persons and among those with CD4 counts <200 cells/mm3 HCV was associated with an increased risk of ADIs (rate ratio [RR], 1.38; 95% CI, 1.01-1.88) and a 2-fold increased risk of mycotic infections (RR, 2.21; 95% CI, 1.35-3.62) in univariate analyses and after adjusting for age, baseline viral load, baseline CD4 count, and region of Canada. However, after further adjustment for HAART interruptions, HCV was no longer associated with an increased rate of ADIs overall (RR, 1.13; 95% CI, 0.80-1.59), but remained associated with an increased rate of mycotic infections (RR, 1.97, 95% CI, 1.08-3.61). Although HCV coin-fected individuals are at increased risk of developing ADIs overall, our analysis suggests that behavioral variables associated with HCV (including rates of retention on HAART), and not biological interactions with HCV itself, are primarily responsible.

  1. Long-term anti-HBs antibody persistence and immune memory in children and adolescents who received routine childhood hepatitis B vaccination.

    PubMed

    Behre, Ulrich; Bleckmann, Gerhard; Crasta, Priya Diana; Leyssen, Maarten; Messier, Marc; Jacquet, Jeanne-Marie; Hardt, Karin

    2012-06-01

    This paper presents data from two studies that evaluated 5-y and 10-y persistence of antibodies against hepatitis B (HBV) surface antigen (anti-HBs) and immune response to an HBV vaccine challenge in children and adolescents who had received three doses of a HBV vaccine in infancy as part of routine clinical practice [NCT00519649/NCT00984139]. Anti-HBs antibody concentrations ≥ 10 mIU/ml persisted in 83.3% (95% confidence interval [CI]: 78.5–87.5) and 78.3% (95% CI: 73.1–83.0) of subjects aged 7–8 y and 12–13 y, respectively 5–10 y after infant vaccination. One month postchallenge dose, 98.2% (95% CI: 95.9–99.4) and 93.7% (95% CI: 90.2–96.2) of subjects in the two age groups, respectively had anti-HBs antibody concentrations ≥ 100 mIU/ml. Overall, 99.6% (95% CI: 98–100) and 97.2% (95% CI: 94.5–98.8) of subjects aged 7–8 y and 12–13 y mounted an anamnestic response to the HBV challenge dose, which was well-tolerated. Healthy children aged 7–8 y and adolescents aged 12–13 y received three doses of a monovalent pediatric HBV vaccine (10 μg of HBsAg) before 18 mo of age. Serum samples collected before and one month post-HBV vaccine challenge dose were tested for anti-HBs antibody concentrations. Safety assessments were made for the HBV vaccine challenge dose. A three-dose childhood HBV immunization regimen induced persistence of antibodies against HBV infection for 10 y, up to adolescence. This vaccination regimen also conferred long-term immune memory against HBV as evidenced by the strong anamnestic response to the HBV vaccine challenge, despite waning anti-HBs antibody levels.

  2. Prevalence and associated factors for four sexually transmissible microorganisms in middle-aged men receiving general prostate health checkups: a polymerase chain reaction-based study in Korea.

    PubMed

    Choi, Jae Young; Cho, In-Chang; Lee, Gyeong In; Min, Seung Ki

    2013-01-01

    To investigate the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), and Ureaplasma urealyticum (UU) in first-voided urine samples and to determine the factors associated with positivity for sexually transmissible microorganisms in healthy, middle-aged Korean men. Five hundred fifty-one men who came to the hospital for a general prostate health checkup were tested between August 2011 and December 2011. PCR assays for CT, NG, MG, and UU were done with first-voided urine samples and the prevalence of microorganism positivity and association with several clinical parameters were evaluated. The mean age of the men studied was 50.8±4.7 years. Among the 551 men, 72 (13.1%) had a positive result for at least one microorganism; one (0.2%) had two different species. The overall prevalence of asymptomatic sexually transmitted infections was 11.1% (61/551). The prevalence rates of CT, NG, MG, and UU infection in the general population were 0.4% (2/551), 0.0% (0/551), 1.0% (6/551), and 11.8% (65/551), respectively. CT-positive patients had a lower mean age than did CT-negative patients. There were no significant differences in symptoms by positivity of each microorganism. We checked the prevalence rates of four microorganisms, the proportion of symptomatic people, and the association of microbes, age, and symptoms, as the baseline data for Korean middle-aged men. In this population, CT, NG, MG, and UU infections do not seem to be symptomatic. However, the potential role of CT in young men and of UU in middle-aged men with a high rate of detection should be studied continuously as a source of opportunistic infection.

  3. Cost and threshold analysis of an HIV/STI/hepatitis prevention intervention for young men leaving prison: Project START.

    PubMed

    Johnson, A P; Macgowan, R J; Eldridge, G D; Morrow, K M; Sosman, J; Zack, B; Margolis, A

    2013-10-01

    The objectives of this study were to: (a) estimate the costs of providing a single-session HIV prevention intervention and a multi-session intervention, and (b) estimate the number of HIV transmissions that would need to be prevented for the intervention to be cost-saving or cost-effective (threshold analysis). Project START was evaluated with 522 young men aged 18-29 years released from eight prisons located in California, Mississippi, Rhode Island, and Wisconsin. Cost data were collected prospectively. Costs per participant were $689 for the single-session comparison intervention, and ranged from $1,823 to 1,836 for the Project START multi-session intervention. From the incremental threshold analysis, the multi-session intervention would be cost-effective if it prevented one HIV transmission for every 753 participants compared to the single-session intervention. Costs are comparable with other HIV prevention programs. Program managers can use these data to gauge costs of initiating these HIV prevention programs in correctional facilities.

  4. Incident Hepatitis B Virus Infection in HIV-Infected and HIV-Uninfected Men Who Have Sex With Men From Pre-HAART to HAART Periods: A Cohort Study.

    PubMed

    Falade-Nwulia, Oluwaseun; Seaberg, Eric C; Snider, Anna E; Rinaldo, Charles R; Phair, John; Witt, Mallory D; Thio, Chloe L

    2015-11-03

    Men who have sex with men (MSM) are at high risk for hepatitis B virus (HBV) infection. Data on the effect of highly active antiretroviral therapy (HAART) on incident HBV infection in HIV-infected and HIV-uninfected MSM are limited. To determine predictors of incident HBV infection in MSM during pre-HAART and HAART periods. Observational cohort study. Cohort of MSM who have, or are at risk for, HIV infection. 2375 HBV-uninfected MSM in the Multicenter AIDS Cohort Study. Poisson regression was used to compare incidence rates of HBV infection in the pre-HAART and HAART eras and to identify factors associated with incidence of HBV infection. In 25,322 person-years of follow-up, 244 incident HBV infections occurred. The unadjusted incidence rate was higher in HIV-infected MSM than in HIV-uninfected MSM (incidence rate ratio [IRR], 1.9 [95% CI, 1.5 to 2.4]) and was significantly lower in the HAART era than in the pre-HAART era among HIV-infected (IRR, 0.2 [CI, 0.1 to 0.4]) and HIV-uninfected (IRR, 0.3 [CI, 0.2 to 0.4]) MSM. Age younger than 40 years (IRR, 2.3 [CI, 1.7 to 3.0]), more than 1 recent sexual partner (IRR, 3.1 [CI, 2.3 to 4.2]), and HIV infection (IRR, 2.4 [CI, 1.8 to 3.1]) were independently associated with higher incidence of HBV infection, whereas HBV vaccination was protective (IRR, 0.3 [CI, 0.2 to 0.4]). Highly active antiretroviral therapy with HIV RNA levels less than 400 copies/mL was associated with protection (IRR, 0.2 [CI, 0.1 to 0.5]), but HAART in those with HIV RNA levels of 400 copies/mL or greater was not. The observational nature limits inferences about causality. Effective HAART is associated with lower incidence of HBV infection; however, even in the HAART era, incidence of HBV infection remains high among MSM. National Institute of Allergy and Infectious Diseases.

  5. Regression of liver fibrosis over a 24-week period after completing direct-acting antiviral therapy in patients with chronic hepatitis C receiving care within the national hepatitis C elimination program in Georgia: results of hepatology clinic HEPA experience.

    PubMed

    Dolmazashvili, Ekaterine; Abutidze, Akaki; Chkhartishvili, Nikoloz; Karchava, Marine; Sharvadze, Lali; Tsertsvadze, Tengiz

    2017-11-01

    We assessed the impact of direct-acting antiviral (DAA) therapy on liver fibrosis regression measured by transient elastography (TE) in patients with chronic hepatitis C virus (HCV) infection. A prospective cohort study was carried out in HCV monoinfected patients with advanced liver fibrosis or cirrhosis receiving interferon (IFN)-containing or IFN-free DAA therapy. Liver stiffness (LS) score more than 14.5 kPa indicated LS-defined cirrhosis. The primary outcome was improvement in liver stiffness measurement (LSM) at week 24 after treatment measured as (a) decrease in the median LS compared with baseline and (b) at least a 20% decrease in LSM compared with baseline. A multivariate logistic regression model was utilized to identify the factors associated with at least a 20% improvement in LSM. Of a total of 304 patients, 172 (56.6%) had LS-defined cirrhosis before treatment. LSM decreased from the baseline median value of 16.9 (interquartile range: 11.8-27.7) kPa to a post-treatment week 24 score of 11.9 (interquartile range: 8.2-20.9) kPa (P<0.0001). Of a total of 304 patients, 198 (65.1%) achieved at least a 20% reduction in LS. In multivariate logistic regression analysis, sustained virological response (SVR) was associated significantly with this reduction (P<0.0001). The addition of IFN to the treatment regimen had no impact on the decrease in LSM. Despite decreasing baseline LSM, more than half of the LS-defined cirrhotic patients remained cirrhotic at week 24 after treatment. In patients with advanced fibrosis, pretreatment LS significantly reduced during DAA therapy. SVR was the only independent factor associated with the regression in LSM. However, irrespective of achieving SVR, liver damage still persisted in a substantial proportion of patients. Thus, early treatment of HCV-infected patients can significantly prevent residual liver damage.

  6. Global photographic assessment of men aged 18 to 60 years with male pattern hair loss receiving finasteride 1 mg or placebo.

    PubMed

    Olsen, Elise A; Whiting, David A; Savin, Ronald; Rodgers, Anthony; Johnson-Levonas, Amy O; Round, Elizabeth; Rotonda, Jennifer; Kaufman, Keith D

    2012-09-01

    Finasteride (1 mg) has been shown to increase vertex hair growth in men aged 18 to 60 years with male pattern hair loss and to increase frontal scalp hair growth in subjects aged 18 to 41 years. A secondary efficacy analysis was conducted to determine effects of finasteride (1 mg) on scalp hair growth in the 4 distinct scalp regions affected by male pattern hair loss. Multicenter, double-blind studies randomized patients with vertex hair loss (men aged 18-41 and 41-60 years) to finasteride (1 mg/d) or placebo. Efficacy was evaluated by review of standardized clinical photographs (global photographic assessment) of the vertex, anterior/mid scalp regions, and frontal and temporal hairlines over 24 months relative to baseline. At 24 months, treatment with finasteride resulted in statistically significant (P ≤ .05) hair growth versus placebo in all scalp regions. There was also a significant decrease in hair loss in the younger men treated with finasteride in all areas, but only in the vertex and anterior/mid scalp regions in the older men. A slightly higher incidence of drug-related sexual adverse experiences was reported in the finasteride group than in the placebo group, irrespective of age. These studies enrolled men with vertex pattern hair loss; therefore, the findings may not be extrapolated to men with predominantly anterior/mid scalp, frontal, or temporal hair loss. Based on global photographic assessment, finasteride (1 mg) is able to increase hair growth in all areas of the scalp affected by male pattern hair loss. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  7. Immunogenicity and safety of concomitant administration of a combined hepatitis A/B vaccine and a quadrivalent meningococcal conjugate vaccine in healthy adults.

    PubMed

    Alberer, Martin; Burchard, Gerd; Jelinek, Tomas; Reisinger, Emil C; Meyer, Seetha; Forleo-Neto, Eduardo; Dagnew, Alemnew F; Arora, Ashwani Kumar

    2015-01-01

    This phase 3b randomized, open-label study evaluated the immunogenicity and safety of coadministration of a hepatitis A and/or B vaccine with a quadrivalent oligosaccharide meningococcal CRM197 -conjugate vaccine (MenACWY-CRM), in the context of an accelerated hepatitis A and/or B immunization schedule. A total of 252 healthy adult subjects were randomized to three groups to receive hepatitis A/B only (HepA/B), hepatitis A/B coadministered with MenACWY-CRM (HepA/B+MenACWY-CRM), or MenACWY-CRM only (MenACWY-CRM). Hepatitis A and/or B vaccination was administered in the form of a single booster dose or a primary three-dose series, depending on the hepatitis A and/or B vaccination history of subjects. Antibody responses to hepatitis A/B vaccination were assessed 1 month following the last hepatitis A and/or B dose. Serum bactericidal activity with human complement (hSBA) against meningococcal serogroups A, C, W-135, and Y was assessed 1 month post-MenACWY-CRM vaccination. Safety was monitored throughout the study. At 1 month following the final hepatitis A and/or B vaccination, concomitant administration of hepatitis A/B and MenACWY-CRM was non-inferior to administration of hepatitis A/B alone in terms of geometric mean concentrations of antibodies against the hepatitis A and B antigens. One month post-MenACWY-CRM vaccination, the percentages of subjects achieving hSBA titers ≥8 for serogroups A, C, W-135, and Y in the HepA/B+MenACWY-CRM group (76, 87, 99, and 94%, respectively) were comparable to those in the MenACWY-CRM group (67, 82, 96, and 88%, respectively). The percentages of subjects reporting adverse events (AEs) were similar across study groups and a majority of the reported AEs were mild to moderate in nature. There were no study vaccine-related serious AEs. MenACWY-CRM can be administered concomitantly with a hepatitis A and/or B vaccine in the context of an accelerated hepatitis A and/or B immunization schedule without increasing safety concerns

  8. Prospective assessment of health-related quality of life in men with late-onset hypogonadism who received testosterone replacement therapy.

    PubMed

    Sumii, K; Miyake, H; Enatsu, N; Matsushita, K; Fujisawa, M

    2016-03-01

    The objective of this study was to characterise the status of health-related quality of life (HRQOL) in Japanese men with late-onset hypogonadism (LOH) treated with testosterone replacement therapy (TRT). HRQOL in 69 consecutive Japanese men with LOH undergoing TRT for at least 6 months was prospectively evaluated before and 6 months after the initiation of TRT using the Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8). All eight-scale scores except for bodily pain (BP) in the 69 patients at 6 months after the introduction of TRT significantly improved compared with those before TRT; however, all scale scores except for BP in the 69 patients were significantly inferior to those in age-matched Japanese controls irrespective of the timing of SF-8. Multivariate analyses of several parameters revealed that both age and Aging Male Symptom (AMS) score had an independent impact on mental health (MH), despite the lack of an independent association between any score and the remaining factors examined. TRT appeared to significantly improve the status of HRQOL in men with LOH; however, even after the introduction of TRT, HRQOL associated with MH remained significantly impaired in elderly men and/or those with a high AMS score. © 2015 Blackwell Verlag GmbH.

  9. Management of patients with hepatitis C in a community population: diagnosis, discussions, and decisions to treat.

    PubMed

    Rocca, Liliana Gazzuola; Yawn, Barbara P; Wollan, Peter; Kim, W Ray

    2004-01-01

    Chronic hepatitis C, a treatable condition caused by the hepatitis C virus (HCV), can be found in almost all primary care and community practices. The rate of hepatitis C treatment is low, however. This study explores the frequency of hepatitis C treatment, documented discussions of treatment consideration, and the reasons treatment may not be offered in a community population. This study is a retrospective medical record review of care provided to all patients in Olmsted County, Minn, who had a confirmed diagnosis of hepatitis C. Using all records from all health care providers in Olmsted County, the rates of documented discussions regarding hepatitis C treatment and the treatment rates by specialty of diagnosing physician were assessed. In addition, comorbidities listed as reasons not to treat and or comorbid conditions in patients without a documented treatment discussion were assessed. Of the 366 patients with hepatitis C, 62% were men. Hepatitis C was more commonly diagnosed by generalist physicians (41% of cases). Treatment discussions were documented for 77% of patients with hepatitis C diagnosed by either a generalist or a gastrointestinal specialist (gastroenterologist or hepatologist) compared with 46% of patients with hepatitis C diagnosed by other physicians. Generalists' patients were more likely to have documented contraindications to treatment and were only one half as likely to receive hepatitis C treatment compared with patients with hepatitis C diagnosed by gastrointestinal specialists (16% vs 33%). Documented attempts to treat or reassess after resolution of potentially reversible contraindications to hepatitis C therapy were infrequent. In this community population, hepatitis C treatment was discussed with the majority of patients with a diagnosis of hepatitis C; however, the actual treatment rate was low. Many opportunities exist for treating more patients for HCV infection, particularly those found during emergency care and chemical dependency

  10. Management of Patients With Hepatitis C in a Community Population: Diagnosis, Discussions, and Decisions to Treat

    PubMed Central

    Rocca, Liliana Gazzuola; Yawn, Barbara P.; Wollan, Peter; Kim, W. Ray

    2004-01-01

    BACKGROUND Chronic hepatitis C, a treatable condition caused by the hepatitis C virus (HCV), can be found in almost all primary care and community practices. The rate of hepatitis C treatment is low, however. This study explores the frequency of hepatitis C treatment, documented discussions of treatment consideration, and the reasons treatment may not be offered in a community population. METHODS This study is a retrospective medical record review of care provided to all patients in Olmsted County, Minn, who had a confirmed diagnosis of hepatitis C. Using all records from all health care providers in Olmsted County, the rates of documented discussions regarding hepatitis C treatment and the treatment rates by specialty of diagnosing physician were assessed. In addition, comorbidities listed as reasons not to treat and or comorbid conditions in patients without a documented treatment discussion were assessed. RESULTS Of the 366 patients with hepatitis C, 62% were men. Hepatitis C was more commonly diagnosed by generalist physicians (41% of cases). Treatment discussions were documented for 77% of patients with hepatitis C diagnosed by either a generalist or a gastrointestinal specialist (gastroenterologist or hepatologist) compared with 46% of patients with hepatitis C diagnosed by other physicians. Generalists’ patients were more likely to have documented contraindications to treatment and were only one half as likely to receive hepatitis C treatment compared with patients with hepatitis C diagnosed by gastrointestinal specialists (16% vs 33%). Documented attempts to treat or reassess after resolution of potentially reversible contraindications to hepatitis C therapy were infrequent. CONCLUSIONS In this community population, hepatitis C treatment was discussed with the majority of patients with a diagnosis of hepatitis C; however, the actual treatment rate was low. Many opportunities exist for treating more patients for HCV infection, particularly those found

  11. Correlates of hepatitis B virus and HIV knowledge among gay and bisexual homeless young adults in Hollywood.

    PubMed

    Nyamathi, Adeline; Salem, Benissa; Reback, Cathy J; Shoptaw, Steven; Branson, Catherine M; Idemundia, Faith E; Kennedy, Barbara; Khalilifard, Farinaz; Marfisee, Mary; Liu, Yihang

    2013-01-01

    Homeless gay and bisexual (G/B) young men have multiple risk factors that increase their risk of contracting hepatitis B virus (HBV) and human immunodeficiency virus (HIV). This study used baseline information from structured instruments to assess correlates of knowledge to HIV and HBV infection from 267 young (18-39 year old) G/B active methamphetamine, cocaine, and crack-using homeless men enrolled in a longitudinal trial. The study is designed to reduce drug use and improve knowledge of hepatitis and HIV/AIDS in a community center in Hollywood, California. Regression modeling revealed that previous hepatitis education delivered to G/B men was associated with higher levels of HIV/AIDS and hepatitis knowledge. Moreover, higher HIV/AIDS knowledge was associated with combining sex and drinking alcohol. Associations with hepatitis B knowledge was found among G/B men who were engaging in sex while under the influence of marijuana, who were receiving support from non-drug users, and who had been homeless in the last 4 months. Although being informed about HIV/AIDS and hepatitis did not preclude risky sexual and drug use behavior, knowledge about the dangers of concurrent sex with substance use is important. As higher levels of knowledge of hepatitis was associated with more moderate drug use, early access to testing and teaching harm reduction strategies remain critical to reduce exposure and infection of HBV and HIV in this population.

  12. YMDD Motif Mutation Profile Among Patients Receiving Liver Transplant Due to Hepatitis B Virus Infection With Long Term Lamivudine/Immunoglobulin Therapy

    PubMed Central

    Rahimi, Rahim; Hosseini, Seyed Younes; Fattahi, Mohammad Reza; Sepehrimanesh, Masood; Safarpour, Alireza; Malekhosseini, Seyed Ali; Nejabat, Maryam; Khodadad, Mahboobeh; Ardebili, Maryam

    2015-01-01

    Background: Recurrence of Hepatitis B Virus infection in patients undergoing liver transplanted (LT) is a serious and often fatal problem. Lamivudine (LAM) and Hepatitis B Immunoglobulin (HBIG) are widely used to manage hepatitis B recurrence after liver transplantation. However, the outcomes in patients are less elucidated. Objectives: The current study aimed to evaluate the YMDD motif mutations profile among the patients undergoing LT infected with HBV and treated with LAM/HBIG at least for one year. Patients and Methods: Thirty patients with liver transplantation due to HBV were enrolled, while DNA level remained under detection limit of 50 IU/mL before transplantation and abnormal higher levels of liver enzymes after LT. The HBV genome detection was performed by two different Polymerase Chain Reaction methods following viral quantification by commercial Real-Time PCR. HbsAg detection, besides liver function tests were conducted as complementary assays. To assess nucleotide analogue mutations, the major part of polymerase gene (aa 80 - 240) was amplified by Nested-PCR, introduced to sequencing and subjected to phylogenetic analysis. Results: Totally, according to the laboratory criteria there were 13 cases with detectable HBV genome, while the mean liver enzyme levels were higher in recurrent patients and HBsAg was detected only in four out of the 13 cases. Phylogenetic analysis demonstrated that all isolated genomes belonged to genotype D. Critical M204I mutation, as a proof for resistance to LAM, was detected among 46% of the subjects and natural entecavir resistance (S202I) was also distinguished in one subject. Viral quantification showed higher titer in LAM resistant group in comparison to the group with undetectable drug resistance mutant (P > 0.05). Conclusions: Although the patients carrying M204I mutation were more likely to show lack of responses to LAM therapy, LAM replacing by other nucleoside/tide analogs plus HBIG maybe still effective in

  13. Association between heroin use, needle sharing and tattoos received in prison with hepatitis B and C positivity among street-recruited injecting drug users in New Mexico, USA.

    PubMed

    Samuel, M C; Doherty, P M; Bulterys, M; Jenison, S A

    2001-12-01

    This study aimed to assess the seroprevalence and risk factors for hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV-1 infections among injecting drug users (IDU) in New Mexico. Serological and behavioural surveys were conducted in conjunction with street-based outreach, education and HIV counselling and testing. High rates of antibody positivity for HCV (82.2%) and HBV (61.1%), and a low rate for HIV (0.5%) were found. In multivariate analyses, both HBV and HCV infection were positively associated with increasing age, increasing years of injection and heroin use. Receipt of a tattoo in prison/jail was associated with HBV (odds ratio = 2.3, 95% confidence interval 1.4, 3.8) and HCV (OR = 3.4, 95% CI = 1.6, 7.5) infections. Prevention of bloodborne pathogens among IDUs should focus on young users, early in their drug use experience. Studies examining the relationship between tattooing and HBV and HCV infection are needed as are efforts to promote sterile tattooing, in prisons and elsewhere.

  14. Sexual behaviour, recreational drug use and hepatitis C co-infection in HIV-diagnosed men who have sex with men in the United Kingdom: results from the ASTRA study.

    PubMed

    Daskalopoulou, Marina; Rodger, Alison; Thornton, Alicia; Phillips, Andrew; Sherr, Lorraine; Gilson, Richard; Johnson, Margaret; Fisher, Martin; Anderson, Jane; McDonnell, Jeffrey; Edwards, Simon; Perry, Nicky; Collins, Simon; Bhagani, Sanjay; Speakman, Andrew; Smith, Colette; Lampe, Fiona

    2014-01-01

    Transmission of Hepatitis C virus (HCV) among HIV-positive men who have sex with men (MSM) in the United Kingdom is ongoing. We explore associations between self-reported sexual behaviours and drug use with cumulative HCV prevalence, as well as new HCV diagnosis. ASTRA is a cross-sectional questionnaire study including 2,248 HIV-diagnosed MSM under care in the United Kingdom during 2011-2012. Socio-demographic, lifestyle, HIV-related and sexual behaviour data were collected during the study. One thousand seven hundred and fifty two (≥70%) of the MSM who consented to linkage of ASTRA and clinical information (prior to and post questionnaire) were included. Cumulative prevalence of HCV was defined as any positive anti-HCV or HCV-RNA test result at any point prior to questionnaire completion. We excluded 536 participants with clinical records only after questionnaire completion. Among the remaining 1,216 MSM, we describe associations of self-reported sexual behaviours and recreational drug use in the three months prior to ASTRA with cumulative HCV prevalence, using modified Poisson regression with robust error variances. New HCV was defined as any positive anti-HCV or HCV-RNA after questionnaire completion. We excluded 591 MSM who reported ever having a HCV diagnosis at questionnaire, any positive HCV result prior to questionnaire or did not have any HCV tests after the questionnaire. Among the remaining 1,195 MSM, we describe occurrence of new HCV diagnosis during follow-up according to self-reported sexual behaviours and recreational drug use three months prior to questionnaire (Fisher's exact test). Cumulative HCV prevalence among MSM prior to ASTRA was 13.3% (95% CI 11.5-15.4). Clinic- and age-adjusted prevalence ratios (95% CI) for cumulative HCV prevalence were 4.6 (3.1-6.7) for methamphetamine, 6.5 (3.5-12.1) for injection drugs, 2.3 (1.6-3.4) for gamma hydroxybutyrate (GHB), 1.6 (1.3-2.0) for nitrites, 1.7 (1.5-2.0) for all condom-less sex (CLS), 2.1 (1

  15. Hepatitis A

    MedlinePlus

    Hepatitis A Hepatitis A Hepatitis A is a contagious viral infection that can easily affect children and adults. It is one of the most common types of hepatitis virus. Often when you hear about hepatitis A ...

  16. A chronic subdural hematoma in a patient receiving combination therapy with pegylated interferon alfa-2b and ribavirin for chronic hepatitis C.

    PubMed

    Goto, Takashi; Ohshima, Shigetoshi; Miura, Kouichi; Shibuya, Tomomi; Sato, Wataru; Dohmen, Takahiro; Kamada, Kentaro; Kanata, Ryo; Sakai, Toshitaka; Chiba, Mitsuru; Sugimoto, Yuko; Minami, Shinichiro; Ohnishi, Hirohide

    2013-01-01

    A 70-year-old man who suffered from chronic hepatitis C was infected with HCV genotype 1 and exhibited a high viral load. He had hypertension and had consumed the equivalent of 50 g of ethanol per day. He was treated with pegylated interferon and ribavirin. After 51 weeks, he developed an unsteady gait while walking and demonstrated Barre's sign on the right foot and a headache. Contrast computed tomography showed a subdural hematoma with a mass effect. The patient was treated with drainage and aspiration surgery via a burr hole. Following the drainage procedure, there were no neurological sequelae. Treatment with pegylated interferon and ribavirin was discontinued. Fortunately, a sustained virological response was achieved.

  17. Lipopolysaccharide, immune activation, and liver abnormalities in HIV/hepatitis B virus (HBV)-coinfected individuals receiving HBV-active combination antiretroviral therapy.

    PubMed

    Crane, Megan; Avihingsanon, Anchalee; Rajasuriar, Reena; Velayudham, Pushparaj; Iser, David; Solomon, Ajantha; Sebolao, Baotuti; Tran, Andrew; Spelman, Tim; Matthews, Gail; Cameron, Paul; Tangkijvanich, Pisit; Dore, Gregory J; Ruxrungtham, Kiat; Lewin, Sharon R

    2014-09-01

    We investigated the relationship between microbial translocation, immune activation, and liver disease in human immunodeficiency virus (HIV)/hepatitis B virus (HBV) coinfection. Lipopolysaccharide (LPS), soluble CD14, CXCL10, and CCL-2 levels were elevated in patients with HIV/HBV coinfection. Levels of LPS, soluble CD14, and CCL-2 declined following receipt of HBV-active combination antiretroviral therapy (cART), but the CXCL10 level remained elevated. No markers were associated with liver disease severity on liver biopsy (n = 96), but CXCL10, interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor α, and interferon γ (IFN-γ) were all associated with elevated liver enzyme levels during receipt of HBV-active cART. Stimulation of hepatocyte cell lines in vitro with IFN-γ and LPS induced a profound synergistic increase in the production of CXCL10. LPS may contribute to liver disease via stimulating persistent production of CXCL10.

  18. Increased depressive ratings in patients with hepatitis C receiving interferon-alpha-based immunotherapy are related to interferon-alpha-induced changes in the serotonergic system.

    PubMed

    Bonaccorso, Stefania; Marino, Valentina; Puzella, Antonella; Pasquini, Massimo; Biondi, Massimo; Artini, Marco; Almerighi, Cristiana; Verkerk, Robert; Meltzer, Herbert; Maes, Michael

    2002-02-01

    There is now evidence that repeated administration of interferon-alpha (IFN-alpha) to patients with chronic active hepatitis and cancers induces depressive symptoms. There is also evidence that induction of the cytokine network modulates the serotonergic system and that major depression is related to activation of the cytokine network and disturbances in the serotonergic metabolism. The aims of this study were to examine the effects of IFN-alpha-based immunotherapy on the development of depressive symptoms in relation to its effects on plasma tryptophan and kynurenine and serum serotonin (5-HT). Eighteen patients affected by chronic active hepatitis C were treated with IFN-alpha (3-6 million units subcutaneously three to six times a week for 6 months) and had measurements of the previous parameters before starting immunotherapy and 2, 4, 16, and 24 weeks later. Severity of depression and anxiety were measured with the Montgomery-Asberg Depression Rating Scale (MADRS) and the Hamilton Rating Scale for Anxiety (HAM-A) scale, respectively. Immunochemotherapy with IFN-alpha (1) significantly increased the MADRS and HAM-A scores and serum kynurenine concentrations and (2) significantly reduced plasma tryptophan and serum 5-HT concentrations. IFN-alpha-based immunotherapy significantly increased the kynurenine per tryptophan quotient, which estimates the activity of indoleamine 2,3-dioxygenase, the major tryptophan-catabolizing enzyme, which is induced by IFNs. There are significant relationships between the IFN-alpha-induced changes in the MADRS score and serum kynurenine (positive) and 5-HT (negative) concentrations. Immunotherapy with IFN-alpha significantly increases the severity of depressive symptoms. The latter is related to changes in the serotonergic system, such as depletion of serum 5-HT and induction of the catabolism of tryptophan to kynurenine. It is suggested that the IFN-alpha-induced changes in the serotonergic turnover could play a role in the

  19. Survey of receiving-water environmental impacts associated with discharges from pulp mills; 2: Gonad size, liver size, hepatic erod activity and plasma sex steroid levels in white sucker

    SciTech Connect

    Munkittrick, K.R.; Servos, M.R. . Great Lakes Lab. for Fisheries and Aquatic Sciences); Van Der Kraak, G.J.; McMaster, M.E. . Dept. of Zoology); Portt, C.B. ); Heuvel, M.R. van den . Dept. of Biology)

    1994-07-01

    Fish collected from the receiving areas of 12 Canadian pulp mills were examined, including sites receiving effluent from kraft mills using chlorine as well as sulfite mills. Field collections included sampling of receiving water for chemistry and toxicity testing, and sampling of local fish for organ weights, hepatic MFO (ethoxyresorufin-O-deethylase, EROD) activity, plasma steroid levels, and levels of liver dioxins. The main objectives of this study were to determine whether the discharge of effluent from pulp mills to sites other than Jackfish Bay was associated with physiological or biochemical disruptions in wild fish, whether there was any correlation between waste treatment and the presence of biological responses in wild fish, and whether there was any association between the use of chlorine as a bleaching agent and these responses. Although white sucker collected near bleached-kraft mills exhibited the highest EROD induction and dioxin levels, elevated enzyme activity was observed in fish from sites that did not use chlorine, and depressions in plasma sex steroid levels was not correlated with the level of EROD activity. The absence of chlorine bleaching or the presence of secondary treatment did not eliminate responses in fish, including decreased circulating levels of sex steroids, decreased gonadal size, and increase liver size. This survey has shown that (a) induction of hepatic EROD enzymes and depressions of plasma sex steroid levels during gonadal growth are found downstream of several pulp mills; (b) these changes are seen at some mills without chlorine bleaching and at mills that have secondary treatment; (c) substantial dilutions of nontoxic effluent do not appear to remove these responses; (d) the dominant factor determining the presence or absence of responses appeared to be dilution level; and (e) lab toxicity tests on invertebrates, rainbow trout, and fat-head minnows could not predict the presence of these responses in wild fish.

  20. Report of the Clinical and Functional Primary Outcomes in Men of the ACL-SPORTS Trial: Similar Outcomes in Men Receiving Secondary Prevention With and Without Perturbation Training 1 and 2 Years After ACL Reconstruction.

    PubMed

    Arundale, Amelia J H; Cummer, Kathleen; Capin, Jacob J; Zarzycki, Ryan; Snyder-Mackler, Lynn

    2017-02-21

    Athletes often are cleared to return to activities 6 months after anterior cruciate ligament (ACL) reconstruction; however, knee function measures continue to improve up to 2 years after surgery. Interventions beyond standard care may facilitate successful return to preinjury activities and improve functional outcomes. Perturbation training has been used in nonoperative ACL injury and preoperative ACL reconstruction rehabilitation, but has not been examined in postoperative ACL reconstruction rehabilitation, specifically return to sport rehabilitation. The purpose of this study was to determine whether there were differences at 1 and 2 years after ACL reconstruction between the male SAP (strengthening, agility, and secondary prevention) and SAP+PERT (SAP protocol with the addition of perturbation training) groups with respect to (1) quadriceps strength and single-legged hop limb symmetry; (2) patient-reported knee outcome scores; (3) the proportion who achieve self-reported normal knee function; and (4) the time from surgery to passing return to sport criteria. Forty men who had completed ACL reconstruction rehabilitation and met enrollment criteria (3-9 months after ACL reconstruction, > 80% quadriceps strength limb symmetry, no pain, full ROM, minimal effusion) were randomized into the SAP or SAP+PERT groups of the Anterior Cruciate Ligament-Specialised Post-Operative Return to Sports trial (ACL-SPORTS), a single-blind randomized clinical study of secondary prevention and return to sport. Quadriceps strength, single-legged hopping, the International Knee Documentation Committee (IKDC) 2000 subjective knee form, Knee Injury and Osteoarthritis Outcome Score (KOOS)-sports and recreation, and KOOS-quality-of-life subscales were collected 1 and 2 years after surgery by investigators blind to group. Athletes were categorized as having normal or abnormal knee function at each time point based on IKDC score, and the time until athletes passed strict return

  1. Early phase viral kinetics of chronic hepatitis C patients receiving telaprevir-based triple therapy: a comparison of two real-time PCR assays.

    PubMed

    Ogawa, Eiichi; Furusyo, Norihiro; Murata, Masayuki; Toyoda, Kazuhiro; Eiraku, Kunimitsu; Shimizu, Motohiro; Harada, Yuji; Mitsumoto, Fujiko; Takayama, Koji; Okada, Kyoko; Kainuma, Mosaburo; Hayashi, Jun

    2013-08-01

    Monitoring hepatitis C virus (HCV) kinetics during antiviral treatment is recommended for determining the best form of treatment management. We compared the measurement of HCV RNA by two Real-time PCR assays during the first 12weeks phase of telaprevir in combination with pegylated interferon α2b and ribavirin treatment for chronic hepatitis C patients. The viral kinetics of 65 patients with HCV genotype 1b was assessed. HCV RNA was tested at baseline, on day 3, and every week from 1 to 12 by both the first-generation Roche COBAS® AmpliPrep/COBAS® TaqMan® HCV (CAP/CTM) assay and the Abbott RealTime HCV (ART) assay. A total of 910 serum samples were obtained from the 65 patients. Of these, 168 (28.5%) of the 590 samples HCV RNA negative by CAP/CTM were positive by ART. In contrast, 17 (3.9%) of the 439 samples HCV RNA negative by ART were positive by CAP/CTM. The rates of HCV RNA negativity by ART at weeks 3, 4, and 5 were significantly lower than those by CAP/CTM (21.5% vs. 50.8%, 36.9% vs. 70.8% and 44.6% vs. 81.5%; P<0.001, P<0.0001 and P<0.05, respectively). Although the ART is superior for the determination of HCV RNA negativity, the predictive value of detectable HCV RNA for non-sustained virological response (non-SVR) by CAP/CTM is higher than by ART at weeks 4, 6, and 8. We also found that 16 (24.6%) by CAP/CTM and 28 (43.1%) by ART had a reappearance of residual HCV RNA during the telaprevir treatment period. However, the reappearance of residual HCV RNA was not associated with non-SVR. In conclusion, a significant difference was found between the two real-time PCR assays for the assessment of virological response based on undetectable HCV RNA.

  2. Hepatitis C and sex.

    PubMed

    Page, Emma E; Nelson, Mark

    2016-04-01

    An outbreak of acute hepatitis C among HIV-positive men who have sex with men (MSM) in the last decade has been shown to be sexually transmitted. Initially recreational drug use, in particular drug injection, was not prevalent among those becoming infected with hepatitis C. However more recently chemsex (the use of drugs to enhance sexual experience) and its associated drugs, which are not uncommonly injected, have become more frequently reported among those diagnosed with hepatitis C. It is hoped that the widespread -introduction of direct-acting antivirals and upscaling of numbers treated may have a positive impact on this epidemic. However their introduction may negatively impact on the perceived risk of acquiring hepatitis C and in conjunction with the introduction of HIV transmission prevention strategies may result in increased transmissions and spread to the HIV-negative MSM population. © 2016 Royal College of Physicians.

  3. Acquired haemophilia A in a patient with chronic hepatitis C virus infection receiving treatment with pegylated interferon plus ribarivin: role of rituximab.

    PubMed

    Fernández de Palencia Espinosa, M Á; Arocas Casañ, V; Garrido Corro, B; de la Rubia Nieto, A

    2013-01-01

    Antecedentes: la hemofilia adquirida es un trastorno infrecuente causado por el desarrollo de inhibidores del factor de coagulación. Para eliminarlos, se requiere tratamiento con corticoides y fármacos citotóxicos. Métodos: describimos el caso del uso de rituximab en hemofilia adquirida refractaria al tratamiento convencional en un hombre de 63 años con infección crónica por el virus de la hepatitis C y que estaba recibiendo tratamiento con interferón pegilado a-2a y ribarivina. Resultados: tras 21 semanas de tratamiento antivírico, el paciente fue ingresado en el hospital por un gran hematoma en la musculatura abdominal. La concentración de factor VIII era nula y el título de inhibidor fue de 345 unidades Bethesda. Se administró tratamiento inmunosupresor oral con metilprednisolona y ciclofosfamida durante 1 mes, con escasa mejoría. Así pues, se sustituyó la ciclofosfamida por una dosis semanal de rituximab intravenoso. Dos meses después, la concentración de factor VIII se normalizó y el título de inhibidor era indetectable. Conclusión: Rituximab puede ser útil en el tratamiento de la hemofilia adquirida resistente al tratamiento estándar.

  4. Validation of the AFP model as a predictor of HCC recurrence in patients with viral hepatitis-related cirrhosis who had received a liver transplant for HCC.

    PubMed

    Notarpaolo, Andrea; Layese, Richard; Magistri, Paolo; Gambato, Maria; Colledan, Michele; Magini, Giulia; Miglioresi, Lucia; Vitale, Alessandro; Vennarecci, Giovanni; Ambrosio, Cecilia D; Burra, Patrizia; Di Benedetto, Fabrizio; Fagiuoli, Stefano; Colasanti, Marco; Maria Ettorre, Giuseppe; Andreoli, Arnoldo; Cillo, Umberto; Laurent, Alexis; Katsahian, Sandrine; Audureau, Etienne; Roudot-Thoraval, Françoise; Duvoux, Christophe

    2017-03-01

    The AFP model was shown to be superior to the Milan criteria for predicting hepatocellular carcinoma (HCC) recurrence after liver transplantation in a French population. Our aim was to test the AFP model in a non-French, post-hepatitic cirrhosis-based population of HCC candidates. 574 patients transplanted for HCC in four Italian centers were studied. AFP score was assessed at the last evaluation before liver transplantation (LT). Probabilities of recurrence and survival were estimated by the log-rank test or competing risk analysis and compared according to the AFP model. 24.7% patients were beyond Milan criteria. HCC complicated hepatitis C virus (HCV) and hepatitis B virus (HBV) cirrhosis in 58.7% and 24% of the cases, respectively. Five-year probabilities of recurrence differed according to AFP score ⩽2 vs. >2 in the whole population (13.2±1.8% vs. 49.8±8.7%, p<0.001, HR=4.98), in patients within Milan criteria (12.8±2.0% vs. 32.4±12.1%, p=0.009, HR=3.51), beyond Milan criteria (14.9±4.2% vs. 58.9±11.5%, p<0.001, HR=4.26), HCV patients (14.9±2.5% vs. 67.6±14.7%, p<0.001, HR=6.56) and HBV patients (11.6±3.4% vs. 34.3±12.5%, p=0.012, HR=3.49). By net reclassification improvement analysis AFP score significantly improved prediction of non-recurrence compared to Milan criteria. Overall five-year survival rates according to AFP score ⩽2 or >2 were 71.7±2.2% vs. 42.2±8.3% (p<0.001, HR=2.14). The AFP model identifies HCC candidates at low risk of recurrence, otherwise excluded by Milan criteria in a population with a predominance of post-hepatitic-related HCC. The AFP score can be proposed for selection of HCC candidates in programs with a high proportion of viral/HCV-related cirrhosis. Selection criteria for liver transplantation of patients affected with hepatocellular carcinoma (HCC) are based on the Milan criteria, which have been shown to be too restrictive, precluding access to liver transplantation for some patients who might be cured by this

  5. Long-term survival after infection with human immunodeficiency virus type 1 (HIV-1) among homosexual men in hepatitis B vaccine trial cohorts in Amsterdam, New York City, and San Francisco, 1978-1995.

    PubMed

    Koblin, B A; van Benthem, B H; Buchbinder, S P; Ren, L; Vittinghoff, E; Stevens, C E; Coutinho, R A; van Griensven, G J

    1999-11-15

    Information on long-term survival after infection with human immunodeficiency virus type 1 (HIV-1) is limited. In hepatitis B vaccine trials in Amsterdam, New York City, and San Francisco, 362 gay men were followed up to 18 years (1978-1995). The median survival time from seroconversion was 12.1 years (95% confidence interval: 11.4, 12.9). The annual risk of dying increased at a constant rate until 8 years after seroconversion and then leveled off, suggesting a group that is relatively resistant to progression. These data provide a picture of the natural history of HIV-1 infection, especially in the era prior to widespread use of highly effective treatments.

  6. Risk of HIV and Hepatitis B and C Over Time Among Men Who Inject Image and Performance Enhancing Drugs in England and Wales: Results From Cross-Sectional Prevalence Surveys, 1992–2013

    PubMed Central

    Harris, Ross; McVeigh, Jim; Cullen, Katelyn J.; Smith, Josie; Parry, John V.; DeAngelis, Daniela; Ncube, Fortune

    2016-01-01

    Background: Infection risks among people who inject drugs (PWID) are widely recognized, but few studies have focused on image and performance enhancing drugs (IPEDs). Globally, concern about IPED injection has increased and, in the United Kingdom, IPED injectors have become the largest group using Needle and Syringe Programmes. Blood-borne virus prevalence trends among IPED injectors are explored. Method: Data from 2 surveys of IPED injectors (2010–2011; 2012–2013) and the national bio-behavioral surveillance system for PWID (1992–1997; 1998–2003; 2004–2009) were merged. Psychoactive drug injectors and women were excluded. Logistic regression analyses explored temporal changes. Results: Between 1992 and 2009, median age increased from 25 to 29 years (N = 1296), years injecting from 2 to 4. There were 53 men who had sex with men (MSM). Overall, 0.93% had HIV, 4.4% ever had hepatitis B (HBV), and 3.9% hepatitis C (HCV, from 1998, N = 1083). In multivariable analyses, HIV increased in 2004–2009 [adjusted odds ratio (AOR) = 10 (95% confidence interval (CI): 0.94 to 106) vs. 1992–2003], and remained elevated (AOR = 4.12, 95% CI: 0.31 to 54, 2012–2013); HBV also increased in 2004–2009 (AOR = 3.98, 95% CI: 1.59 to 9.97). HCV prevalence increase was only borderline significant (AOR = 2.47, 95% CI: 0.90 to 6.77, 2010–2011). HIV and HBV were associated with MSM and HCV with sharing needles/syringes. Uptake of diagnostic testing for HIV and HCV, and HBV vaccination increased (to 43%, 32% and 44% respectively). Condom use was consistently poor; needle/syringe sharing occurred. Conclusion: Blood-borne virus prevalences among IPED injectors have increased and for HIV, is now similar to that among psychoactive drug injectors. Targeted interventions to reduce risks are indicated. PMID:26361173

  7. Risk of HIV and Hepatitis B and C Over Time Among Men Who Inject Image and Performance Enhancing Drugs in England and Wales: Results From Cross-Sectional Prevalence Surveys, 1992-2013.

    PubMed

    Hope, Vivian D; Harris, Ross; McVeigh, Jim; Cullen, Katelyn J; Smith, Josie; Parry, John V; DeAngelis, Daniela; Ncube, Fortune

    2016-03-01

    Infection risks among people who inject drugs (PWID) are widely recognized, but few studies have focused on image and performance enhancing drugs (IPEDs). Globally, concern about IPED injection has increased and, in the United Kingdom, IPED injectors have become the largest group using Needle and Syringe Programmes. Blood-borne virus prevalence trends among IPED injectors are explored. Data from 2 surveys of IPED injectors (2010-2011; 2012-2013) and the national bio-behavioral surveillance system for PWID (1992-1997; 1998-2003; 2004-2009) were merged. Psychoactive drug injectors and women were excluded. Logistic regression analyses explored temporal changes. Between 1992 and 2009, median age increased from 25 to 29 years (N = 1296), years injecting from 2 to 4. There were 53 men who had sex with men (MSM). Overall, 0.93% had HIV, 4.4% ever had hepatitis B (HBV), and 3.9% hepatitis C (HCV, from 1998, N = 1083). In multivariable analyses, HIV increased in 2004-2009 [adjusted odds ratio (AOR) = 10 (95% confidence interval (CI): 0.94 to 106) vs. 1992-2003], and remained elevated (AOR = 4.12, 95% CI: 0.31 to 54, 2012-2013); HBV also increased in 2004-2009 (AOR = 3.98, 95% CI: 1.59 to 9.97). HCV prevalence increase was only borderline significant (AOR = 2.47, 95% CI: 0.90 to 6.77, 2010-2011). HIV and HBV were associated with MSM and HCV with sharing needles/syringes. Uptake of diagnostic testing for HIV and HCV, and HBV vaccination increased (to 43%, 32% and 44% respectively). Condom use was consistently poor; needle/syringe sharing occurred. Blood-borne virus prevalences among IPED injectors have increased and for HIV, is now similar to that among psychoactive drug injectors. Targeted interventions to reduce risks are indicated.

  8. Hepatitis C Viral Evolution in Genotype 1 Treatment-Naïve and Treatment-Experienced Patients Receiving Telaprevir-Based Therapy in Clinical Trials

    PubMed Central

    Kieffer, Tara L.; De Meyer, Sandra; Bartels, Doug J.; Sullivan, James C.; Zhang, Eileen Z.; Tigges, Ann; Dierynck, Inge; Spanks, Joan; Dorrian, Jennifer; Jiang, Min; Adiwijaya, Bambang; Ghys, Anne; Beumont, Maria; Kauffman, Robert S.; Adda, Nathalie; Jacobson, Ira M.; Sherman, Kenneth E.; Zeuzem, Stefan; Kwong, Ann D.; Picchio, Gaston

    2012-01-01

    Background In patients with genotype 1 chronic hepatitis C infection, telaprevir (TVR) in combination with peginterferon and ribavirin (PR) significantly increased sustained virologic response (SVR) rates compared with PR alone. However, genotypic changes could be observed in TVR-treated patients who did not achieve an SVR. Methods Population sequence analysis of the NS3•4A region was performed in patients who did not achieve SVR with TVR-based treatment. Results Resistant variants were observed after treatment with a telaprevir-based regimen in 12% of treatment-naïve patients (ADVANCE; T12PR arm), 6% of prior relapsers, 24% of prior partial responders, and 51% of prior null responder patients (REALIZE, T12PR48 arms). NS3 protease variants V36M, R155K, and V36M+R155K emerged frequently in patients with genotype 1a and V36A, T54A, and A156S/T in patients with genotype 1b. Lower-level resistance to telaprevir was conferred by V36A/M, T54A/S, R155K/T, and A156S variants; and higher-level resistance to telaprevir was conferred by A156T and V36M+R155K variants. Virologic failure during telaprevir treatment was more common in patients with genotype 1a and in prior PR nonresponder patients and was associated with higher-level telaprevir-resistant variants. Relapse was usually associated with wild-type or lower-level resistant variants. After treatment, viral populations were wild-type with a median time of 10 months for genotype 1a and 3 weeks for genotype 1b patients. Conclusions A consistent, subtype-dependent resistance profile was observed in patients who did not achieve an SVR with telaprevir-based treatment. The primary role of TVR is to inhibit wild-type virus and variants with lower-levels of resistance to telaprevir. The complementary role of PR is to clear any remaining telaprevir-resistant variants, especially higher-level telaprevir-resistant variants. Resistant variants are detectable in most patients who fail to achieve SVR, but their levels decline over

  9. Seropositivity rates for toxoplasmosis, rubella, syphilis, cytomegalovirus, hepatitis and HIV among pregnant women receiving care at a public health service, São Paulo state, Brazil.

    PubMed

    Gonçalves, Márcia Aparecida dos Santos; Matos, Cinara de Cássia Brandão de; Spegiorin, Lígia Cosentino Junqueira Franco; Oliani, Denise Cristina Mós Vaz; Oliani, Antonio Hélio; Mattos, Luiz Carlos de

    2010-01-01

    Infectious and parasitic diseases affecting women during their reproductive age may result in vertical transmission. The aim of this study was to determine the seroprevalence for TORSCH among pregnant women receiving care at a university hospital. Records of 574 pregnant women who received medical attention from January 2006 to December 2007 were assessed. The mean age was 27.2 ± 6.5 years ranging from 13 to 44. The results of the immunodiagnostic tests were: 62.0% (345/556) for IgG and 3.4% (19/556) for IgM anti-T. gondii; 93.1% (433/465) for IgG and 0.6% (3/465) for IgM anti-rubella; 0.9% (5/561) for VDRL; 1.8% (10/554) for HBsAg; 0.7% (4/545) for anti-HCV and 2.1% (11/531) for HIV. In conclusion, the results of immunodiagnostic tests for the TORSCH panel among pregnant women attending a perinatal service of a university hospital are in agreement with those reported by previous studies and by governmental sources.

  10. Chumnguh Thleum: Understanding Liver Illness and Hepatitis B Among Cambodian Immigrants

    PubMed Central

    Do, Hoai Huyen; Talbot, Jocelyn; Sos, Channdara; Svy, Danika; Taylor, Victoria M.

    2010-01-01

    Cambodian immigrants are over 25 times more likely to have evidence of chronic hepatitis B infection than the general US population. Carriers of HBV are over 100 times more likely to develop liver cancer than non-carriers. Liver cancer incidence is the second leading cancer for Cambodian men and the sixth for Cambodian women. Despite this, this underserved population has received very little attention from health disparities researchers. Culturally and linguistically appropriate interventions are necessary to increase hepatitis B knowledge, serologic testing, and vaccination among Cambodian Americans. Eight group interviews were held with Cambodian American men (48) and women (49). Focus group discussion revealed unanticipated information about sociocultural influences on participants’ understanding about hepatitis B transmission, disease course, and prevention and treatment informed by humoral theories underlying Khmer medicine, by biomedicine, and by migration experiences. Our findings reveal the value of qualitative exploration to providing cultural context to biomedical information—a formula for effective health promotion and practice. PMID:20496000

  11. Chumnguh thleum: understanding liver illness and hepatitis B among Cambodian immigrants.

    PubMed

    Burke, Nancy J; Do, Hoai Huyen; Talbot, Jocelyn; Sos, Channdara; Svy, Danika; Taylor, Victoria M

    2011-02-01

    Cambodian immigrants are over 25 times more likely to have evidence of chronic hepatitis B infection than the general US population. Carriers of HBV are over 100 times more likely to develop liver cancer than non-carriers. Liver cancer incidence is the second leading cancer for Cambodian men and the sixth for Cambodian women. Despite this, this underserved population has received very little attention from health disparities researchers. Culturally and linguistically appropriate interventions are necessary to increase hepatitis B knowledge, serologic testing, and vaccination among Cambodian Americans. Eight group interviews were held with Cambodian American men (48) and women (49). Focus group discussion revealed unanticipated information about sociocultural influences on participants' understanding about hepatitis B transmission, disease course, and prevention and treatment informed by humoral theories underlying Khmer medicine, by biomedicine, and by migration experiences. Our findings reveal the value of qualitative exploration to providing cultural context to biomedical information--a formula for effective health promotion and practice.

  12. Viral Hepatitis

    MedlinePlus

    ... with hepatitis? How does a pregnant woman pass hepatitis B virus to her baby? If I have hepatitis B, what does my baby need so that she ... Can I breastfeed my baby if I have hepatitis B? More information on viral hepatitis What is hepatitis? ...

  13. Higher risk of incident hepatitis C virus among young women who inject drugs compared with young men in association with sexual relationships: a prospective analysis from the UFO Study cohort.

    PubMed

    Tracy, Daniel; Hahn, Judith A; Fuller Lewis, Crystal; Evans, Jennifer; Briceño, Alya; Morris, Meghan D; Lum, Paula J; Page, Kimberly

    2014-05-29

    Female injection drug users (IDUs) may report differences in injection behaviours that put them at greater risk for hepatitis C virus (HCV). Few studies have examined these in association with HCV incidence. Longitudinal data from a cohort of 417 HCV-uninfected IDU aged 30 or younger were analysed. Cox proportional hazards was used to model female sex as a predictor of new HCV infection. General estimating equation (GEE) analysis was used to model female sex as a predictor of HCV-associated risk behaviour prospectively. Women were significantly more likely than men to become infected with HCV during study follow-up (HR 1.4, p<0.05), and were also more likely than men to report high-risk injecting behaviours, especially in the context of sexual and injecting relationships. Sex differences in injecting behaviours appeared to explain the relationship between sex and HCV infection. Young women's riskier injection practices lead to their higher rates of HCV infection. Further study on the impact of intimate partnership on women's risk behaviour is warranted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Higher risk of incident hepatitis C virus among young women who inject drugs compared with young men in association with sexual relationships: a prospective analysis from the UFO Study cohort

    PubMed Central

    Tracy, Daniel; Hahn, Judith A; Fuller Lewis, Crystal; Evans, Jennifer; Briceño, Alya; Morris, Meghan D; Lum, Paula J; Page, Kimberly

    2014-01-01

    Background Female injection drug users (IDUs) may report differences in injection behaviours that put them at greater risk for hepatitis C virus (HCV). Few studies have examined these in association with HCV incidence. Methods Longitudinal data from a cohort of 417 HCV-uninfected IDU aged 30 or younger were analysed. Cox proportional hazards was used to model female sex as a predictor of new HCV infection. General estimating equation (GEE) analysis was used to model female sex as a predictor of HCV-associated risk behaviour prospectively. Results Women were significantly more likely than men to become infected with HCV during study follow-up (HR 1.4, p<0.05), and were also more likely than men to report high-risk injecting behaviours, especially in the context of sexual and injecting relationships. Sex differences in injecting behaviours appeared to explain the relationship between sex and HCV infection. Conclusions Young women’s riskier injection practices lead to their higher rates of HCV infection. Further study on the impact of intimate partnership on women’s risk behaviour is warranted. PMID:24875490

  15. CALUTRON RECEIVER

    DOEpatents

    Barnes, S.W.

    1959-06-16

    An improved receiver and receiver mount for calutrons are described. The receiver can be manipulated from outside the tank by a single control to position it with respect to the beam. A door can be operated exteriorly also to prevent undesired portions of the beam from entering the receiver. The receiver has an improved pocket which is more selective in the ions collected. (T.R.H.)

  16. Prevalence of Hepatitis B and Knowledge About Hepatitis B Among Migrant Workers in Shandong Province, China: A Cross-Sectional Study

    PubMed Central

    Yang, Yan; Yan, Ming; Yue, Meng; Wang, Xiaohua; Zhang, Wei; Li, Jie; Li, Shuqing

    2015-01-01

    Background: China is a country with a high prevalence of hepatitis B. As a special population, migrant workers are more vulnerable to hepatitis B. Objectives: The present study was conducted to gain insight into the prevalence of hepatitis B and knowledge about hepatitis B among migrant workers in Shandong Province, China, as well as to explore a series of strategies for preventing and controlling the spread and prevalence of hepatitis B. Patients and Methods: A cross-sectional study was conducted without age restriction, in Shandong Province in China. The sample-size was determined scientifically. The study population was selected using the random multistage cluster sampling. Personal information, including sex, age, ethnicity, marital status, education level, years of duration of stay in Jinan and health insurance were obtained from 2065 migrant workers. Moreover, blood samples were collected for hepatitis B infection screening. Knowledge about hepatitis B was assessed using a self-administered questionnaire. Correct response rates were calculated. Results: Of 2065 migrant workers tested for Hepatitis B Surface Antigen (HBsAg), 167 (126 men and 41 women) tested positive for HBsAg; the overall prevalence was 8.1%. The prevalence rates in men and women were 9.6% and 5.4%, respectively. The prevalence rates in subjects 18 - 30 years old and 30 years older were 3.5% and 9.3%, respectively. There were statistically significant differences between those groups (P < 0.05). Correct response rates for the transmission of hepatitis B questions were low, especially for a question regarding whether hepatitis B can be transferred by sexual contact (36.8%) and whether it can be transferred from mothers to infants (33.9%). A total of 80.9% of migrant workers correctly responded that vaccination is effective for hepatitis B. However, 68% of migrants also had the misconception that it is necessary to receive a booster vaccination. Conclusions: The hepatitis B virus infection rate

  17. [Management of the risk of hepatitis B virus reactivation in patients receiving immunosuppressive and immunomodulatory agents in internal medicine: data from the REACTI-B survey and proposal for a management algorithm].

    PubMed

    Terrier, B; Pol, S; Thibault, V; Gottenberg, J-E; Cacoub, P

    2012-01-01

    [corrected] This study aimed to evaluate the screening practices and management of the risk of hepatitis B virus (HBV) reactivation in patients receiving immunosuppressive and immunomodulatory agents in internal medicine departments and to propose a diagnostic and therapeutic algorithm. Descriptive, cross-sectional survey of the 1350 members of the French Society of Internal Medicine, which took place in France in January 2011 using an electronic questionnaire. Experts in the field of HBV infection proposed a decisional algorithm. The overall response rate was 21.5%. Screening of HBV infection was performed in 44%, 68% and 76% of patients receiving or prior to initiating corticosteroids, immunosuppressive and immunomodulatory agents, respectively. Among participants, 35% had been confronted with one or several cases of HBV reactivation, mainly in patients receiving corticosteroids (54%), cyclophosphamide (34%) or rituximab (33%). Chronic, inactive carriers of HBV were considered to be at risk of reactivation in 89% of cases, while 41% of anti-HBc positive patients were considered at risk. In at-risk patients initiating immunosuppressive and/or immunomodulatory agents, 43% of practitioners consider the use of pre-emptive therapy, whereas 33% treat in case of confirmed reactivation. Systematic HBV vaccination of seronegative patients is planned in less than 50% of cases. Finally, 89% of participants feel they are not sufficiently educated regarding the risks of HBV reactivation and its prevention. This survey highlights the need to improve the education of physicians regarding the risks of HBV reactivation prior to initiating corticosteroids, immunosuppressive and immunomodulatory agents, and to provide more specific guidelines for patients managed in internal medicine departments. Copyright © 2011 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  18. Men's Health

    MedlinePlus

    ... men need to pay more attention to their health. Compared to women, men are more likely to ... regular checkups and medical care There are also health conditions that only affect men, such as prostate ...

  19. Investigating the widely held belief that men and women with learning disabilities receive poor quality healthcare when admitted to hospital: a single-site study of 30-day readmission rates.

    PubMed

    Kelly, C L; Thomson, K; Wagner, A P; Waters, J P; Thompson, A; Jones, S; Holland, A J; Redley, M

    2015-09-01

    This study aims to use 30-day readmission rates to investigate the presumption that men and women with learning disabilities (LDs, known internationally as intellectual disabilities) receive poorer quality hospital care than their non-disabled peers. A 12-month retrospective audit was conducted using Hospital Episode Statistics (HES) at a single acute hospital in the East of England. This identified all in-patient admissions; admissions where the person concerned was recognised as having a LD; and all emergency readmissions within 30 days of discharge. Additionally, the healthcare records of all patients identified as having a LD and readmitted within 30 days as a medical emergency were examined in order to determine whether or not these readmissions were potentially preventable. Over the study period, a total of 66 870 adults were admitted as in-patients, among whom 7408 were readmitted as medical emergencies within 30 days of discharge: a readmission rate of 11%. Of these 66 870 patients, 256 were identified as having a LD, with 32 of them experiencing at least one emergency readmission within 30 days: a readmission rate of 13%. When examined, the healthcare records pertaining to these 32 patients who had a total of 39 unique 30-day readmissions revealed that 69% (n = 26) of these readmissions were potentially preventable. Although overall readmission rates were similar for patients with LDs and those from the general population, patients with LDs had a much higher rate of potentially preventable readmissions when compared to a general population estimate from van Walraven et al. This suggests that there is still work to be done to ensure that this patient population receives hospital care that is both safe and of high quality. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  20. CALUTRON RECEIVER

    DOEpatents

    Brunk, W.O.

    1959-09-29

    A description is given for an improved calutron receiver having a face plate lying at an angle to the direction of the entering ion beams but having an opening, the plane of which is substantially perpendicular to that of the entering ion beams. By so positioning the opening in the receiver, the effective area through which the desired material may enter the receiver is increased, and at the same time the effective area through which containattng material may enter the receiver is reduced.

  1. Sexual transmission of viral hepatitis.

    PubMed

    Gorgos, Linda

    2013-12-01

    Identification and vaccination of adults at risk for hepatitis B virus acquisition through sexual contact is a key strategy to reduce new hepatitis B virus infections among at-risk adults. Hepatitis C has emerged as a sexually transmitted infection among men with male sex partners (MSM). Several biological and behavioral factors have been linked to hepatitis C virus transmission among MSM, including human immunodeficiency virus coinfection; participation in sexual practices that result in mucosal damage or result in exposure to blood; presence of sexually transmitted diseases (STIs), particularly ulcerative STIs; multiple/casual sex partners; and unprotected anal intercourse. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Implementation of a hepatitis A/B vaccination program using an accelerated schedule among high-risk inmates, Los Angeles County Jail, 2007-2010.

    PubMed

    Costumbrado, John; Stirland, Ali; Cox, Garrett; El-Amin, Alvin Nelson; Miranda, Armidia; Carter, Ann; Malek, Mark

    2012-11-06

    The Centers for Disease Control and Prevention recommend vaccination for men who have sex with men (MSM) and injection drug users against hepatitis A and B. This study is the first report of a hepatitis vaccination program in a United States jail with a combined vaccine using an accelerated schedule. Los Angeles County has the largest jail system in the nation and Men's Central Jail (MCJ) is the largest facility within that system. MCJ includes a unit for self-identified MSM, where approximately 2700 inmates are housed per year. Starting in August 2007, a combined hepatitis A and B vaccine was offered to all inmates housed in this special unit. Using an accelerated schedule (0-, 7-, 21-30 days, 12-month booster), a total of 3931 doses were administered to 1633 inmates as of June 2010. Of those, 77% received 2 doses, 58% received 3 doses, and 11% received the booster dose. Inmates who screened positive for a sexually transmitted infection in this unit were 1.3 times more likely to be vaccinated (95% CI 1.2-1.4) compared to others in the same housing unit who screened negative. Hepatitis vaccination initiatives can be successfully implemented in an urban jail among an extremely high-risk population using the accelerated, combined hepatitis A/B vaccine. Ours may be a useful model for other programs to vaccinate incarcerated populations. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Human immunodeficiency virus, hepatitis B, C and D in Bangladesh's trucking industry: prevalence and risk factors.

    PubMed

    Gibney, L; Saquib, N; Metzger, J; Choudhury, P; Siddiqui, M; Hassan, M

    2001-08-01

    Human immunodeficiency virus (HIV) and hepatitis B and C, viral infections with shared percutaneous, mucosal and perinatal routes of transmission, are responsible for serious morbidity and mortality globally. In Bangladesh there is a dearth of research on prevalence and risk factors for these diseases. This study examines the prevalence of HIV and hepatitis (B, C, D) and risk factors associated with infection in men in Bangladesh's trucking industry (drivers and helpers on trucks), a population at risk for sexually transmitted infections. The study population comprised 388 men (245 drivers, 143 helpers) working out of Tejgaon truck stand in Dhaka, Bangladesh. Subjects were selected through a two-tiered sampling strategy. Of 185 trucking agencies 38 were randomly selected and a of 10 subjects was recruited from each agency. Subjects were interviewed, underwent a comprehensive physical examination and had blood samples taken. Gold standard laboratory tests were conducted to detect HIV, hepatitis B, C, and D infections. To assess risk factors associated with current hepatitis B infections or being a carrier (HBsAg) and lifetime exposure to hepatitis B infection (anti-HBc), simple and multiple logistic regression analyses were performed. The prevalence of diseases were: HIV 0%, hepatitis C <1%, hepatitis B surface antigen 5.9%, antibody to hepatitis B core antigen 48.1% (with 5 of the 23 HBsAg positive cases testing positive for HBeAg and 18 for anti-HBe), and hepatitis D 0%. Having ever received a therapeutic injection and having had relations with a commercial sex worker (CSW) in the past year were both significantly associated with lifetime exposure to hepatitis B (anti-HBc); having received a therapeutic injection in the past year was associated with being either currently infected with hepatitis B or a carrier (HBsAg). The results of the study illustrate the importance of educating health care practitioners about the dangers of unsterile injections, and of

  4. CALUTRON RECEIVER

    DOEpatents

    York, H.F.

    1959-07-01

    A receiver construction is presented for calutrons having two or more ion sources and an individual receiver unit for each source. Design requirements dictate that the face plate defining the receiver entrance slots be placed at an angle to the approaching beam, which means that ions striking the face plate are likely to be scattcred into the entrance slots of other receivers. According to the present invention, the face plate has a surface provided with parallel ridges so disposed that one side only of each ridge's exposed directly to the ion beam. The scattered ions are directed away from adjacent receivers by the ridges on the lace plate.

  5. Hepatitis C

    MedlinePlus

    ... your doctor may want you to get the hepatitis B vaccine (and maybe the hepatitis A vaccine, too), if you don't already have these viruses. If you have hepatitis C, you are more likely to catch hepatitis A or hepatitis B, which would cause more damage to your liver. ...

  6. Application of the Extended Health Control Belief Model to Predict Hepatitis A and B Vaccinations.

    PubMed

    Reynolds, Grace L; Nguyen, Hannah H; Singh-Carlson, Savitri; Fisher, Dennis G; Odell, Anne; Xandre, Pamela

    2016-09-01

    Adult vaccination compliance rates vary according to sample and type of vaccine administered (influenza, pneumococcal). This study looked at vaccination of a community sample of low-income, minority adults. Nurses offered free vaccination for hepatitis A and B in the form of the combined Twinrix vaccine to adults on a walk-in basis. In addition to dosing information, participants completed the Risk Behavior Assessment, the Coping Strategies Indicator and the Cardiovascular Risk Assessment. Skaff's extended Health Belief Model was used as the theoretical framework. Count regression was used to model receipt of one, two, or three doses. The majority of participants were male with a mean age of 40 years. The distribution of doses was: 173 individuals (27.6%) received one dose only, 261 (41.7%) received two doses, and 191 (30.5%) received three doses of vaccine. The multivariate count regression model including being male, having previously been told by a health care provider that one has syphilis, having severe negative emotions, and perceived social support were associated with participants' receiving fewer doses of hepatitis vaccine. A greater problem-solving score was associated with a higher number of vaccine doses received. Despite free vaccinations offered in an easily accessible community setting, the majority of participants failed to complete the hepatitis vaccine series. More effort is needed to get adult men to participate in hepatitis vaccination clinics. Additional research is necessary to understand barriers other than cost to adults receiving vaccination. © 2016 Wiley Periodicals, Inc.

  7. Hepatitis C

    MedlinePlus

    Hepatitis C Overview By Mayo Clinic Staff Hepatitis C is a viral infection that causes liver inflammation, sometimes leading to serious liver damage. The hepatitis C virus (HCV) spreads through contaminated ...

  8. CALUTRON RECEIVERS

    DOEpatents

    Schmidt, F.H.; Stone, K.F.

    1958-09-01

    S>This patent relates to improvements in calutron devices and, more specifically, describes a receiver fer collecting the ion curreot after it is formed into a beam of non-homogeneous isotropic cross-section. The invention embodies a calutron receiver having an ion receiving pocket for separately collecting and retaining ions traveling in a selected portion of the ion beam and anelectrode for intercepting ions traveling in another selected pontion of the ion beam. The electrode is disposed so as to fix the limit of one side of the pontion of the ion beam admitted iato the ion receiving pocket.

  9. Hepatitis C virus infection and its relationship to certain sexual practices in men-who-have-sex-with-men in Spain: results from the European MSM internet survey (EMIS).

    PubMed

    Fernández-Dávila, Percy; Folch, Cinta; Ferrer, Laia; Soriano, Raúl; Diez, Mercedes; Casabona, Jordi

    2015-05-01

    To compare sexual practices and risk behaviours between MSM who were first diagnosed with hepatitis C (HCV) in the previous 12 months and those who were never diagnosed; and, to identify factors associated with a diagnosis of HCV. The European-MSM-Internet-Survey (EMIS) was implemented for 3 months during 2010, mainly on websites for MSM. Data on socio-demographic characteristics, sexual behaviour, drug use, STI history, and other sexual health variables were collected. The Chi-square test and logistic regression analysis were used to analyse the data. Data from 13,111 respondents were analysed. The proportion of MSM who had ever been diagnosed with HCV infection was 1.9% (n=250), and of those currently infected with the virus was 0.6% (n=78). The percentage of those first diagnosed in the last 12 months was 0.4% (n=46), of whom 70% were HIV-negative and 22% had HIV coinfection. Having a first diagnosis of HCV in the last 12 months was more common among HIV-positive than among HIV-negative MSM (0.9% vs 0.4%) and among MSM born abroad than among Spanish-born (0.7% vs 0.3%). MSM diagnosed with HCV in the last 12 months were more likely to have had: more than 10 sexual partners, sex abroad, receptive anal intercourse, insertive/receptive fisting, and unprotected anal intercourse with non-steady partners of unknown or discordant HIV-status. Likewise, they reported more frequent visits to sex-focused venues, higher drug use, as well as a higher proportion of STI diagnosis. In the multivariate model, visiting a public sex-focused venue, practicing receptive fisting, using erection enhancing medication and having a diagnosis of syphilis were independently associated with a first diagnosis of HCV in the last 12 months. HCV infection does not seem to be restricted to HIV-infected MSM. Certain sexual behaviour (fisting, visiting sex-focused venues), drug use, and ulcerative STI seem to be associated with a diagnosis of HCV. Copyright © 2014 Elsevier España, S.L.U. y

  10. Mortality and morbidity among military personnel and civilians during the 1930s and World War II from transmission of hepatitis during yellow fever vaccination: systematic review.

    PubMed

    Thomas, Roger E; Lorenzetti, Diane L; Spragins, Wendy

    2013-03-01

    During World War II, nearly all US and Allied troops received yellow fever vaccine. Until May 1942, it was both grown and suspended in human serum. In April 1942, major epidemics of hepatitis occurred in US and Allied troops who had received yellow fever vaccine. A rapid and thorough investigation by the US surgeon general followed, and a directive was issued discontinuing the use of human serum in vaccine production. The large number of cases of hepatitis caused by the administration of this vaccine could have been avoided. Had authorities undertaken a thorough review of the literature, they would have discovered published reports, as early as 1885, of postvaccination epidemics of hepatitis in both men and horses. It would take 4 additional decades of experiments and epidemiological research before viruses of hepatitis A, B, C, D, and E were identified, their modes of transmission understood, and their genomes sequenced.

  11. Mortality and Morbidity Among Military Personnel and Civilians During the 1930s and World War II From Transmission of Hepatitis During Yellow Fever Vaccination: Systematic Review

    PubMed Central

    Lorenzetti, Diane L.; Spragins, Wendy

    2013-01-01

    During World War II, nearly all US and Allied troops received yellow fever vaccine. Until May 1942, it was both grown and suspended in human serum. In April 1942, major epidemics of hepatitis occurred in US and Allied troops who had received yellow fever vaccine. A rapid and thorough investigation by the US surgeon general followed, and a directive was issued discontinuing the use of human serum in vaccine production. The large number of cases of hepatitis caused by the administration of this vaccine could have been avoided. Had authorities undertaken a thorough review of the literature, they would have discovered published reports, as early as 1885, of postvaccination epidemics of hepatitis in both men and horses. It would take 4 additional decades of experiments and epidemiological research before viruses of hepatitis A, B, C, D, and E were identified, their modes of transmission understood, and their genomes sequenced. PMID:23327242

  12. De Novo Hepatitis B Infection From Hepatitis B Core Antibody-Positive Donors During Hepatitis B Immunoglobulin Prophylaxis.

    PubMed

    Shin, Milljae; Chang, Seong-Hwan

    2016-02-01

    De novo hepatitis B infection in patients receiving liver transplants from hepatitis B core antibody-positive donors is well known, but the effective prevention strategy has not been well established. In our hospital, recipients receive hepatitis B immunoglobulin monotherapy if they are hepatitis B surface antigen negative at the time of transplant and are receiving a liver from a hepatitis B core antibody-positive donor. Since August 2006, we have had 4 patients who were naïve to hepatitis B virus and received a hepatitis B core antibody-positive graft. Two patients died of other causes, and 2 patients, who had liver transplant in October 2006 and October 2009, developed de novo hepatitis B. Both patients were tested annually for serum hepatitis B surface antigen as part of routine visit. Tests were negative; however, both patients recently became hepatitis B surface antigen positive. Other laboratory results, including liver function test, were unremarkable, except HBsAb titer was undetectable even though hepatitis B immunoglobulin monotherapy had been administrated 2 months previously in both patients. The patients had hepatitis B virus DNA levels of 3.07E+08 copies/mL and 1.51E+08 copies/mL. We suggest that additional prophylactic therapies above hepatitis B immunoglobulin monotherapy are needed for these recipients.

  13. Hepatitis B

    MedlinePlus

    ... of the liver), liver cancer, and even death.Hepatitis A can cause varying symptoms, but most often causes fever, tiredness, ... important? The hepatitis B vaccine prevents infection with hepatitis B virus, which causes liver cancer. The hepatitis B virus is 100 ...

  14. Hepatitis A

    MedlinePlus

    ... transaminase enzyme levels Treatment There is no specific treatment for hepatitis A. You should rest when the symptoms are ... and have not had hepatitis A or the hepatitis A vaccine. Common reasons for getting one or both of these treatments include: You live with someone who has hepatitis ...

  15. Hepatitis B Antigen in Viral Hepatitis in West London

    PubMed Central

    Farrow, L. J.; Lamb, S. G.; Coghill, N. F.; Lindon, R. L.; Preece, Jill; Zuckerman, A. J.; Stewart, J. S.

    1974-01-01

    During the first 12 months of a total population survey 249 patients were seen with viral hepatitis. A total of 215 of these were tested for hepatitis B antigen (HB Ag) by radioimmunoassay and 32 (15%) were positive. More than five times as many men (27) as women (5) were HBAg positive and 19 of the men were between the ages of 20 and 39 years. There were only four drug addicts among those tested, two of whom were positive, as were two of the four patients who were tattooed. Sixty out of 86 children (under 15 years) were tested for HBAg and none was positive. PMID:4852256

  16. Hepatitis B antigen in viral hepatitis in West London.

    PubMed

    Farrow, L J; Lamb, S G; Coghill, N F; Lindon, R L; Preece, J; Zuckerman, A J; Stewart, J S

    1974-07-13

    During the first 12 months of a total population survey 249 patients were seen with viral hepatitis. A total of 215 of these were tested for hepatitis B antigen (HB Ag) by radioimmunoassay and 32 (15%) were positive.More than five times as many men (27) as women (5) were HBAg positive and 19 of the men were between the ages of 20 and 39 years. There were only four drug addicts among those tested, two of whom were positive, as were two of the four patients who were tattooed.Sixty out of 86 children (under 15 years) were tested for HBAg and none was positive.

  17. Meningococcal groups C and Y and haemophilus B tetanus toxoid conjugate vaccine (HibMenCY-TT; MenHibrix(®)): a review.

    PubMed

    Perry, Caroline M

    2013-05-01

    The meningococcal groups C and Y and Haemophilus b (Hib) tetanus toxoid conjugate vaccine (HibMenCY-TT) contains Neisseria meningitidis serogroup C and Y capsular polysaccharide antigens, and Hib capsular polysaccharide [polyribosyl-ribitol-phosphate (PRP)]. The HibMenCY-TT vaccine is available in the USA for use as active immunization to prevent invasive disease caused by N. meningitidis serogroups C (MenC) and Y (MenY), and Hib in children 6 weeks-18 months of age. HibMenCY-TT is the first meningococcal vaccine available for use in the USA that can be administered to infants as young as 6 weeks of age. In a randomized, controlled, phase III clinical trial, the HibMenCY-TT vaccine, administered to infants at 2, 4, 6 and 12-15 months of age, was immunogenic against MenC and MenY, and met the prespecified criteria for immunogenicity. Anti-PRP antibodies, which have been shown to correlate with protection against Hib invasive disease, were also induced in the infants who received the HibMenCY-TT vaccine, with induced levels of this antibody noninferior to those occurring in the control group of infants who received a Hib tetanus toxoid conjugate vaccine at 2, 4, and 6 months and a single dose of Hib conjugated to N. meningitidis outer membrane protein at 12-15 months. In several randomized, controlled clinical trials, HibMenCY-TT was coadministered with vaccines that are routinely administered to infants and toddlers in the USA. These vaccines included: diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B (recombinant) and inactivated poliovirus vaccine combined; 7-valent Streptococcus pneumoniae polysaccharide conjugate vaccine; measles, mumps and rubella vaccine; and varicella vaccine. Coadministration of these vaccines did not interfere with the immunogenicity of the HibMenCY-TT vaccine. Similarly, immune responses to the coadministered vaccines were not affected by the HibMenCY-TT vaccine. The tolerability profile of the HibMen

  18. CALUTRON RECEIVER

    DOEpatents

    Barnes, S.W.

    1959-08-25

    An improvement in a calutron receiver for collecting the isotopes ts described. The electromagnetic separation of the isotopes produces a mass spectrum of closely adjacent beams of ions at the foci regions, and a dividing wall between the two pockets is arranged at an angle. Substantially all of the tons of the less abundant isotope enter one of the pockets and strike one side of the wall directly, while substantially none of the tons entering the other pocket strikes the wall directly.

  19. Predicting the impact of adverse events and treatment duration on medical resource utilization-related costs in hepatitis C genotype 1 treatment-naïve patients receiving antiviral therapy.

    PubMed

    Akpo, Essè Ifèbi Hervé; Cerri, Karin; Kleintjens, Joris

    2015-04-01

    Studies on medical resource utilization (MRU) and related costs are important for evaluating the potential patient management and cost-effectiveness implications of antiviral treatments for hepatitis C virus (HCV) infection. The objectives of this study were (i) to compare the MRU and related costs for two treatment approaches; (ii) to identify the main drivers of resource use and costs; and (iii) to assess the effects of various treatment regimen attributes on MRU-related costs in a UK clinical setting. The analysis used data collected alongside the simeprevir (SMV) phase III trials for treatment-naïve genotype 1 HCV-infected patients; these data covered outpatient consultations with specialists, emergency room visits and hospital admissions. Logistic regressions were constructed to estimate the predictors of resource utilization, and a two-part multivariable analysis model was used to determine the total costs of treatment in the UK. Data on 731 patients receiving SMV plus pegylated interferon and ribavirin (SMV/PegIFN/R) or PegIFN/R were included in the analysis. While MRU was similar between the SMV and PegIFN/R groups, MRU-related costs were significantly lower in the SMV group than in the PegIFN/R group (P < 0.05). High body mass index (P < 0.05), severe fibrosis (P < 0.05), shortened treatment duration to 24 weeks (P < 0.05), and anaemia and rash during treatment (P < 0.001) were identified as predictors of hospitalization and outpatient visits and as drivers of total costs. Univariate sensitivity analyses suggested that shortened treatment duration and lower occurrence of rash lead to large cost savings. This study identified both baseline and on-treatment antiviral therapy characteristics as drivers of MRU-related costs for HCV patients following antiviral therapy. The shortened treatment duration and reduction in rash due to treatment with SMV triple therapy lead to substantial non-drug cost savings, compared with PegIFN/R treatment. This suggests that

  20. [Efficacy and safety of vaccination against hepatitis A and B in patients with chronic liver disease].

    PubMed

    de Artaza Varasa, Tomás; Sánchez Ruano, Juan José; García Vela, Almudena; Gómez Rodríguez, Rafael; Romero Gutiérrez, Marta; de la Cruz Pérez, Gema; Gómez Moreno, Ana Zaida; Carrobles Jiménez, José María

    2009-01-01

    Vaccination to protect against hepatitis A and B should be part of the routine management of patients with chronic liver disease (CLD). To evaluate the efficacy and safety of hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination in a group of patients with CLD and to assess the presence of factors predictive of response. We performed a prospective, single-center study in 194 patients (123 men, 71 women; mean age, 48.9+/-10.7 years) with CLD: 107 with chronic hepatitis (CH) and 87 with hepatic cirrhosis (HC), all Child-Pugh class A. The most frequent causes of CLD were HCV infection and alcohol. Patients negative for anti-HAV IgG received the HAV vaccination (1440 ELISA units in two doses) and those with negative HBV serology received the HBV vaccination ( three 20 microg doses). Patients with inadequate response to the latter vaccine received an additional double dose. Thirty patients received a combination vaccine (three doses). Sixty patients (31%) received the HAV vaccine and 150 (77%) patients received the HBV vaccine. Seroconversion was achieved by 91.6% of patients for HAV and by 57% of the patients for HBV. After the additional dose, the response increased to 74%. Efficacy was similar between CH and HC. HBV vaccination was less effective in HC than in CH and the seroconversion rate was significantly lower in patients with HC and previous decompensation. The combination vaccine (30 patients) was highly immunogenic. No adverse effects were registered. HAV vaccination has high efficacy in patients with CLD. Patients with HC respond weakly to HBV vaccination compared with those with CH and especially if there is prior decompensation. The combination vaccine seems particularly effective in patients with CLD. The three vaccines are safe.

  1. Autoimmune hepatitis

    MedlinePlus

    ... them. Causes This form of hepatitis is an autoimmune disease . The body's immune system cannot tell the difference ... inflammation, or hepatitis, may occur along with other autoimmune diseases. These include: Graves disease Inflammatory bowel disease Rheumatoid ...

  2. Hepatitis B

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000279.htm Hepatitis B To use the sharing features on this page, please enable JavaScript. Hepatitis B is irritation and swelling (inflammation) of the ...

  3. Hepatitis B

    MedlinePlus

    ... Financial Report (AFR) Budget Submission Recovery Act Resources Business Congressional Affairs Jobs Benefits Booklet Data & Statistics National ... with hepatitis B need to be on treatment. Choosing the right time for hepatitis B treatment is ...

  4. Hepatitis A

    MedlinePlus

    ... an inflammation of the liver. One type, hepatitis A, is caused by the hepatitis A virus (HAV). The disease spreads through contact with ... washed in untreated water Putting into your mouth a finger or object that came into contact with ...

  5. Hepatitis B virus DNA in saliva, urine, and seminal fluid of carriers of hepatitis B e antigen.

    PubMed Central

    Karayiannis, P; Novick, D M; Lok, A S; Fowler, M J; Monjardino, J; Thomas, H C

    1985-01-01

    Concentrated samples of saliva, urine, and seminal fluid from 23 men with chronic liver disease who were positive for hepatitis B e antigen were examined for the presence of hepatitis B virus deoxyribonucleic acid (HBV-DNA) by molecular hybridisation. HBV-DNA was detected in saliva from 15 of 17 men (88%), urine from 12 of 22 men (55%), and seminal fluid from 13 of 21 men (62%). The presence of hepatitis B virus in such secretions has important epidemiological implications for heterosexual and homosexual contact. Images p1854-a PMID:3924282

  6. Hepatitis C

    MedlinePlus

    ... an inflammation of the liver. One type, hepatitis C, is caused by the hepatitis C virus (HCV). It usually spreads through contact with ... childbirth. Most people who are infected with hepatitis C don't have any symptoms for years. If ...

  7. The Relationships between Metabolic Disorders (Hypertension, Dyslipidemia, and Impaired Glucose Tolerance) and Computed Tomography-Based Indices of Hepatic Steatosis or Visceral Fat Accumulation in Middle-Aged Japanese Men

    PubMed Central

    Yokokawa, Hirohide; Naito, Toshio; Sasabe, Noriko; Okumura, Mitsue; Iijima, Kimiko; Shibuya, Katsuhiko; Hisaoka, Teruhiko; Fukuda, Hiroshi

    2016-01-01

    Background Most studies on the relationships between metabolic disorders (hypertension, dyslipidemia, and impaired glucose tolerance) and hepatic steatosis (HS) or visceral fat accumulation (VFA) have been cross-sectional, and thus, these relationships remain unclear. We conducted a retrospective cohort study to clarify the relationships between components of metabolic disorders and HS/VFA. Methods The participants were 615 middle-aged men who were free from serious liver disorders, diabetes, and HS/VFA and underwent multiple general health check-ups at our institution between 2009 and 2013. The data from the initial and final check-ups were used. HS and VFA were assessed by computed tomography. HS was defined as a liver to spleen attenuation ratio of ≤1.0. VFA was defined as a visceral fat cross-sectional area of ≥100 cm2 at the level of the navel. Metabolic disorders were defined using Japan’s metabolic syndrome diagnostic criteria. The participants were divided into four groups based on the presence (+) or absence (-) of HS/VFA. The onset rates of each metabolic disorder were compared among the four groups. Results Among the participants, 521, 55, 24, and 15 were classified as HS(-)/VFA(-), HS(-)/VFA(+), HS(+)/VFA(-), and HS(+)/VFA(+), respectively, at the end of the study. Impaired glucose tolerance was more common among the participants that exhibited HS or VFA (p = 0.05). On the other hand, dyslipidemia was more common among the participants that displayed VFA (p = 0.01). Conclusions It is likely that VFA is associated with impaired glucose tolerance and dyslipidemia, while HS might be associated with impaired glucose tolerance. Unfortunately, our study failed to detect associations between HS/VFA and metabolic disorders due to the low number of subjects that exhibited fat accumulation. Although our observational study had major limitations, we consider that it obtained some interesting results. HS and VFA might affect different metabolic disorders

  8. Radiation receiver

    DOEpatents

    Hunt, A.J.

    1983-09-13

    The apparatus for collecting radiant energy and converting same to alternate energy form includes a housing having an interior space and a radiation transparent window allowing, for example, solar radiation to be received in the interior space of the housing. Means are provided for passing a stream of fluid past said window and for injecting radiation absorbent particles in said fluid stream. The particles absorb the radiation and because of their very large surface area, quickly release the heat to the surrounding fluid stream. The fluid stream particle mixture is heated until the particles vaporize. The fluid stream is then allowed to expand in, for example, a gas turbine to produce mechanical energy. In an aspect of the present invention properly sized particles need not be vaporized prior to the entrance of the fluid stream into the turbine, as the particles will not damage the turbine blades. In yet another aspect of the invention, conventional fuel injectors are provided to inject fuel into the fluid stream to maintain the proper temperature and pressure of the fluid stream should the source of radiant energy be interrupted. In yet another aspect of the invention, an apparatus is provided which includes means for providing a hot fluid stream having hot particles disbursed therein which can radiate energy, means for providing a cooler fluid stream having cooler particles disbursed therein, which particles can absorb radiant energy and means for passing the hot fluid stream adjacent the cooler fluid stream to warm the cooler fluid and cooler particles by the radiation from the hot fluid and hot particles. 5 figs.

  9. Radiation receiver

    DOEpatents

    Hunt, Arlon J.

    1983-01-01

    The apparatus for collecting radiant energy and converting same to alternate energy form includes a housing having an interior space and a radiation transparent window allowing, for example, solar radiation to be received in the interior space of the housing. Means are provided for passing a stream of fluid past said window and for injecting radiation absorbent particles in said fluid stream. The particles absorb the radiation and because of their very large surface area, quickly release the heat to the surrounding fluid stream. The fluid stream particle mixture is heated until the particles vaporize. The fluid stream is then allowed to expand in, for example, a gas turbine to produce mechanical energy. In an aspect of the present invention properly sized particles need not be vaporized prior to the entrance of the fluid stream into the turbine, as the particles will not damage the turbine blades. In yet another aspect of the invention, conventional fuel injectors are provided to inject fuel into the fluid stream to maintain the proper temperature and pressure of the fluid stream should the source of radiant energy be interrupted. In yet another aspect of the invention, an apparatus is provided which includes means for providing a hot fluid stream having hot particles disbursed therein which can radiate energy, means for providing a cooler fluid stream having cooler particles disbursed therein, which particles can absorb radiant energy and means for passing the hot fluid stream adjacent the cooler fluid stream to warm the cooler fluid and cooler particles by the radiation from the hot fluid and hot particles.

  10. If You Have Chronic Hepatitis B Virus (HBV) Infection

    MedlinePlus

    ... B immune globulin (HBIG) and started on the hepatitis B vaccine series within 12 hours of birth to prevent ... testing and should receive the first dose of hepatitis B vaccine at this same visit after the blood is ...

  11. Hepatitis Vaccines

    PubMed Central

    Ogholikhan, Sina; Schwarz, Kathleen B.

    2016-01-01

    Viral hepatitis is a serious health problem all over the world. However, the reduction of the morbidity and mortality due to vaccinations against hepatitis A and hepatitis B has been a major component in the overall reduction in vaccine preventable diseases. We will discuss the epidemiology, vaccine development, and post-vaccination effects of the hepatitis A and B virus. In addition, we discuss attempts to provide hepatitis D vaccine for the 350 million individuals infected with hepatitis B globally. Given the lack of a hepatitis C vaccine, the many challenges facing the production of a hepatitis C vaccine will be shown, along with current and former vaccination trials. As there is no current FDA-approved hepatitis E vaccine, we will present vaccination data that is available in the rest of the world. Finally, we will discuss the existing challenges and questions facing future endeavors for each of the hepatitis viruses, with efforts continuing to focus on dramatically reducing the morbidity and mortality associated with these serious infections of the liver. PMID:26978406

  12. Detection of Hepatitis B Virus (HBV) Genotype E Carried—Even in the Presence of High Titers of Anti-HBs Antibodies—by an Argentinean Patient of African Descent Who Had Received Vaccination against HBV

    PubMed Central

    Mathet, Verónica L.; Cuestas, María L.; Ruiz, Vanesa; Minassian, María L.; Rivero, Cintia; Trinks, Julieta; Daleoso, Graciela; León, Liliana M.; Sala, Andrea; Libellara, Beatriz; Corach, Daniel; Oubiña, José R.

    2006-01-01

    Genotype E hepatitis B virus (HBV) was detected in two Argentine sisters exhibiting an African mitochondrial lineage. One of them (who had been vaccinated against HBV) exhibited anti-HBs cocirculating antibodies without HBsAg escape mutants, while her unvaccinated sister showed a D144A HBsAg escape mutant without anti-HBs antibodies. Both sisters carried an unusual L209V substitution within HBsAg. PMID:16954295

  13. Detection of hepatitis B virus (HBV) genotype E carried--even in the presence of high titers of anti-HBs antibodies--by an Argentinean patient of African descent who had received vaccination against HBV.

    PubMed

    Mathet, Verónica L; Cuestas, María L; Ruiz, Vanesa; Minassian, María L; Rivero, Cintia; Trinks, Julieta; Daleoso, Graciela; León, Liliana M; Sala, Andrea; Libellara, Beatriz; Corach, Daniel; Oubiña, José R

    2006-09-01

    Genotype E hepatitis B virus (HBV) was detected in two Argentine sisters exhibiting an African mitochondrial lineage. One of them (who had been vaccinated against HBV) exhibited anti-HBs cocirculating antibodies without HBsAg escape mutants, while her unvaccinated sister showed a D144A HBsAg escape mutant without anti-HBs antibodies. Both sisters carried an unusual L209V substitution within HBsAg.

  14. Liver transplantation for hepatitis B: what is the best hepatitis B immune globulin/antiviral regimen?

    PubMed

    Angus, Peter W; Patterson, Scott J

    2008-10-01

    1. Prophylaxis using the combination of lamivudine and high-dose intravenous hepatitis B immunoglobulin (approximately 10,000 IU monthly) reduces the long-term risk of recurrence of hepatitis B in hepatitis B surface antigen-positive transplant recipients to 5% to 10%. However, this therapy is expensive and inconvenient for patients. 2. Recent studies have shown that similar results can be obtained, at far less cost, with much lower doses of intramuscular hepatitis B immune globulin (400-800 IU monthly) in combination with pretransplant and posttransplant lamivudine therapy. 3. The development of lamivudine resistance pre-transplant can lead to hepatic decompensation and increases the risk of posttransplant recurrence in patients receiving hepatitis B immune globulin/lamivudine prophylaxis. Newer nucleos(t)ide analogues with lower resistance rates such as entecavir, adefovir, and tenofovir should therefore replace lamivudine in hepatitis B prophylaxis. 4. Combination therapy with these newer agents and low-dose intramuscular hepatitis B immune globulin is likely to be the most cost effective hepatitis B immune globulin-containing regimen for the prevention of hepatitis B recurrence post-transplant. 5. Some form of hepatitis B virus prophylaxis needs be continued indefinitely post-transplant. However, the use of antivirals with very low rates of drug resistance will make it possible to stop hepatitis B immune globulin therapy in many patients currently receiving hepatitis B immune globulin/nucleos(t)ide combination therapy.

  15. Insulin Resistance and Inflammation in Hypogonadotropic Hypogonadism and Their Reduction After Testosterone Replacement in Men With Type 2 Diabetes

    PubMed Central

    Dhindsa, Sandeep; Ghanim, Husam; Batra, Manav; Kuhadiya, Nitesh D.; Abuaysheh, Sanaa; Sandhu, Sartaj; Green, Kelly; Makdissi, Antoine; Hejna, Jeanne; Chaudhuri, Ajay; Punyanitya, Mark

    2016-01-01

    OBJECTIVE One-third of men with type 2 diabetes have hypogonadotropic hypogonadism (HH). We conducted a randomized placebo-controlled trial to evaluate the effect of testosterone replacement on insulin resistance in men with type 2 diabetes and HH. RESEARCH DESIGN AND METHODS A total of 94 men with type 2 diabetes were recruited into the study; 50 men were eugonadal, while 44 men had HH. Insulin sensitivity was calculated from the glucose infusion rate (GIR) during hyperinsulinemic-euglycemic clamp. Lean body mass and fat mass were measured by DEXA and MRI. Subcutaneous fat samples were taken to assess insulin signaling genes. Men with HH were randomized to receive intramuscular testosterone (250 mg) or placebo (1 mL saline) every 2 weeks for 24 weeks. RESULTS Men with HH had higher subcutaneous and visceral fat mass than eugonadal men. GIR was 36% lower in men with HH. GIR increased by 32% after 24 weeks of testosterone therapy but did not change after placebo (P = 0.03 for comparison). There was a decrease in subcutaneous fat mass (−3.3 kg) and increase in lean mass (3.4 kg) after testosterone treatment (P < 0.01) compared with placebo. Visceral and hepatic fat did not change. The expression of insulin signaling genes (IR-β, IRS-1, AKT-2, and GLUT4) in adipose tissue was significantly lower in men with HH and was upregulated after testosterone treatment. Testosterone treatment also caused a significant fall in circulating concentrations of free fatty acids, C-reactive protein, interleukin-1β, tumor necrosis factor-α, and leptin (P < 0.05 for all). CONCLUSIONS Testosterone treatment in men with type 2 diabetes and HH increases insulin sensitivity, increases lean mass, and decreases subcutaneous fat. PMID:26622051

  16. Insulin Resistance and Inflammation in Hypogonadotropic Hypogonadism and Their Reduction After Testosterone Replacement in Men With Type 2 Diabetes.

    PubMed

    Dhindsa, Sandeep; Ghanim, Husam; Batra, Manav; Kuhadiya, Nitesh D; Abuaysheh, Sanaa; Sandhu, Sartaj; Green, Kelly; Makdissi, Antoine; Hejna, Jeanne; Chaudhuri, Ajay; Punyanitya, Mark; Dandona, Paresh

    2016-01-01

    One-third of men with type 2 diabetes have hypogonadotropic hypogonadism (HH). We conducted a randomized placebo-controlled trial to evaluate the effect of testosterone replacement on insulin resistance in men with type 2 diabetes and HH. A total of 94 men with type 2 diabetes were recruited into the study; 50 men were eugonadal, while 44 men had HH. Insulin sensitivity was calculated from the glucose infusion rate (GIR) during hyperinsulinemic-euglycemic clamp. Lean body mass and fat mass were measured by DEXA and MRI. Subcutaneous fat samples were taken to assess insulin signaling genes. Men with HH were randomized to receive intramuscular testosterone (250 mg) or placebo (1 mL saline) every 2 weeks for 24 weeks. Men with HH had higher subcutaneous and visceral fat mass than eugonadal men. GIR was 36% lower in men with HH. GIR increased by 32% after 24 weeks of testosterone therapy but did not change after placebo (P = 0.03 for comparison). There was a decrease in subcutaneous fat mass (-3.3 kg) and increase in lean mass (3.4 kg) after testosterone treatment (P < 0.01) compared with placebo. Visceral and hepatic fat did not change. The expression of insulin signaling genes (IR-β, IRS-1, AKT-2, and GLUT4) in adipose tissue was significantly lower in men with HH and was upregulated after testosterone treatment. Testosterone treatment also caused a significant fall in circulating concentrations of free fatty acids, C-reactive protein, interleukin-1β, tumor necrosis factor-α, and leptin (P < 0.05 for all). Testosterone treatment in men with type 2 diabetes and HH increases insulin sensitivity, increases lean mass, and decreases subcutaneous fat. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  17. Hepatitis B and Hepatitis C in Pregnancy

    MedlinePlus

    ... signs and symptoms of hepatitis C virus infection? Hepatitis C virus infection causes signs and symptoms similar to those of hepatitis B virus infection. It also can cause no symptoms. Unlike hepatitis B virus infection, most ...

  18. Feature Hepatitis: Hepatitis Can Strike Anyone

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues Feature Hepatitis Hepatitis Can Strike Anyone Past Issues / Spring 2009 Table ... from all walks of life are affected by hepatitis, especially hepatitis C, the most common form of ...

  19. Optimising healthcare for men who have sex with men: A role for general practitioners.

    PubMed

    Cornelisse, Vincent J; Fairley, Christopher; Roth, Norman J

    2016-04-01

    General practitioners (GPs) are well placed to identify patients who are at risk of human immunodeficiency virus (HIV) infection, including men who have sex with men (MSM). Hence, GPs play a vital role in facilitating MSM with HIV to gain early access to HIV treatment, which will also help to reduce HIV transmission rate. This article provides a summary of current management issues when providing primary care for MSM, such as HIV testing and treatment, biomedical HIV prevention strategies, and current trends in other sexually transmissible infections (STIs). In order for MSM to receive optimal care in general practice, questions about sexual history need to be a routine part of clinical care. Those individuals who are found to be at risk of HIV infection should be offered regular HIV testing and access to risk-reduction strategies such as pre- and post-exposure prophylaxis. Patients who are diagnosed with HIV should be offered early access to HIV treatment, and regular screening for STIs and hepatitis C.

  20. Hepatitis C Test

    MedlinePlus

    ... Hepatitis C Antibody; Anti-HCV; HCV-PCR; HCV-RNA; Hepatitis C Viral Load Formal name: Viral Hepatitis C Antibody Screen; Viral Hepatitis C RNA by PCR; Hepatitis C Virus Genotype Related tests: ...

  1. Travelers' Health: Hepatitis B

    MedlinePlus

    ... Chapter 3 - Hepatitis A Chapter 3 - Hepatitis C Hepatitis B Francisco Averhoff INFECTIOUS AGENT Hepatitis B is ... their exposures. Map 3-04. Prevalence of chronic hepatitis B virus infection among adults PDF Version (printable) ...

  2. A homosexual Japanese man with acute hepatitis due to hepatitis B virus genotype ae, concurrent with amebic colitis.

    PubMed

    Miyake, Yasuhiro; Iwasaki, Yoshiaki; Ishikawa, Shin; Tatsukawa, Masashi; Nawa, Toru; Kato, Jun; Takaki, Akinobu; Kobashi, Haruhiko; Sakaguchi, Kohsaku; Shiratori, Yasushi

    2007-02-01

    We report herein a case with acute hepatitis due to hepatitis B virus genotype Ae, concurrent with amebic colitis. A 39-year-old homosexual Japanese man was admitted to our hospital with jaundice. Laboratory tests showed an elevation of transaminase and positivity for hepatitis B surface antigen and IgM-type antibody to hepatitis B core antigen. The hepatitis B virus genotype was determined to be Ae. Furthermore, a mud-like stool with blood and mucous had sometimes been noted during the past 3 years, and amebic colitis was shown by colonofiberscopy during hospitalization. The patient was diagnosed with acute hepatitis B, concurrent with amebic colitis, and was successfully treated with lamivudine and metronidazole. In Japanese patients with acute hepatitis B virus genotype A infection, homosexual activity tends to be high. Furthermore, in Japanese homosexual men, amebiasis has been increasing. Thus, in Japanese patients with acute hepatitis B, a determination of genotype should be performed in order to investigate the route of transmission of hepatitis B virus, and a search for amebiasis should be performed in patients with acute hepatitis due to hepatitis B virus genotype A. Furthermore, education of homosexual men regarding hepatitis B virus, hepatitis B virus vaccination, and amebiasis is urgently required.

  3. Energy dialogue technique in healing and health: relieving side effects and thyroid dysfunction in a male with hemophilia receiving pegylated interferon and ribavirin treatment for hepatitis C virus--an anecdotal case study.

    PubMed

    Krug, Phyllis; Kramer, Deborah; Bukatman, Rochelle; Gordon, Phyllis; Mermelstein, Pamela

    2013-09-01

    This article describes the use of energy dialogue technique (EDT), a healing intervention that provides awareness of imbalances in the energetic field that affect patients' health and guide the practitioner to sense and direct the frequency, vibration, intention, awareness, or consciousness to correct these imbalances. The authors document the effectiveness of this technique as it was used to treat side effects of the medical intervention for hepatitis C in a male with hemophilia. Following EDT, the client's symptoms of fatigue and pain improved by 30% to 40%; moreover, thyroid function returned to normal. The authors suggest that EDT be studied and explored for inclusion as a treatment modality.

  4. Hepatitis A

    MedlinePlus

    ... inflammation of the liver.” This inflammation can be caused by a wide variety of toxins, drugs, and metabolic diseases, as well as infection. There are at least 5 hepatitis viruses. Hepatitis A is contracted when a child eats food or drinks water that is contaminated with the virus or has ...

  5. Hepatitis A

    MedlinePlus

    ... MW, Sheffield JS. Prevention and management of viral hepatitis in pregnancy. Obstetrics and Gynecology Clinics of North America . 2014;41(4):573–592. [4] Centers for Disease Control and Prevention. Chapter 9: Hepatitis A. In Hamborsky J, Kroger A, Wolfe S, eds. ...

  6. HPV vaccine coverage among men who have sex with men - National HIV Behavioral Surveillance System, United States, 2011.

    PubMed

    Meites, Elissa; Markowitz, Lauri E; Paz-Bailey, Gabriela; Oster, Alexandra M

    2014-11-12

    Men who have sex with men (MSM) are at high risk for disease associated with human papillomavirus (HPV). In late 2011, HPV vaccine was recommended for males through age 21 and MSM through age 26. Using data from the 2011 National HIV Behavioral Surveillance System, we assessed self-reported HPV vaccine uptake among MSM, using multivariate analysis to calculate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs). Among 3221 MSM aged 18-26, 157 (4.9%) reported ≥1 vaccine dose. Uptake was higher among men who visited a healthcare provider (aPR 2.3, CI: 1.2-4.2), disclosed same-sex sexual attraction/behavior to a provider (aPR 2.1, CI: 1.3-3.3), reported a positive HIV test (aPR 2.2, CI: 1.5-3.2), or received hepatitis vaccine (aPR 3.9, CI: 2.4-6.4). Of 3064 unvaccinated MSM, 2326 (75.9%) had visited a healthcare provider within 1 year. These national data on HPV vaccine uptake among MSM provide a baseline as vaccination recommendations are implemented.

  7. Hepatitis A Incidence and Hepatitis A Vaccination Among American Indians and Alaska Natives, 1990–2001

    PubMed Central

    Bialek, Stephanie R.; Thoroughman, Douglas A.; Hu, Diana; Simard, Edgar P.; Chattin, Jody; Cheek, Jim; Bell, Beth P.

    2004-01-01

    Objectives. We assessed the effect on trends in hepatitis A incidence of the 1996 recommendation for routine hepatitis A vaccination of American Indian/Alaska Native (AIAN) children. Methods. We examined trends in hepatitis A incidence among AIAN peoples during 1990–2001 and vaccination coverage levels among children on the largest American Indian reservation. Results. Hepatitis A rates among AIANs declined 20-fold during 1997–2001. Declines in hepatitis A incidence occurred among AIANs in reservation and metropolitan areas. Among 1956 children living on the Navajo Nation whose medical records were reviewed, 1508 (77.1%) had received at least one dose of hepatitis A vaccine, and 1020 (52.1%) had completed the vaccine series. Conclusions. Hepatitis A rates among AIAN peoples have declined dramatically coincident with implementation of routine hepatitis A vaccination of AIAN children. PMID:15249305

  8. Men's Role and Men's Lives.

    ERIC Educational Resources Information Center

    Harrison, James B.

    1978-01-01

    The growing literature on men is clearly a response to the cultural ferment generated by feminism. However, as in the discussion of women's lives since the first advent of feminism, centuries of assumptions do not give way readily to appropriate scientific skepticism. (Author/MC)

  9. Interferon γ-induced protein 10 kinetics in treatment-naive versus treatment-experienced patients receiving interferon-free therapy for hepatitis C virus infection: implications for the innate immune response.

    PubMed

    Lin, Jennifer C; Habersetzer, François; Rodriguez-Torres, Maribel; Afdhal, Nezam; Lawitz, Eric J; Paulson, Matthew S; Zhu, Yanni; Subramanian, Gangadharan Mani; McHutchison, John G; Sulkowski, Mark; Wyles, David L; Schooley, Robert T

    2014-12-15

    We measured interferon γ-induced protein 10 (IP-10) levels in 428 patients at baseline, week 1, and week 2 of all-oral treatment for hepatitis C virus (HCV) infection. An increased baseline IP-10 level was associated with a T allele in the IL28B gene, an increased alanine aminotransferase level in treatment-naive but not experienced patients, and an increased body mass index. At week 1, the mean decline in plasma IP-10 levels was the same in treatment-naive and treatment-experienced patients (-49%), whereas during week 2 the mean decline in IP-10 levels in treatment-naive patients (-14%) was significantly larger than in treatment-experienced patients (-2%; P = .0176). IP-10 thus may be a surrogate marker of the rate of intracellular viral replication complex decay.

  10. Hepatitis A in Poland in 2012.

    PubMed

    Baumann-Popczyk, Anna

    2014-01-01

    The aim of the article is evaluation of the epidemiological situation of hepatitis A in Poland in 2012. Assessment of epidemiological situation of hepatitis A was based on results from analysis of the annual bulletins: "Infectious diseases and poisonings in Poland in 2012", "Vaccinations in Poland in 2012", reports from individual cases and epidemiological investigations of outbreaks linked to hepatitis A, sent by Epidemiological Departments in Sanitary Epidemiological Stations to the Department of Epidemiology at NIPH-NIH. In Poland, 71 cases of hepatitis A were registered in 2012. The incidence of 0.17/ per 100 000 inhabitants was slightly higher than previous year. The incidence of hepatitis A ranged from 0.08/100 000 in Łódzkie and Podlaskie to 0.35/100 000 in Śląskie. The incidence of hepatitis A in men and women was at an approximate level and amounted to 0.19 and 0.18/100 000 respectively. The peak of incidence was recorded during the summer and autumn-winter months. In 2012 imported cases constituted 52.1% of all cases of hepatitis A. There were five outbreaks involving of 11 registered cases in 2012. In 2012, there was a slight increase in the incidence of hepatitis A in compared with the previous year. However, apart from that there were no significant changes in the epidemiological situation of hepatitis A. In Poland there is still very low endemicity for hepatitis A. Decreased incidence and the small number of people vaccinated against hepatitis A facilitates the accumulation of a fairly numerous population of persons susceptible to infection which is connected with the possibility to increase the number of cases of hepatitis A. Despite the fact that the current epidemiological situation of hepatitis A in Poland is good, the disease still requires monitoring and analysis within the framework of epidemiological surveillance system.

  11. Street Men, Family Men: Race and Men's Extended Family Integration

    ERIC Educational Resources Information Center

    Sarkisian, Natalia

    2007-01-01

    Disorganization theories postulate that black men have largely abandoned their familial roles. Using the NSFH data, this article refutes the hypothesis of black men's familial disengagement by focusing on extended family integration. Black men are more likely than white men to live with or near extended kin, as well as to frequently see kin in…

  12. Hepatic ischemia

    MedlinePlus

    ... blood or oxygen, causing injury to liver cells. Causes Low blood pressure from any condition can lead to hepatic ischemia. ... liver's blood vessels Treatment Treatment depends on the cause. Low blood pressure and blood clots must be treated right away. ...

  13. Autoimmune hepatitis.

    PubMed

    Heneghan, Michael A; Yeoman, Andrew D; Verma, Sumita; Smith, Alastair D; Longhi, Maria Serena

    2013-10-26

    Autoimmune hepatitis is a disease of the hepatic parenchyma that can present in acute or chronic forms. In common with many autoimmune diseases, autoimmune hepatitis is associated with non-organ-specific antibodies in the context of hepatic autoimmunity. This dichotomy has made definition of a unifying hypothesis in the pathophysiology of the disease difficult, although data from the past 8 years have drawn attention to the role of regulatory T cells. Several triggers have been identified, and the disease arises in genetically susceptible individuals. Clinical and biochemical remission is achievable in up to 85% of cases. For the remaining patients, alternative immunosuppression strategies are an option. Liver transplantation provides an excellent outcome for patients with acute liver failure or complications of end-stage liver disease, including hepatocellular carcinoma. Variant or overlapping syndromes are worthy of consideration when unexpected disease features arise.

  14. Autoimmune Hepatitis

    MedlinePlus

    ... the same symptoms as those of other liver diseases or metabolic disorders. Blood tests. A blood test involves drawing ... the same symptoms as those of other liver diseases or metabolic disorders. Treatment for autoimmune hepatitis includes medication to ...

  15. Hepatic Encephalopathy

    MedlinePlus Videos and Cool Tools

    ... is a condition that causes temporary worsening of brain function in people with advanced liver disease. When ... travel through your body until they reach your brain, causing mental and physical symptoms of HE. Hepatic ...

  16. Hepatitis B

    MedlinePlus

    ... My Health e Vet Prescriptions Refills Crisis Prevention Mental Health PTSD Public Health Veterans Access, Choice & Accountability Act ... and Complementary Therapies Diet and Nutrition Managing Pain Mental Health Sex and Sexuality (for Hepatitis C) Success Stories ...

  17. Alcoholic Hepatitis

    MedlinePlus

    ... alcoholic hepatitis include: Fluid accumulation in your abdomen (ascites) Confusion and behavior changes due to a buildup ... is life-threatening and requires immediate medical care. Ascites. Fluid that accumulates in the abdomen might become ...

  18. Hepatitis A

    MedlinePlus

    ... bowel movements Loss of appetite Low-grade fever Dark urine Joint pain Yellowing of the skin and ... person ingests even tiny amounts of contaminated fecal matter. The hepatitis A virus infects liver cells and ...

  19. Treatment of viral hepatitis in pregnancy.

    PubMed

    Fiore, Simona; Savasi, Valeria

    2009-12-01

    Viral hepatitis can be caused by the hepatitis A, B, C, D and E viruses. In the Western world, hepatitis A, B or C do not seem to influence the course of pregnancy, whereas hepatitis E infection, when contracted during the second or third trimester, seems to have a higher risk of developing into a fulminant hepatitis. Mother-to-infant transmission of hepatitis A seems to be very uncommon. The majority of HBsAg-positive and HBeAg-positive mothers can transmit the disease vertically. The timing of transmission is predominantly peripartum, and newborns of HBsAg-positive mothers should receive hepatitis B immunoglobulins within 12 h of birth, with HBV vaccine at birth and 1 and 6 months later. Hepatitis C is more often a chronic disease. Vertical transmission of hepatitis C is considered to be relatively rare but high viraemia or coinfection with HIV can increase this risk. There is currently no treatment to prevent this vertical transmission and pregnancies among HCV-positive mothers should not be discouraged. Infants should be tested for anti-HCV at 1 year and followed for the development of hepatitis. Breast feeding does not seem to play an important role in the transmission of hepatitis B and C.

  20. Sexually transmitted diseases in men who have sex with men.

    PubMed

    Mayer, Kenneth H

    2011-12-01

    Men who have sex with men (MSM) have increased rates of human immunodeficiency virus (HIV) infection and sexually transmitted diseases (STDs) compared with demographically matched controls. The reasons for the disproportionate infection burden are complex, including biological, behavioral, and sociocultural factors. HIV and syphilis may often be coprevalent among MSM. The use of nucleic acid amplification testing has enhanced the ability to detect frequently asymptomatic gonococcal and chlamydial infections of the rectum and other sites. Lymphogranuloma proctitis outbreaks among MSM were noted in the developed world several years ago but have not been common recently. MSM are at increased risk for viral hepatitis and anal human papillomavirus disease. Preventive interventions include vaccination for the former and anal cytologic screening for the latter. Because of the diverse ways in which MSM may be exposed to STDs, it is essential for clinicians to obtain a thorough sexual history in a culturally competent manner.

  1. Hepatitis (For Parents)

    MedlinePlus

    ... people at risk for contracting hepatitis. But frequent hand washing and good hygiene practices can reduce this risk. ... After Having Hepatitis B? Hepatitis B (HBV) Hepatitis Hand Washing Blood Transfusions Body Piercing Tattoos Contact Us Print ...

  2. Hepatitis A Test

    MedlinePlus

    ... AACC products and services. Advertising & Sponsorship: Policy | Opportunities Hepatitis A Testing Share this page: Was this page ... HAV-Ab total; Anti-HAV Formal name: Viral Hepatitis A Antibody Related tests: Hepatitis B Testing ; Hepatitis ...

  3. Hepatitis B Foundation

    MedlinePlus

    ... worldwide 2 Billion People have been infected with Hepatitis B Worldwide The Hepatitis B Foundation is working ... of people living with hepatitis B. Learn About Hepatitis B in 11 Other Languages . Resource Video See ...

  4. Hepatitis A - Multiple Languages

    MedlinePlus

    ... Hepatitis A Vaccine: What You Need to Know - English Vaccine Information Statement (VIS) -- Hepatitis A Vaccine: What ... Hepatitis A Vaccine: What You Need to Know - English Vaccine Information Statement (VIS) -- Hepatitis A Vaccine: What ...

  5. Correlation of pathohistotogical changes and serology parameters in chronic hepatitis C.

    PubMed

    Gogov, Bisera; Vukobrat-Bijedic, Zora

    2012-01-01

    Viral Hepatitis C, formerly known as non A-non B hepatitis, as a separate clinical entity described in 1975 is most often reported in patients who received blood transfusions, and also called it post transfusion hepatitis. Goal was to quantify the number of HCV RNA copies by PCR method, histologically determine the stage of fibrosis and degree of necroinflammatory activity in biopsies of liver parenchyma, and compare the histopathological changes with the number of the virus copies. The study was prospective and involved 50 patients suffering from chronic hepatitis C of viral etiology. All patients underwent liver biopsy and the specimens were patohistologically investigated to determine the stage of fibrosis score, and necroinflammatory activities. In every case was determined the concentration of AST, ALT, bilirubin, CBC, DR, and all underwent percutaneous ultrasonography and gastroscopy. We performed genotyping of viruses and virus quantification of HCV RNA-PCR. The study showed that women were older than men. The stage of fibrosis and degree of necroinflammatory activities were higher in women than men, meaning that older people carry the virus longer, increasing the number of virus copies the disease lasted longer. According to the etiology of infection the patients who were infected by blood transfusions had a higher stage of fibrosis. Score of necroinflammatory activity was significantly dependent on variables AST with p = 0.02 and ALT with p = 0026. Our research has shown that the stage of fibrosis was significantly dependent on alanine aminotransferases, duration of infection, number of virus copies and mode of infection. Patients who received blood transfusions, had the longest duration of infection, higher stage of fibrosis and degree necroinflammatory activity.

  6. Hepatitis A through E (Viral Hepatitis)

    MedlinePlus

    ... the treatment of chronic hepatitis B include alpha interferon and peginterferon, which slow the replication of the ... Chronic hepatitis D is usually treated with pegylated interferon, although other potential treatments are under study. Hepatitis ...

  7. Feature Hepatitis: Hepatitis Symptoms, Diagnosis, Treatment & Prevention

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues Feature Hepatitis Hepatitis: Symptoms, Diagnosis, Treatment & Prevention Past Issues / Spring 2009 ... No appetite Fever Headaches Diagnosis To check for hepatitis viruses, your doctor will test your blood. You ...

  8. Oncological results, functional outcomes and health-related quality-of-life in men who received a radical prostatectomy or external beam radiation therapy for localized prostate cancer: a study on long-term patient outcome with risk stratification.

    PubMed

    Takizawa, Itsuhiro; Hara, Noboru; Nishiyama, Tsutomu; Kaneko, Masaaki; Hoshii, Tatsuhiko; Tsuchida, Emiko; Takahashi, Kota

    2009-05-01

    Health-related quality-of-life (HRQOL) after a radical prostatectomy (RP) or external beam radiation therapy (EBRT) has not been studied in conjunction with oncological outcomes in relation to disease risk stratification. Moreover, the long-term outcomes of these treatment approaches have not been studied. We retrospectively analyzed oncological outcomes between consecutive patients receiving RP (n=86) and EBRT (n=76) for localized prostate cancer. HRQOL and functional outcomes could be assessed in 62 RP (79%) and 54 EBRT (79%) patients over a 3-year follow-up period (median: 41 months) using the Medical Outcomes Study Short Form-36 (SF-36) and the University of California Los Angeles Prostate Cancer Index (UCLA PCI). The 5-year biochemical progression-free survival did not differ between the RP and EBRT groups for low-risk (74.6% vs. 75.0%, P=0.931) and intermediate-risk (61.3% vs. 71.1%, P=0.691) patients. For high-risk patients, progression-free survival was lower in the RP group (45.1%) than in the EBRT group (79.7%) (P=0.002). The general HRQOL was comparable between the two groups. Regarding functional outcomes, the RP group reported lower scores on urinary function and less urinary bother and sexual bother than the EBRT group (P<0.001, P<0.05 and P<0.001, respectively). With risk stratification, the low- and intermediate-risk patients in the RP group reported poorer urinary function than patients in the EBRT group (P<0.001 for each). The sexual function of the high-risk patients in the EBRT group was better than that of the same risk RP patients (P<0.001). Biochemical recurrence was not associated with the UCLA PCI score in either group. In conclusion, low- to intermediate-risk patients treated with an RP may report relatively decreased urinary function during long-term follow-up. The patient's HRQOL after treatment did not depend on biochemical recurrence.

  9. Treatment of osteoporosis in men

    PubMed Central

    Kaufman, J.-M.; Reginster, J.-Y.; Boonen, S.; Brandi, M. L.; Cooper, C.; Dere, W.; Devogelaer, J.-P.; Diez-Perez, A.; Kanis, J. A.; McCloskey, E.; Mitlak, B.; Orwoll, E.; Ringe, J.D.; Weryha, G.; Rizzoli, R.

    2013-01-01

    Summary Aspects of osteoporosis in men, such as screening and identification strategies, definitions of diagnosis and intervention thresholds, and treatment options (both approved and in the pipeline) are discussed. Introduction Awareness of osteoporosis in men is improving, although it remains under-diagnosed and under-treated. A European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) workshop was convened to discuss osteoporosis in men and to provide a report by a panel of experts (the authors). Methods A debate with an expert panel on preselected topics was conducted. Results and Conclusions Although additional fracture data are needed to endorse the clinical care of osteoporosis in men, consensus views were reached on diagnostic criteria and intervention thresholds. Empirical data in men display similarities with data acquired in women, despite pathophysiological differences, which may not be clinically relevant. Men should receive treatment at a similar 10-year fracture probability as in women. The design of mixed studies may reduce the lag between comparable treatments for osteoporosis in women becoming available in men. PMID:23201268

  10. Antidepressant prophylaxis reduces depression risk but does not improve sustained virological response in hepatitis C patients receiving interferon without depression at baseline: A systematic review and meta-analysis

    PubMed Central

    Al-Omari, Awad; Cowan, Juthaporn; Turner, Lucy; Cooper, Curtis

    2013-01-01

    BACKGROUND: Depression complicates interferon-based hepatitis C virus (HCV) antiviral therapy in 10% to 40% of cases, and diminishes patient well-being and ability to complete a full course of therapy. As a consequence, the likelihood of achieving a sustained virological response (SVR [ie, permanent viral eradication]) is reduced. OBJECTIVE: To systematically review the evidence of whether preemptive antidepressant prophylaxis started before HCV antiviral initiation is beneficial. METHODS: Inclusion was restricted to randomized controlled trials in which prophylactic antidepressant therapy was started at least two weeks before the initiation of HCV antiviral treatment. Studies pertaining to patients with active or recent depressive symptoms before commencing HCV antiviral therapy were excluded. English language articles from 1946 to July 2012 were included. The MEDLINE, Embase and Cochrane Central databases were searched. Where possible, meta-analyses were conducted evaluating the effect of antidepressant prophylaxis on SVR and major depression as well as on Montgomery-Asberg Depression Rating Scale and Beck Depression Index scores at four, 12 and 24 weeks. The Cochrane Collaboration tool was used to assess bias risk. RESULTS: Six randomized clinical trials involving 522 patients met the inclusion criteria. Although the frequency of on-treatment clinical depression was decreased with antidepressant prophylaxis (risk ratio 0.60 [95% CI 0.38 to 0.93]; P=0.02; I2=24%), no benefit to SVR was identified (risk ratio 1.08 [95% CI 0.74 to 1.57]; P=0.69; I2=58%). CONCLUSION: This practice is not justified to improve SVR in populations free of active depressive symptoms leading up to HCV antiviral therapy. PMID:24106729

  11. Liver Cancer and Hepatitis B

    MedlinePlus

    ... Our Accomplishments Annual Reports Our Videos What Is Hepatitis B? What Is Hepatitis B? The ABCs of Viral Hepatitis Liver Cancer and Hepatitis B Hepatitis Delta Coinfection Hepatitis C Coinfection HIV/AIDS ...

  12. Postmarketing surveillance of rabeprazole in upper gastrointestinal peptic lesions in Japanese patients with coexisting hepatic disorders

    PubMed Central

    Makino, Isao; Nakamura, Kimihide; Sato, Yoichi; Sato, Yuzuru; Sezai, Shuichi; Ikeda, Yusei; Shinmura, Wahei; Watahiki, Hajime; Yamamoto, Hideaki; Hioki, Yayuki; Suzuki, Masao; Kumada, Takashi; Honda, Takashi; Rikitoku, Tomoo; Hisanaga, Yasuhiro; Fukui, Hiroshi; Yamao, Junichi; Kawasaki, Hironaka; Hosoda, Akihide; Onji, Morikazu; Matsui, Hidetaka; Sata, Michio; Torimura, Takuji; Oho, Kazuhiko; Maekawa, Ryuichiro; Takagi, Yoshiyuki; Shakado, Satoshi; Nakayama, Masafumi; Gondo, Kazuhisa; Fukushima, Hirofumi; Kusaba, Taku; Tsubouchi, Hirohito; Hayashi, Katsuhiro; Hori, Takeshi; Iida, Yozo; Yutoku, Kouki; Maetani, Noboru; Kubo, Yoshitsugu; Miyata, Yoshifumi

    2006-01-01

    Background: Many Japanese patients with hepatic disorders confirmed on diagnostic imaging and coexisting upper gastrointestinal (GI) peptic lesions receive treatment with proton pump inhibitors. Some pharmacotherapies used to treat peptic ulcers have been associated with adverse drug reactions (ADRs), including elevated liver enzyme levels. Objective: The aim of this study was to determine the tolerability and effectiveness of rabeprazole sodium in treating peptic lesions in patients with coexisting hepatic disorders. Methods: This open-label, practice-based, postmarketing surveillance investigation was conducted at 15 centers across Japan. Male and female patients aged ≥18 years with peptic lesions confirmed on upper GI endoscopy and with underlying hepatic disease were enrolled. Patients were randomly assigned to receive rabeprazole 10 or 20 mg PO (tablet) QD after a meal for up to 8 weeks. Tolerability was assessed using monitoring of the incidence of ADRs determined by direct patient questioning, spontaneous reporting, and laboratory assessment. All patients who received at least 1 dose of study drug were included in the tolerability assessment. Effectiveness was assessed at baseline and study end using the rates of achievement of improvement on endoscopy, relief of subjective/objective symptoms (rates of improvement in epigastric pain and heartburn), and global improvement. The effectiveness analysis included all patients with complete data before and after treatment. Subanalyses were conducted to determine the effectiveness of drug by identification of the proportion of patients with coexisting hepatic disorders (cirrhosis, chronic hepatitis, and other hepatic diseases [eg, alcoholic hepatitis, fatty liver]) and by peptic lesion (gastric ulcer, duodenal ulcer, stomal ulcer, and reflux esophagitis) who achieved improvement. Results: A total of 114 patients were enrolled; 108 patients were included in the tolerability analysis (81 men, 27 women; mean age, 59

  13. Postmarketing surveillance of rabeprazole in upper gastrointestinal peptic lesions in Japanese patients with coexisting hepatic disorders.

    PubMed

    Makino, Isao; Nakamura, Kimihide; Sato, Yoichi; Sato, Yuzuru; Sezai, Shuichi; Ikeda, Yusei; Shinmura, Wahei; Watahiki, Hajime; Yamamoto, Hideaki; Hioki, Yayuki; Suzuki, Masao; Kumada, Takashi; Honda, Takashi; Rikitoku, Tomoo; Hisanaga, Yasuhiro; Fukui, Hiroshi; Yamao, Junichi; Kawasaki, Hironaka; Hosoda, Akihide; Onji, Morikazu; Matsui, Hidetaka; Sata, Michio; Torimura, Takuji; Oho, Kazuhiko; Maekawa, Ryuichiro; Takagi, Yoshiyuki; Shakado, Satoshi; Nakayama, Masafumi; Gondo, Kazuhisa; Fukushima, Hirofumi; Kusaba, Taku; Tsubouchi, Hirohito; Hayashi, Katsuhiro; Hori, Takeshi; Iida, Yozo; Yutoku, Kouki; Maetani, Noboru; Kubo, Yoshitsugu; Miyata, Yoshifumi

    2006-01-01

    Many Japanese patients with hepatic disorders confirmed on diagnostic imaging and coexisting upper gastrointestinal (GI) peptic lesions receive treatment with proton pump inhibitors. Some pharmacotherapies used to treat peptic ulcers have been associated with adverse drug reactions (ADRs), including elevated liver enzyme levels. The aim of this study was to determine the tolerability and effectiveness of rabeprazole sodium in treating peptic lesions in patients with coexisting hepatic disorders. This open-label, practice-based, postmarketing surveillance investigation was conducted at 15 centers across Japan. Male and female patients aged ≥18 years with peptic lesions confirmed on upper GI endoscopy and with underlying hepatic disease were enrolled. Patients were randomly assigned to receive rabeprazole 10 or 20 mg PO (tablet) QD after a meal for up to 8 weeks. Tolerability was assessed using monitoring of the incidence of ADRs determined by direct patient questioning, spontaneous reporting, and laboratory assessment. All patients who received at least 1 dose of study drug were included in the tolerability assessment. Effectiveness was assessed at baseline and study end using the rates of achievement of improvement on endoscopy, relief of subjective/objective symptoms (rates of improvement in epigastric pain and heartburn), and global improvement. The effectiveness analysis included all patients with complete data before and after treatment. Subanalyses were conducted to determine the effectiveness of drug by identification of the proportion of patients with coexisting hepatic disorders (cirrhosis, chronic hepatitis, and other hepatic diseases [eg, alcoholic hepatitis, fatty liver]) and by peptic lesion (gastric ulcer, duodenal ulcer, stomal ulcer, and reflux esophagitis) who achieved improvement. A total of 114 patients were enrolled; 108 patients were included in the tolerability analysis (81 men, 27 women; mean age, 59.9 years; 10-mg dose, 90 patients; 20-mg

  14. Hepatitis B in pregnancy

    PubMed Central

    Dyson, Jessica Katharine; Waller, Julia; Turley, Andrena; Michael, Enid; Moses, Samuel; Valappil, Manoj; Hudson, Mark; Bassendine, Margaret; McPherson, Stuart

    2014-01-01

    Objective Vertical transmission of the hepatitis B virus (HBV) is the commonest mode of infection and can be prevented with immunoprophylaxis of the infant and antiviral therapy in the mother. Our aim was to review a cohort of subjects with HBV in pregnancy to determine the prevalence of active disease or high HBV-DNA levels that required treatment to prevent transmission, and to review the management of mothers and infants. Methods A retrospective case-note review was conducted of all the HBV-infected pregnant women and their infants who attended the Newcastle obstetric services from 2007 to 2011. Results There were 113 pregnancies in 81 women (median age 28 years; 15% hepatitis B e antigen (HBeAg) positive) during 2007–11. 71% of mothers were first diagnosed with HBV during pregnancy. The mothers were born in 28 different countries. 69% of mothers had an HBV-DNA level less than 2000 IU/mL and 13% had HBV-DNA levels greater than 1.0×107 IU/mL so would be eligible for antiviral therapy to prevent transmission to the infant. 9% had active eAg-positive HBV and 3% had active eAg-negative HBV requiring treatment. All infants born to HBeAg-positive mothers received hepatitis B immunoglobulin (HBIG) appropriately and 76% of infants received a full HBV vaccination course. One infant born to an HBeAg-negative mother was hepatitis B surface antigen positive 1 year post-delivery. Conclusions One in six women had active HBV requiring treatment or high HBV-DNA levels that would benefit from antiviral treatment to reduce the transmission risk. HBIG was administered appropriately but completion of the vaccination course was suboptimal. PMID:24683447

  15. Young Men, Masculinities and Sex Education

    ERIC Educational Resources Information Center

    Limmer, Mark

    2010-01-01

    This paper draws on focus group and interview data from 45 young men from the north of England to explore the barriers to effective sex and relationships education (SRE). Recent policy debates in relation to establishing statutory SRE in schools provide an opportunity to revisit how it is currently delivered to, and received by, young men. The…

  16. Men of Color Focus Group Manual

    ERIC Educational Resources Information Center

    Center for Community College Student Engagement, 2014

    2014-01-01

    The Center for Community College Student Engagement received funding from"The Kresge Foundation to deepen its work on improving outcomes for men of color in community colleges. The primary goals of the initiative were: (1) to advance the understanding within the community college field regarding the assets and challenges that men of color…

  17. Young Men, Masculinities and Sex Education

    ERIC Educational Resources Information Center

    Limmer, Mark

    2010-01-01

    This paper draws on focus group and interview data from 45 young men from the north of England to explore the barriers to effective sex and relationships education (SRE). Recent policy debates in relation to establishing statutory SRE in schools provide an opportunity to revisit how it is currently delivered to, and received by, young men. The…

  18. Hepatitis E.

    PubMed

    Kamar, Nassim; Bendall, Richard; Legrand-Abravanel, Florence; Xia, Ning-Shao; Ijaz, Samreen; Izopet, Jacques; Dalton, Harry R

    2012-06-30

    Hepatitis E virus (HEV) was discovered during the Soviet occupation of Afghanistan in the 1980s, after an outbreak of unexplained hepatitis at a military camp. A pooled faecal extract from affected soldiers was ingested by a member of the research team. He became sick, and the new virus (named HEV), was detected in his stool by electron microscopy. Subsequently, endemic HEV has been identified in many resource-poor countries. Globally, HEV is the most common cause of acute viral hepatitis. The virus was not initially thought to occur in developed countries, but recent reports have shown this notion to be mistaken. The aim of this Seminar is to describe recent discoveries regarding HEV, and how they have changed our understanding of its effect on human health worldwide. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. HBeAg Seroconversion in HBeAg-Positive Chronic Hepatitis B Patients Receiving Long-Term Nucleos(t)ide Analog Treatment: A Systematic Review and Network Meta-Analysis

    PubMed Central

    Xing, Tongjing; Xu, Hongtao; Cao, Lin; Ye, Maocong

    2017-01-01

    Background HBeAg seroconversion is an important intermediate outcome in HBeAg-positive chronic hepatitis B (CHB) patients. This study aimed to compare the effect of nucleos(t)ide analogs (NAs) on HBeAg seroconversion in treating CHB with lamivudine, adefovir, telbivudine, entecavir, and tenofovir. Methods Network meta-analysis of NA treatment-induced HBeAg seroconversion after 1–2 years of treatment was performed. In addition, NA treatment-induced HBeAg seroconversion after 3–5 years of treatment was systematically evaluated. Results A total of 31 articles were included in this study. Nine and five studies respectively reporting on 1- and 2-year treatment were included in our network meta-analysis. In addition, 6, 5, and 5 studies, respectively reporting on 3-, 4-, and 5-year treatment were included in our systematic evaluation. Telbivudine showed a significantly higher HBeAg seroconversion rate after a 1 year treatment period compared to the other NAs (odds ratio (OR) = 3.99, 95% CI 0.68–23.6). This was followed by tenofovir (OR = 3.36, 95% CI 0.70–16.75). Telbivudine also showed a higher seroconversion rate compared to the other NAs after a 2 year treatment period, (OR = 1.38, 95% CI 0.92–2.22). This was followed by entecavir (OR = 1.14, 95% CI 0.72–1.72). No significant difference was observed between spontaneous induction and long-term telbivudine treatment-induced HBeAg seroconversion. However, entecavir and tenofovir treatment-induced HBeAg seroconversions were significantly lower than spontaneous seroconversion. Conclusion Long-term treatment with potent anti-HBV drugs, especially tenofovir and entecavir, may reduce HBeAg seroconversion compared with spontaneous HBeAg seroconversion rate. Telbivudine treatment, whether short term or long term, is associated with higher HBeAg seroconversion compared with the other NAs. However, the high rates of drug resistance likely limit the application of telbivudine. PMID:28107377

  20. [Viral hepatitis of enteric origin].

    PubMed

    Debord, T; Buisson, Y

    1998-01-01

    Hepatitis viruses of oral-fecal origin are responsible for a high morbidity and mortality throughout the world, even if they never result in chronic hepatitis. Two viruses, the virus of hepatitis A (VHA) and of hepatitis E (VHE) are at present the cause of severe viral hepatitis of enteric origin. Water is the principle vector in the spread of these viruses. However, the epidemiological aspects vary according to the pathogenic agent. VHA is excreted in a highly concentrated form in the feces for a relatively short period of time. Since it resists in an exterior environment, the virus remains infectious for a long time. VHE is excreted for a short period of time and in low concentrations. The viral particles are fragile in vitro and their variability in the environment is little known. The possible reservoir role of certain animals has been envisaged. Epidemics arise especially in countries suffering from poor hygiene and massive water pollution. Hepatitis A should no longer be considered a benign disease of childhood. The progress made in hygiene and economic development in industrialized countries have made contacts with this virus scarce, rendering the populations more receptive to it and epidemics more widespread. When the sickness occurs later in life, infection is more often symptomatic and can be serious, resulting sometimes long-term indisposition. Hepatitis E has a vast distribution throughout the world and manifests itself either in epidemic or endemic-sporadic form in many poor countries. In developed countries, it comes about mostly as a result of imported pathology, even if there exists a "substratum" of infection in these areas. The main clinical aspects, such as we were able to study them in 39 cases of military men from Tchad, Guyana and Somalia, are comparable to those of hepatitis A. The reasons for the particular gravity of symptoms in pregnant women are unknown. These affections have no specific treatment. In the field of prevention, vaccination

  1. Yeast-recombinant hepatitis B vaccine: efficacy with hepatitis B immune globulin in prevention of perinatal hepatitis B virus transmission

    SciTech Connect

    Stevens, C.E.; Taylor, P.E.; Tong, M.J.; Toy, P.T.; Vyas, G.N.; Nair, P.V.; Weissman, J.Y.; Krugman, S.

    1987-05-15

    A yeast-recombinant hepatitis B vaccine was licensed recently by the Food and Drug administration and is now available. To assess the efficacy of the yeast-recombinant vaccine, the authors administered the vaccine in combination with hepatitis B immune globulin to high-risk newborns. If infants whose mothers were positive for both hepatitis B surface antigen and the e antigen receive no immunoprophylaxis, 70% to 90% become infected with the virus, and almost all become chronic carriers. Among infants in this study who received hepatitis B immune globulin at birth and three 5-/sup +/g doses of yeast-recombinant hepatitis B vaccine, only 4.8% became chronic carriers, a better than 90% level of protection and a rate that is comparable with that seen with immune globulin and plasma-derived hepatitis B vaccine. Hepatitis surface antigen and antibodies were detected by radioimmunoassay. These data suggest that, in this high-risk setting, the yeast-recombinant vaccine is as effective as the plasma-derived vaccine in preventing hepatitis B virus infection and the chronic carrier state.

  2. Hepatitis E virus is the leading cause of acute viral hepatitis in Lothian, Scotland

    PubMed Central

    Kokki, I.; Smith, D.; Simmonds, P.; Ramalingam, S.; Wellington, L.; Willocks, L.; Johannessen, I.; Harvala, H.

    2015-01-01

    Acute viral hepatitis affects all ages worldwide. Hepatitis E virus (HEV) is increasingly recognized as a major cause of acute hepatitis in Europe. Because knowledge of its characteristics is limited, we conducted a retrospective study to outline demographic and clinical features of acute HEV in comparison to hepatitis A, B and C in Lothian over 28 months (January 2012 to April 2014). A total of 3204 blood samples from patients with suspected acute hepatitis were screened for hepatitis A, B and C virus; 913 of these samples were also screened for HEV. Demographic and clinical information on patients with positive samples was gathered from electronic patient records. Confirmed HEV samples were genotyped. Of 82 patients with confirmed viral hepatitis, 48 (59%) had acute HEV. These patients were older than those infected by hepatitis A, B or C viruses, were more often male and typically presented with jaundice, nausea, vomiting and/or malaise. Most HEV cases (70%) had eaten pork or game meat in the few months before infection, and 14 HEV patients (29%) had a recent history of foreign travel. The majority of samples were HEV genotype 3 (27/30, 90%); three were genotype 1. Acute HEV infection is currently the predominant cause of acute viral hepatitis in Lothian and presents clinically in older men. Most of these infections are autochthonous, and further studies confirming the sources of infection (i.e. food or blood transfusion) are required. PMID:26904201

  3. Autoimmune hepatitis.

    PubMed

    Strassburg, Christian P

    2010-10-01

    Autoimmune hepatitis is a chronic inflammatory disease of the liver with a dismal prognosis when left untreated. Key for the improvement of prognosis is a timely diagnosis before cirrhosis has developed. This is reached by the exclusion of other causes of hepatitis, elevated immunoglobulin G, autoantibody profile and histological assessment. Treatment achieves remission rates in 80% of individuals and consists of immunosuppression with corticosteroids and azathioprine. A recent randomised controlled multicenter trial has added budesonide to the effective treatment options in non-cirrhotic patients and leads to a reduction of unwanted steroid side effects. Autoimmune hepatitis is an autoimmune disease of unknown aetiology. Association studies of major histocompatibility complex and other genes demonstrate an influence of immunogenetics. However, apart from the autoimmune polyglandular syndrome type 1, in which 10% of patients suffer from an autoantibody-positive autoimmune hepatitis linked to mutations of the autoimmune regulator gene, there is no clear evidence for a hereditary aetiology of this disease. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. High non-responsiveness of males and the elderly to standard hepatitis B vaccination among a large cohort of healthy employees.

    PubMed

    Vermeiren, Angelique P A; Hoebe, Christian J P A; Dukers-Muijrers, Nicole H T M

    2013-09-01

    Hepatitis B virus infection is a major health problem. Although non-response is known to increase with age, hepatitis B vaccinations are considered to have only minor non-response rates (anti-HBs<10IU/L) in healthy subjects. The aim of this study was to quantify immunosenescence in a large retrospective cohort of 11,439 healthy adults who received HBV immunisation according to the standard vaccination regime. We evaluated the response to the standard three-dose vaccination regimen, consisting of 20-μg doses of the HbsAg recombinant DNA hepatitis B vaccine, among 11,439 healthy employees using a retrospective cohort design. Logistic regression was applied to predict the non-response rate, and multivariate regression analysis was applied to predict antibody response. Predictors of responsiveness included sex, age and time between the last vaccination and antibody titre measurement. From the age of 29 on in men and 43 on in women, more than 5% of subjects did not respond. Compared with women, men had a higher risk of non-response and exhibited a steeper decline in antibody titres produced with increasing age. This retrospective cohort study demonstrates that immunosenescence starts at young age, especially among men, underlining the importance of vaccination at a young age to achieve long-lasting immunity. Moreover, HBV vaccination should always include testing for antibodies to facilitate the performance of necessary interventions to prevent long-term fatal complications. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. Hepatitis A Vaccine

    MedlinePlus

    Twinrix® (as a combination product containing Hepatitis A Vaccine, Hepatitis B Vaccine) ... Why get vaccinated against hepatitis A?Hepatitis A is a serious liver disease. It is caused by the hepatitis A virus (HAV). HAV is spread from ...

  6. Factors relating to transmission of viral hepatitis in a United States military population stationed in Thailand.

    PubMed

    Scott, R M; Schneider, R J; Snitbhan, R; Karwacki, J J

    1981-05-01

    To determine the incidence of clinical and inapparent hepatitis in a US military population stationed in Thailand, the authors prospectively studied a cohort of 326 men during one year. Clinical hepatitis A occurred in one man (clinical attack rate = 3.1/1000 men/year), and clinical hepatitis B was found in four men (clinical attack rate = 12.3/1000 men/year). No non-A, non-B hepatitis was identified. There was no serologically identified inapparent hepatitis A but inapparent hepatitis B occurred in 17 men. The apparent/inapparent ratio for hepatitis B was 1:4.25. Serotype analysis suggested that hepatitis B virus largely originated from Thai contacts, although 23% of cases were derived from western sources. To determine the relative contribution of 16 statistically significant (out of 67 studied) behavioral variables to the transmission of HBV, a factor analysis and a multivariate correlation analysis were employed. Factor analysis indicated that social and sexual contact with the indigenous population, including prostitutes, residence within the Thai community and marijuana use were behavioral areas that were associated with the acquisition of hepatitis B. Residence in the Thai community during the first four-month period in Thailand, sexual contact with a prostitute during the third four-month period, and ever having maintained a Thai mistress were found to be significant and independent risk factors by multiple regression analysis.

  7. Breast Cancer in Men

    MedlinePlus

    ... men may have radiation after surgery. Since most breast cancers in men are hormone receptor-positive, hormone therapy (with tamoxifen) is often used depending on the stage. Chemotherapy may be given before tamoxifen. For men ...

  8. Men Learning through Life (and Men's Sheds)

    ERIC Educational Resources Information Center

    Golding, Barry

    2015-01-01

    This "Futures" column shares insights about men's learning beyond work, based on several decades of research in men's learning in international community contexts. The article focuses' particularly on men who want and need to learn to re-create and broaden their identities beyond their working lives. This practice, well established in…

  9. Men Learning through Life (and Men's Sheds)

    ERIC Educational Resources Information Center

    Golding, Barry

    2015-01-01

    This "Futures" column shares insights about men's learning beyond work, based on several decades of research in men's learning in international community contexts. The article focuses' particularly on men who want and need to learn to re-create and broaden their identities beyond their working lives. This practice, well established in…

  10. Hepatitis A and B vaccination--the rate of uptake and course completion in patients with hepatitis C.

    PubMed

    Fredericks, Trinity; Kwan, Kellie; Mak, Donna

    2010-10-01

    Western Australian general practitioners may order Department of Health funded hepatitis A and B vaccines for patients newly notified with hepatitis C to prevent complications associated with co-infections. The aim of this study was to determine vaccination uptake of hepatitis C patients through this program. We reviewed hepatitis C notifications and hepatitis A and B vaccine orders received in 2007 and 2008 to determine the rate of vaccine uptake and course completion. Vaccination orders for initial doses were received for 37% (448/1209) of patients. Vaccination uptake was positively associated with age and non- Aboriginality. Final vaccination doses were ordered for 30% of patients for whom an initial order had been received. Uptake of hepatitis A and B vaccination was higher than that of similar populations. However, vaccination course completion was low. General practitioners need to emphasise to their patients the importance of completing a vaccine course.

  11. Earnings Differences between Women and Men. Facts on Working Women.

    ERIC Educational Resources Information Center

    Women's Bureau (DOL), Washington, DC.

    Although the gap between women's and men's wages differs slightly depending on how the gap is measured, no matter how they are measured, women's earnings are below those received by men in 97% of the occupations for which data are available. Since 1979, women's earnings have been climbing when compared with men's earnings, gaining steeply during…

  12. Preventing hepatitis A

    MedlinePlus

    Hepatitis A is inflammation (irritation and swelling) of the liver caused by the hepatitis A virus. You can take several steps to ... reduce your risk of spreading or catching the hepatitis A virus: Always wash your hands thoroughly after ...

  13. Travelers' Health: Hepatitis A

    MedlinePlus

    ... Recommend on Facebook Tweet Share Compartir Chapter 3 - Helminths, Soil-Transmitted Chapter 3 - Hepatitis B Hepatitis A ... Dec 20;2(6):227–30. Chapter 3 - Helminths, Soil-Transmitted Chapter 3 - Hepatitis B File Formats ...

  14. Hepatitis Risk Assessment

    MedlinePlus

    ... please visit this page: About CDC.gov . Hepatitis Risk Assessment Recommend on Facebook Tweet Share Compartir Viral Hepatitis. Are you at risk? Take this 5 minute Hepatitis Risk Assessment developed ...

  15. Hepatitis B virus (image)

    MedlinePlus

    Hepatitis B is also known as serum hepatitis and is spread through blood and sexual contact. It is ... population. This photograph is an electronmicroscopic image of hepatitis B virus particles. (Image courtesy of the Centers for ...

  16. HIV and Hepatitis C

    MedlinePlus

    ... AIDS-Related Opportunistic Infections and Coinfections HIV and Hepatitis C (Last updated 8/31/2016; last reviewed ... the medicines for any side effects. What is hepatitis C? Hepatitis C is a liver disease caused ...

  17. HIV and Hepatitis B

    MedlinePlus

    ... AIDS-Related Opportunistic Infections and Coinfections HIV and Hepatitis B (Last updated 8/31/2016; last reviewed ... should be treated for both diseases. What is hepatitis B? Hepatitis B is a liver disease caused ...

  18. High-Yield Birth-Cohort Hepatitis C Virus Screening and Linkage to Care Among Underserved African Americans, Atlanta, Georgia, 2012-2013.

    PubMed

    Miller, Lesley S; Rollin, Francois; Fluker, Shelly-Ann; Lundberg, Kristina L; Park, Brandi; Quairoli, Kristi; Niyibizi, Nyiramugisha K; Spaulding, Anne C

    2016-01-01

    Hepatitis C virus (HCV) infection disproportionately affects certain populations, including those born between 1945 and 1965 (i.e., baby boomers) and African Americans. As part of the Hepatitis Testing and Linkage to Care initiative, which promoted hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites, we conducted routine HCV screening to identify previously undiagnosed, primarily African American baby boomers with chronic hepatitis C infection and link them to care. We launched the Internal Medicine Trainees Identifying and Linking to Treatment for Hepatitis C (TILT-C) initiative at the Grady Memorial Hospital Primary Care Center and Grady Liver Clinic in Atlanta, Georgia, in October 2012, and present results from the first year. TILT-C faculty implemented an electronic medical record prompt and conducted educational sessions to boost HCV screening. A project coordinator tracked testing outcomes and linked HCV-positive patients to care. Of 2,894 patients tested for anti-HCV, 201 (6.9%) tested positive. Men had a significantly higher (p<0.001) prevalence of HCV infection than women, with 106 of 1,091 (9.7%) men compared with 95 of 1,803 (5.3%) women testing anti-HCV positive. A total of 174 of 201 (86.6%) anti-HCV-positive patients received HCV ribonucleic acid (RNA) testing. Of 124 patients with a positive HCV RNA test, 122 were referred to care and 120 attended the first appointment. The TILT-C screening program was feasible and effective in detecting previously undiagnosed HCV infection and linking patients to care. The unexpectedly high prevalence of HCV infection in this primarily African American, baby boomer population underscores the need for aggressive HCV screening efforts in similar populations.

  19. Hepatitis C.

    PubMed

    Sharara, A I; Hunt, C M; Hamilton, J D

    1996-10-15

    To review the virology, epidemiology, pathogenesis, natural history, clinical manifestations, and current treatment of hepatitis C virus (HCV) infection. The MEDLINE database (1966 to 1996) was searched for English-language articles and abstracts on HCV and non-A, non-B hepatitis. Papers cited in relevant primary articles were also reviewed. More than 500 original and review articles were evaluated, and the most relevant were selected. Data were extracted and reviewed by all authors. In most patients, HCV infection results in chronic hepatitis. The disease is insidious and subclinical but may progress over decades into end-stage liver disease and hepatocellular carcinoma, which makes HCV cirrhosis a leading indication for orthotopic liver transplantation. Current diagnostic methods are highly sensitive and specific, and quantitative assessment of viral load may help to predict and monitor response to treatment. The only available therapeutic option is interferon, and this agent is effective in only a small subset of patients. Infection with HCV is a significant public health problem that has important clinical and financial consequences. The tailoring of specific therapy according to viral load or genotype, better patient selection, and use of combination drug regimens may improve the chance of viral clearance and sustained biochemical and histologic response. Further understanding of the basic virology of HCV and the exact mechanisms of viral persistence and tissue injury is needed to help define future therapeutic and preventive strategies.

  20. [Hepatitis E].

    PubMed

    Scotto, Gaetano; Bulla, Fabio; Campanale, Francesca; Tartaglia, Alessandra; Fazio, Vincenzina

    2013-09-01

    Hepatitis E virus (HEV) represents the main aetiological agent of enteric non-A hepatitis and is the only member of a new virus, Hepevirus, belonging to the family of Hepeviridae. HEV is the single most important cause of acute clinical hepatitis among adults in many areas of the developing world, specifically the Indian subcontinent and Southeast Asia, the Middle East and North Africa, where it is a common cause of sporadic and epidemic waterborne outbreaks and results in a high rate of morbidity and death, especially in pregnant women. Once thought of as an infection confined to developing countries, it is now recognized as a geographically widely distributed disease. In low-endemic regions (Western countries), sporadic cases of locally-acquired HEV infection are reported, acquired possibly through zoonotic transmission from pigs, wild boars or deer. In persons with pre-existing chronic liver disease, HEV superinfection can present as acute-on-chronic liver disease. In European countries, chronic infection, which may progress to liver cirrhosis, has been reported among immunosuppressed persons. Two testing vaccines proved to be highly effective in preventing the disease; these vaccines should be of particular use in groups that are at high risk of HEV infection.

  1. Transfusion-associated hepatitis before the screening of blood for hepatitis risk factors

    PubMed Central

    Engle, Ronald E.; Bukh, Jens; Alter, Harvey J.; Emerson, Suzanne U.; Trenbeath, Joni L.; Nguyen, Hanh T.; Brockington, Alicia; Mitra, Tanaji; Purcell, Robert H.

    2017-01-01

    BACKGROUND The true incidence of transfusion-associated hepatitis (TAH) before blood screening is unknown. Our aims were to reevaluate blood recipients receiving unscreened blood and analyze hepatitis viruses circulating more than 45 years ago. STUDY DESIGN AND METHODS Cryopreserved serum samples from 66 patients undergoing open heart surgery in the 1960s were reevaluated with modern diagnostic tests to determine the incidence of TAH and its virologic causes. RESULTS In this heavily transfused population receiving a mean of 20 units per patient of predominantly paid-donor blood, 30 of 66 (45%) developed biochemical evidence of hepatitis; of these, 20 (67%) were infected with hepatitis C virus (HCV) alone, four (13%) with hepatitis B virus (HBV) alone, and six (20%) with both viruses. Among the 36 patients who did not develop hepatitis, four (11%) were newly infected with HCV alone, nine (25%) with HBV alone, and one (3%) with both viruses. Overall, 100% of patients with hepatitis and 39% of those without hepatitis were infected with HBV and/or HCV; one patient was also infected with hepatitis E virus. The donor carrier rate for HBV and/or HCV was estimated to be more than 6%; contemporaneously prepared pooled normal human plasma was also contaminated with multiple hepatitis viruses. CONCLUSION TAH virus infections were a larger problem than perceived 50 years ago and HCV was the predominant agent transmitted. All hepatitis cases could be attributed to HCV and/or HBV and hence there was no evidence to suggest that an additional hepatitis agent existed undetected in the blood supply. PMID:24797372

  2. Adult Living with Hepatitis B

    MedlinePlus

    ... Viral Hepatitis Liver Cancer and Hepatitis B Hepatitis Delta Coinfection Hepatitis C Coinfection HIV/AIDS Coinfection Prevention & ... Institute Education & Training Hep B United Coalition Hepatitis Delta Connect 2017 International HBV Meeting National Patient Advocacy ...

  3. Chronic hepatitis E: A brief review.

    PubMed

    Murali, Arvind R; Kotwal, Vikram; Chawla, Saurabh

    2015-09-08

    Hepatitis E viral infection has traditionally been considered an acute, self-limited, water borne disease similar to hepatitis A, endemic to developing countries. However, over the past decade, zoonotic transmission and progression to chronicity in human patients has been identified, resulting in persistently elevated transaminase levels, progressive liver injury and cirrhosis. In addition to liver injury, neurological, renal and rheumatological manifestations have also been reported. Chronic hepatitis E occurs mainly in immunosuppressed individuals such as transplant recipients, human immunodeficiency virus patients with low CD4 counts and in patients with hematological malignancies receiving chemotherapy. Diagnosis is established by persistent elevation of hepatitis E virus RNA in the stool or serum. This population often requires treatment with antiviral agents, particularly ribavirin, as spontaneous clearance with reduction in immunosuppression occurs only in about a third of the patients. The purpose of this review, is to further discuss the clinical presentation, and recent advances in diagnosis, treatment and prophylaxis of chronic hepatitis E.

  4. Prostate cancer in men of African origin.

    PubMed

    McGinley, Kathleen F; Tay, Kae Jack; Moul, Judd W

    2016-02-01

    Men of African origin are disproportionately affected by prostate cancer: prostate cancer incidence is highest among men of African origin in the USA, prostate cancer mortality is highest among men of African origin in the Caribbean, and tumour stage and grade at diagnosis are highest among men in sub-Saharan Africa. Socioeconomic, educational, cultural, and genetic factors, as well as variations in care delivery and treatment selection, contribute to this cancer disparity. Emerging data on single-nucleotide-polymorphism patterns, epigenetic changes, and variations in fusion-gene products among men of African origin add to the understanding of genetic differences underlying this disease. On the diagnosis of prostate cancer, when all treatment options are available, men of African origin are more likely to choose radiation therapy or to receive no definitive treatment than white men. Among men of African origin undergoing surgery, increased rates of biochemical recurrence have been identified. Understanding differences in the cancer-survivorship experience and quality-of-life outcomes among men of African origin are critical to appropriately counsel patients and improve cultural sensitivity. Efforts to curtail prostate cancer screening will likely affect men of African origin disproportionately and widen the racial disparity of disease.

  5. HIV, Hepatitis C, and Hepatitis B Infections and Associated Risk Behavior in Injection Drug Users, Kabul, Afghanistan

    PubMed Central

    Todd, Catherine S.; Abed, Abdullah M.S.; Strathdee, Steffanie A.; Botros, Boulos A.; Safi, Naqibullah; Earhart, Kenneth C.

    2007-01-01

    Limited prevalence data for HIV, hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) exist for Afghanistan. We studied a cross-sectional sample of adult injection drug users (IDUs) in Kabul, Afghanistan, from June 2005 through June 2006. Study participants completed interviewer-administered questionnaires and underwent testing for HIV, antibody to HCV, and HBsAg. Overall prevalences of HIV, HCV, and HBsAg were 3.0% (95% confidence interval [CI] 1.7%–5.1%), 36.6% (95% CI 32.2%–41.0%), and 6.5% (95% CI 4.2%–8.7%), respectively (N = 464). Among male IDUs (n = 463), risky behavior, including sharing syringes (50.4%), paying women for sex (76.2%), and having sex with men or boys (28.3%), were common. Needle sharing, injecting for >3 years, and receiving injections from nonmedical providers were independently associated with increased risk for HCV infection. The high prevalence of risky behavior indicate that Kabul is at risk for an HIV epidemic. Scale-up of harm-reducing interventions is urgently needed. PMID:18252103

  6. Perceptions of Risk for Hepatitis B Infection among the Hmong

    PubMed Central

    Thorburn, Sheryl; Szalacha, Laura A.

    2017-01-01

    The Hmong in the U.S. who emigrated from Southeast Asia, an area where hepatitis B is endemic, experience high rates of hepatitis B infection and liver cancer compared to non-Hispanic whites. This exploratory study examined the Hmong’s perceptions of risk of hepatitis B infection. We interviewed 83 Hmong women and men living in Oregon. In bivariate statistical analysis, greater perceived susceptibility, lower perceived barriers, and having a healthcare provider recommendation were each significantly related to having ever been screened for hepatitis B. Logistic regression models indicated that having a recommendation by a doctor or healthcare provider was the strongest predictor of having been screened for hepatitis B, followed by education and insurance. Future interventions with the Hmong population should focus on the important role of health care providers play in raising awareness about hepatitis B infection and increasing screening uptake. PMID:28154502

  7. Putting the "receive" in accounts receivable.

    PubMed

    McDaniel, John W; Baum, Neil

    2006-01-01

    There isn't a practice in the United States that doesn't have a concern about accounts receivable. The financial success of any practice depends on the care and feeding of the accounts receivable. This is not an area of practice management that can be taken lightly or delegated to someone who is not attentive to detail and doggedly persistent. In this article, we will discuss how to identify problematic accounts receivable and what can be done to bring the accounts receivable under control. We will provide you with a plan of action that can be adopted by any practice regardless of size, number of physicians, or whether the practice uses in-house billing or outsources its billing arrangements.

  8. Lay beliefs about hepatitis among North American Chinese: implications for hepatitis prevention.

    PubMed

    Chen, Hueifang; Tu, Shin-Ping; Teh, Chong Z; Yip, Mei-Po; Choe, John H; Hislop, T Gregory; Taylor, Victoria M; Thompson, Beti

    2006-04-01

    The objective was to learn about the hepatitis prevention behavior of relatively unacculturated North American Chinese adults, along with their knowledge, beliefs, and perceptions with regard to hepatitis, screening, and vaccination. Forty Chinese men and women, aged 18-64, were recruited from immigrant communities in Seattle, Washington, and Vancouver, British Columbia. Semi-structured interviews (Cantonese or Mandarin) were audiotaped, translated, transcribed verbatim, and coded. Open coding, axial coding, constant comparison methods, and QSR NUD*IST 5 software was used for analysis. Findings were validated using eight focus groups. Findings indicated that many interviewees lack accurate knowledge with regard to hepatitis, often confusing the different types. Perceived causes of hepatitis included potentially harmful food (e.g., fried foods or potentially contaminated foods), alcohol, contact with infected individuals, stress, and inadequate rest. Preventive strategies associated with Chinese health beliefs included the use of Chinese herbal medicine, maintaining a stress-free mind, strengthening the body's natural defenses, and getting enough sleep. Other preventive strategies were the practice of good hygiene, vaccination, and the avoidance of contact with infected persons. Vaccination was not seen as primary, as 65% of those who had heard of hepatitis vaccination did not cite it as a means for hepatitis prevention until asked. Also, participants lacked information about the types and purposes of hepatitis vaccination and were worried about side effects. In conclusion, any attempt to promote hepatitis testing and vaccination among the North American Chinese should take traditional beliefs and practices into consideration.

  9. Viral Hepatitis Surveillance--India, 2011-2013.

    PubMed

    Kumar, Tripurari; Shrivastava, Aakash; Kumar, Anil; Laserson, Kayla F; Narain, Jai P; Venkatesh, Srinivasaraghavan; Chauhan, Lakhbir S; Averhoff, Francisco

    2015-07-24

    The burden of viral hepatitis in India is not well characterized. In 2009, the national Integrated Disease Surveillance Programme (IDSP) began conducting surveillance across all Indian states for epidemic-prone diseases, including foodborne and waterborne forms of viral hepatitis (e.g., hepatitis A and E). Information on outbreaks of all forms of viral hepatitis, including A, B, C, and E, also is collected. This report summarizes viral hepatitis surveillance and outbreak data reported to IDSP during 2011-2013. During this period, 804,782 hepatitis cases and 291 outbreaks were reported; the virus type was unspecified in 92% of cases. Among 599,605 cases tested for hepatitis A, 44,663 (7.4%) were positive, and among 187,040 tested for hepatitis E, 19,508 (10.4%) were positive. At least one hepatitis outbreak report was received from 23 (66%) of 35 Indian states. Two-thirds of outbreaks were reported from rural areas. Among 163 (56%) outbreaks with known etiology, 78 (48%) were caused by hepatitis E, 54 (33%) by hepatitis A, 19 (12%) by both hepatitis A and E, and 12 (7%) by hepatitis B or hepatitis C. Contaminated drinking water was the source of most outbreaks. Improvements in water quality and sanitation as well as inclusion of hepatitis A vaccine in childhood immunization programs should be considered to reduce the public health burden of hepatitis in India. Efforts to decrease the proportion of cases for which the etiology is unspecified, including expanding the IDSP to support hepatitis B and C testing, might help further elucidate the epidemiology of these diseases.

  10. Occult hepatitis B virus infection

    PubMed Central

    Kwak, Min-Sun; Kim, Yoon Jun

    2014-01-01

    Occult hepatitis B virus (HBV) infection (OBI) refers to the presence of HBV DNA in the absence of detectable hepatitis B surface antigen. Since OBI was first described in the late 1970s, there has been increasing interest in this topic. The prevalence of OBI varies according to the different endemicity of HBV infection, cohort characteristics, and sensitivity and specificity of the methods used for detection. Although the exact mechanism of OBI has not been proved, intra-hepatic persistence of viral covalently closed circular DNA under the host’s strong immune suppression of HBV replication and gene expression seems to be a cause. OBI has important clinical significance in several conditions. First, OBI can be transmitted through transfusion, organ transplantation including orthotopic liver transplantation, or hemodialysis. Donor screening before blood transfusion, prophylaxis for high-risk organ transplantation recipients, and dialysis-specific infection-control programs should be considered to reduce the risk of transmission. Second, OBI may reactivate and cause acute hepatitis in immunocompromised patients or those receiving chemotherapy. Close HBV DNA monitoring and timely antiviral treatment can prevent HBV reactivation and consequent clinical deterioration. Third, OBI may contribute to the progression of hepatic fibrosis in patients with chronic liver disease including hepatitis C. Finally, OBI seems to be a risk factor for hepatocellular carcinoma by its direct proto-oncogenic effect and by indirectly causing persistent hepatic inflammation and fibrosis. However, this needs further investigation. We review published reports in the literature to gain an overview of the status of OBI and emphasize the clinical importance of OBI. PMID:25544873

  11. [Using hepatomaks forte in the treatment of chronic alcoholic hepatitis].

    PubMed

    Linevskiĭ, Iu V; Linevskaia, K Iu; Voronin, K A

    2013-01-01

    Installed significantly more pronounced positive effect on clinical manifestations and laboratory indicators of liver in patients with chronic alcoholic hepatitis who received within 4 weeks of basal therapy in conjunction with Gepatomax Forte in comparison with a group of patients with chronic alcoholic hepatitis who received during the same time only basic therapy. Side adverse effects in the group of patients receiving Gepatomax Forte were not registered.

  12. Metformin Increases Cortisol Regeneration by 11βHSD1 in Obese Men With and Without Type 2 Diabetes Mellitus.

    PubMed

    Anderson, Anna J; Andrew, Ruth; Homer, Natalie Z; Jones, Gregory C; Smith, Kenneth; Livingstone, Dawn E; Walker, Brian R; Stimson, Roland H

    2016-10-01

    The mechanism of action of metformin remains unclear. Given the regulation of the cortisol-regenerating enzyme 11βhydroxysteroid dehydrogenase 1 (11βHSD1) by insulin and the limited efficacy of selective 11βHSD1 inhibitors to lower blood glucose when co-prescribed with metformin, we hypothesized that metformin reduces 11βHSD1 activity. To determine whether metformin regulates 11βHSD1 activity in vivo in obese men with and without type 2 diabetes mellitus. Double-blind, randomized, placebo-controlled, crossover study. A hospital clinical research facility. Eight obese nondiabetic (OND) men and eight obese men with type 2 diabetes (ODM). Participants received 28 days of metformin (1 g twice daily), placebo, or (in the ODM group) gliclazide (80 mg twice daily) in random order. A deuterated cortisol infusion at the end of each phase measured cortisol regeneration by 11βHSD1. Oral cortisone was given to measure hepatic 11βHSD1 activity in the ODM group. The effect of metformin on 11βHSD1 was also assessed in human hepatocytes and Simpson-Golabi-Behmel syndrome adipocytes. The effect of metformin on whole-body and hepatic 11βHSD1 activity. Whole-body 11βHSD1 activity was approximately 25% higher in the ODM group than the OND group. Metformin increased whole-body cortisol regeneration by 11βHSD1 in both groups compared with placebo and gliclazide and tended to increase hepatic 11βHSD1 activity. In vitro, metformin did not increase 11βHSD1 activity in hepatocytes or adipocytes. Metformin increases whole-body cortisol generation by 11βHSD1 probably through an indirect mechanism, potentially offsetting other metabolic benefits of metformin. Co-prescription with metformin should provide a greater target for selective 11βHSD1 inhibitors.

  13. Platelet count/spleen diameter ratio to predict esophageal varices in Mexican patients with hepatic cirrhosis.

    PubMed

    González-Ojeda, Alejandro; Cervantes-Guevara, Gabino; Chávez-Sánchez, Manuela; Dávalos-Cobián, Carlos; Ornelas-Cázares, Susana; Macías-Amezcua, Michel Dassaejv; Chávez-Tostado, Mariana; Ramírez-Campos, Kenia Militzi; Ramírez-Arce, Anaís Del Rocío; Fuentes-Orozco, Clotilde

    2014-02-28

    To validate whether the platelet count/spleen size ratio can be used to predict the presence of esophageal varices in Mexican patients with hepatic cirrhosis. This was an analytical cross-sectional study to validate the diagnostic test for hepatic cirrhosis and was performed between February 2010 and December 2011. Patients with a diagnosis of hepatic cirrhosis were included and stratified using their Child-Pugh score. Biochemical parameters were evaluated, and ultrasound was used to measure the longest diameter of the spleen. The platelet count/spleen diameter ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices. Upper gastrointestinal endoscopy was used as the gold standard. Sensitivity and specificity, positive and negative predictive values, and positive and negative likelihood ratios were determined, with the cutoff points determined by receiver-operating characteristic curves. A total of 91 patients were included. The mean age was 53.75 ± 12 years; 50 (54.9%) were men, and 41 (45.0%) women. The etiology of cirrhosis included alcohol in 48 (52.7%), virally induced in 24 (26.3%), alcoholism plus hepatitis C virus in three (3.2%), cryptogenic in nine (9.8%), and primary biliary cirrhosis in seven (7.6%). Esophageal varices were present in 73 (80.2%) patients. Child-Pugh classification, 17 (18.6%) patients were classified as class A, 37 (40.6%) as class B, and 37 (40.6%) as class C. The platelet count/spleen diameter ratio to detect esophageal varices independent of the grade showed using a cutoff value of ≤ 884.3, had 84% sensitivity, 70% specificity, and positive and negative predictive values of 94% and 40%, respectively. Our results suggest that the platelet count/spleen diameter ratio may be a useful tool for detecting esophageal varices in patients with hepatic cirrhosis.

  14. Platelet count/spleen diameter ratio to predict esophageal varices in Mexican patients with hepatic cirrhosis

    PubMed Central

    González-Ojeda, Alejandro; Cervantes-Guevara, Gabino; Chávez-Sánchez, Manuela; Dávalos-Cobián, Carlos; Ornelas-Cázares, Susana; Macías-Amezcua, Michel Dassaejv; Chávez-Tostado, Mariana; Ramírez-Campos, Kenia Militzi; Ramírez-Arce, Anaís del Rocío; Fuentes-Orozco, Clotilde

    2014-01-01

    AIM: To validate whether the platelet count/spleen size ratio can be used to predict the presence of esophageal varices in Mexican patients with hepatic cirrhosis. METHODS: This was an analytical cross-sectional study to validate the diagnostic test for hepatic cirrhosis and was performed between February 2010 and December 2011. Patients with a diagnosis of hepatic cirrhosis were included and stratified using their Child-Pugh score. Biochemical parameters were evaluated, and ultrasound was used to measure the longest diameter of the spleen. The platelet count/spleen diameter ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices. Upper gastrointestinal endoscopy was used as the gold standard. Sensitivity and specificity, positive and negative predictive values, and positive and negative likelihood ratios were determined, with the cutoff points determined by receiver-operating characteristic curves. RESULTS: A total of 91 patients were included. The mean age was 53.75 ± 12 years; 50 (54.9%) were men, and 41 (45.0%) women. The etiology of cirrhosis included alcohol in 48 (52.7%), virally induced in 24 (26.3%), alcoholism plus hepatitis C virus in three (3.2%), cryptogenic in nine (9.8%), and primary biliary cirrhosis in seven (7.6%). Esophageal varices were present in 73 (80.2%) patients. Child-Pugh classification, 17 (18.6%) patients were classified as class A, 37 (40.6%) as class B, and 37 (40.6%) as class C. The platelet count/spleen diameter ratio to detect esophageal varices independent of the grade showed using a cutoff value of ≤ 884.3, had 84% sensitivity, 70% specificity, and positive and negative predictive values of 94% and 40%, respectively. CONCLUSION: Our results suggest that the platelet count/spleen diameter ratio may be a useful tool for detecting esophageal varices in patients with hepatic cirrhosis. PMID:24616574

  15. Nucleos(t)ide analog(s) prophylaxis after hepatitis B immunoglobulin withdrawal against hepatitis B and D recurrence after liver transplantation.

    PubMed

    Cholongitas, E; Goulis, I; Antoniadis, N; Fouzas, I; Imvrios, G; Giakoustidis, D; Giouleme, O; Papanikolaou, V; Akriviadis, E; Vasiliadis, T

    2016-10-01

    Nucleos(t)ide analogs (NAs) have made a hepatitis B immunoglobulin (HBIG)-sparing protocol an attractive approach against hepatitis B virus (HBV) recurrence after liver transplantation (LT). However, this approach is considered controversial in patients transplanted for HBV and hepatitis D (HDV) co-infection. All patients transplanted for HBV/HDV cirrhosis were evaluated. After LT, each patient received HBIG + NAs and then continued with NAs prophylaxis. All patients were followed up with HBV serum markers and HBV DNA, while anti-HDV/HDV RNA was performed in those with HBV recurrence. A total of 34 recipients were included (22 men, age: 46.7 ± 16 years). After HBIG discontinuation, NAs were received as monoprophylaxis (lamivudine [LAM]: 2, adefovir [AFV]: 1, entecavir: 9, tenofovir [TDF]: 12) or dual prophylaxis (LAM + AFV [or TDF]: 10 patients). Two (5.8%) of the 34 patients had HBV/HDV recurrence after HBIG withdrawal (median follow-up: 28 [range, 12-58] months). These 2 patients had undetectable HBV DNA at LT. Statistical analysis revealed that those with recurrence had received HBIG for shorter period, compared to those without recurrence (median: 9 vs. 28 months, P = 0.008). We showed for the first time, to our knowledge, that maintenance therapy with NAs prophylaxis after HBIG discontinuation was effective against HBV/HDV recurrence, but it seems that a longer period of HBIG administration might be needed before it is withdrawn after LT. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Messages for men: the efficacy of EPPM-based messages targeting men's physical activity.

    PubMed

    Hatchell, Alexandra C; Bassett-Gunter, Rebecca L; Clarke, Marie; Kimura, Stacey; Latimer-Cheung, Amy E

    2013-01-01

    The majority of men are insufficiently active. Men's tendencies to participate in risky behaviors and their inactivity likely contribute to their increased risk of morbidity and mortality. Physical activity decreases the risk of developing many chronic diseases and may be an optimal behavior to target in men's health interventions. However, educational resources promoting physical activity for men are lacking. To address this gap, we tested the efficacy of messages based upon the Extended Parallel Process Model (EPPM; Witte, 1992) to increase men's physical activity intentions and behaviors. Men who were not meeting physical activity guidelines (n = 611) were randomly assigned to read high or low efficacy physical activity messages paired with high or no health risk information. Participants read four brief messages on four consecutive days. Intentions were assessed at baseline and the first follow-up (Day 5). Manipulation check measures were assessed at Day 5. Behavior was assessed at baseline and the second follow-up (Day 14). Overall, the messages had small sized effects. A completer analysis revealed that although men's intentions to be active increased over the course of the study regardless of the messages they received, only men who received risk information significantly increased their physical activity. Men who received low efficacy and risk information were less likely to meet the physical activity guidelines at Day 14 than men who only received low efficacy information. From these results, we suggest preliminary recommendations for the development of physical activity messages for men and areas for future EPPM-based research. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  17. Protective effect of inactivated hepatitis A vaccine against the outbreak of hepatitis A in an open rural community

    PubMed Central

    Shen, Yue-Gen; Gu, Xie-Jun; Zhou, Jian-Hong

    2008-01-01

    AIM: To evaluate the protective effect of inactivated hepatitis A vaccine (Healive®) against hepatitis A outbreak in an emergency vaccination campaign. METHODS: During an outbreak of hepatitis A in Honghe Town, Xiuzhou District, Jiaxing City, Zhejiang Province, two nonrandomized controlled trials were conducted in September 2006. The first trial was to vaccinate 108 anti-HAV negative individuals with close contacts of the patients from September with 1 dose of an inactivated hepatitis A vaccine, Healive®. The control group comprised of 115 individuals with close contacts of the patients before September. The second trial was to vaccinate 3365 primary and secondary school students who volunteered to receive a dose of Healive® and 2572 students who did not receive Healive® serving as its controls. An epidemiological survey was conducted to evaluate the protective efficacy of the vaccine. RESULTS: A total of 136 hepatitis A cases were reported during an outbreak that started in June, peaked in August and September, and ended after December of 2006. After a massive vaccination of school children in September, the number of cases declined significantly. No hepatitis A was detected in the 108 vaccinated individuals with close contacts of patients, whereas 4 cases of hepatitis A were found in the controls. The infection rate of hepatitis A was not significantly different in the individuals with close contacts of patients whether or not they received the vaccine (P = 0.122). No hepatitis A was detected in the 3365 students who received the vaccine, four cases of hepatitis A were found in the controls. The infection rate of students with or without vaccination was significantly different in the students who received the vaccine (0/3365 vs 4/2572, P = 0.035). The protective efficacy of the vaccine was 100%. CONCLUSION: Inactivated hepatitis A vaccine demonstrates a good protective effect against an outbreak of hepatitis A. PMID:18461664

  18. Sexual transmission of hepatitis C and early intervention.

    PubMed

    Fletcher, Shona

    2003-01-01

    The major risk factors for the transmission of hepatitis C virus (HCV) have been sharing needles for intravenous drug use (IDU) and receiving blood and blood products; however, recent findings suggest that HCV is being increasingly sexually transmitted, particularly among HIV-positive men who engage in high-risk, unprotected sexual behaviors with other men. Sixteen HIV-positive patients were diagnosed with sexually acquired HCV infection at a leading London HIV outpatient treatment center during 2002. All 16 patients were homosexual males with no history of IDU who had been involved in high-risk, unprotected sexual behaviors, which included active and passive anal intercourse, fisting, rimming, and oral sex. Six patients (37.5%) in the cohort spontaneously cleared HCV infection and consequently tested negative for HCV RNA. The remaining 10 patients were all started on HCV treatment, which consisted of pegylated interferon alpha-2b in combination with ribavirin. Three patients (43%) have achieved a significant reduction in HCV RNA after 12 to 24 weeks of HCV treatment. The earlier HCV seroconversion is detected and treated, the better the chance of achieving viral eradication.

  19. Rifaximin in the treatment of hepatic encephalopathy

    PubMed Central

    Iadevaia, Maddalena Diana; Prete, Anna Del; Cesaro, Claudia; Gaeta, Laura; Zulli, Claudio; Loguercio, Carmelina

    2011-01-01

    Hepatic encephalopathy is a challenging complication in patients with advanced liver disease. It can be defined as a neuropsychiatric syndrome caused by portosystemic venous shunting, ranging from minimal to overt hepatic encephalopathy or coma. Its pathophysiology is still unclear, although increased levels of ammonia play a key role. Diagnosis of hepatic encephalopathy is currently based on specific tests evaluating the neuropsychiatric state of patients and their quality of life; the severity of hepatic encephalopathy is measured by the West Haven criteria. Treatment of hepatic encephalopathy consists of pharmacological and corrective measures, as well as nutritional interventions. Rifaximin received approval for the treatment of hepatic encephalopathy in 2010 because of its few side effects and pharmacological benefits. The aim of this work is to review the use and efficacy of rifaximin both in acute and long-term management of hepatic encephalopathy. Treatment of overt hepatic encephalopathy involves management of the acute episode as well as maintenance of remission in those patients who have previously experienced an episode, in order to improve their quality of life. The positive effect of rifaximin in reducing health care costs is also discussed. PMID:24367227

  20. Coffee and Caffeine Are Associated With Decreased Risk of Advanced Hepatic Fibrosis Among Patients With Hepatitis C.

    PubMed

    Khalaf, Natalia; White, Donna; Kanwal, Fasiha; Ramsey, David; Mittal, Sahil; Tavakoli-Tabasi, Shahriar; Kuzniarek, Jill; El-Serag, Hashem B

    2015-08-01

    Coffee or caffeine has been proposed to protect against hepatic fibrosis, but few data are available on their effects in patients with chronic hepatitis C virus (HCV) infection. We conducted a cross-sectional study of veterans with chronic HCV infection to evaluate the association between daily intake of caffeinated and decaffeinated coffee, tea, and soda, and level of hepatic fibrosis, based on the FibroSURE test (BioPredictive, Paris, France) (F0-F3, mild [controls] vs. F3/F4-F4, advanced). Models were adjusted for multiple potential confounders including age, alcohol abuse, and obesity. Among 910 patients with chronic HCV infection, 98% were male and 38% had advanced hepatic fibrosis. Daily intake of caffeinated coffee was higher among controls than patients with advanced fibrosis (1.37 vs. 1.05 cups/d; P = .038). In contrast, daily intake of caffeinated tea (0.61 vs. 0.56 cups/d; P = .651) or soda (1.14 vs. 0.95 cans/d; P = .106) did not differ between the groups. A higher percentage of controls (66.0%) than patients with advanced fibrosis (57.9%) consumed 100 mg or more of caffeine daily from all sources (P = .014); controls also received a larger proportion of their caffeine from coffee (50.2% vs. 43.0%; P = .035). Hepatoprotective effects of an average daily intake of 100 mg or more of caffeine (adjusted odds ratio, 0.71; 95% confidence interval, 0.53-0.95; P = .020) and 1 cup or more of caffeinated tea by non-coffee drinkers (adjusted odds ratio, 0.56; 95% confidence interval, 0.34-0.94; P = .028) persisted after adjustment for confounders, including insulin resistance. A modest daily caffeine intake (as little as 100 mg) may protect against advanced hepatic fibrosis in men with chronic HCV infection. Additional research is needed to confirm these findings in women and in people with other chronic liver diseases. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  1. [Surveillance of hepatitis A by molecular epidemiologic studies].

    PubMed

    Stene-Johansen, K; Skaug, K; Blystad, H

    1999-10-20

    Hepatitis A virus was studied by molecular epidemiology in connection with an outbreak of hepatitis A associated with intravenous drug users (IVDU) in Norway. Hepatitis A virus was characterised by sequencing 114 of 1,242 notified cases of hepatitis A from January 1995 to July 1998. One hepatitis A variant (IVDU variant I) was detected among IVDU during an outbreak of hepatitis A, as well as among 19 out of 49 cases with no apparent association to this outbreak. During the autumn of 1997, a new variant (IVDU variant II) was detected in the IVDU communities. Genotyping of virus from imported cases associated with travel to endemic regions, revealed that they were distinct from the two other IVDU variants. Hepatitis A has disseminated among IVDU over years; this indicates that hepatitis A is endemic in these communities. At the turn of the year 1997/98, there was a smaller outbreak of hepatitis A among homosexual men in Oslo, distinguished by genotyping from the outbreaks in the IVDU communities. By molecular epidemiology we have been able to identify individual outbreaks of hepatitis A and distinguish them from the IVDU outbreak.

  2. Population-based study on the seroprevalence of hepatitis A, B, and C virus infection in Amsterdam, 2004.

    PubMed

    Baaten, G G G; Sonder, G J B; Dukers, N H T M; Coutinho, R A; Van den Hoek, J A R

    2007-12-01

    In order to enhance screening and preventive strategies, this study investigated the seroprevalence of hepatitis A, B, and C in the general adult urban population and in subgroups. In 2004, sera from 1,364 adult residents of Amsterdam were tested for viral markers. Sociodemographic characteristics were collected using a standardized questionnaire. For hepatitis A, 57.0% was immune. Of first-generation immigrants from Turkey and Morocco, 100% was immune. Of all Western persons and second-generation non-Western immigrants, approximately half was still susceptible. For hepatitis B, 9.9% had antibodies to hepatitis B core antigen (anti-HBc) and 0.4% had hepatitis B surface antigen. Anti-HBc seroprevalences were highest among first-generation immigrants from Surinam, Morocco, and Turkey, and correlated with age at the time of immigration, and among men with a sexual preference for men. Seroprevalence among second-generation immigrants was comparable to Western persons. The seroprevalence of hepatitis C virus antibodies was 0.6%. In conclusion, a country with overall low endemicity for viral hepatitis can show higher endemicity in urban regions, indicating the need for differentiated regional studies and prevention strategies. More prevention efforts in cities like Amsterdam are warranted, particularly for hepatitis A and B among second-generation immigrants, for hepatitis B among men with a sexual preference for men, and for hepatitis C. Active case finding strategies are needed for both hepatitis B and C.

  3. Spaceborne receivers: Basic principles

    NASA Technical Reports Server (NTRS)

    Stacey, J. M.

    1984-01-01

    The underlying principles of operation of microwave receivers for space observations of planetary surfaces were examined. The design philosophy of the receiver as it is applied to operate functionally as an efficient receiving system, the principle of operation of the key components of the receiver, and the important differences among receiver types are explained. The operating performance and the sensitivity expectations for both the modulated and total power receiver configurations are outlined. The expressions are derived from first principles and are developed through the important intermediate stages to form practicle and easily applied equations. The transfer of thermodynamic energy from point to point within the receiver is illustrated. The language of microwave receivers is applied statistics.

  4. CT densities in delayed iodine hepatic scanning

    SciTech Connect

    Perkerson, R.B. Jr.; Erwin, B.C.; Baumgartner, B.R.; Phillips, V.M.; Torres, W.E.; Clements, J.L. Jr.; Gedgaudas-McClees, K.; Bernardino, M.E.

    1985-05-01

    Sixty patients underwent CT scanning of the liver prior to, immediately after, and four hours after intravenous administration of 60% meglumine diatrizoate. Twenty patients received a 50 ml bolus of contrast material, 20 received 100 ml, and 20 received 200 ml. In each group, delayed CT scanning safely raised the inherent density of the liver significantly. Thus, delayed scanning with doses presently used in abdominal and neurological CT examinations may be helpful in detecting hepatic lesions.

  5. Excessive Antibiotic Utilization in Men with Prostatitis

    PubMed Central

    Taylor, Brent C.; Noorbaloochi, Siamak; McNaughton-Collins, Mary; Saigal, Christopher S.; Sohn, Min-Woong; Pontari, Michel A.; Litwin, Mark S.; Wilt, Timothy J.

    2008-01-01

    Background Prostatitis accounts for two million outpatient visits annually. The vast majority of prostatitis cases fit the definition of chronic pelvic pain syndrome for which routine antibiotic use is not indicated. Methods Inpatient, Outpatient, and Pharmacy Datasets from the Veterans Health Administration were used to quantify the magnitude of antibiotic use attributable to chronic pelvic pain syndrome. Specifically, men with a diagnosis of infectious/acute prostatitis, and/or a urinary tract infection were excluded, and the remaining men with a diagnosis of prostatitis were defined as having chronic pelvic pain syndrome. Results Annual prevalence of chronic pelvic pain syndrome was 0.5%. Prescriptions for fluoroquinolone antibiotics were filled in 49% of men with a diagnosis of chronic pelvic pain syndrome compared to five percent in men without chronic pelvic pain syndrome. Men with chronic pelvic pain syndrome were greater than seven times more likely to receive a fluoroquinolone prescription independent of age, race/ethnicity and comorbid conditions. Increased use of other antibiotics was also observed. High utilization was similar in men with either infectious/acute prostatitis or chronic pelvic pain syndrome. Conclusions Despite evidence that antibiotics are not effective in the large majority of men with chronic pelvic pain syndrome, they were prescribed in 69% of men with this diagnosis. Some increased use is probably due to uncontrolled confounding by comorbid conditions or inaccurate diagnostic coding. However, a seven-fold higher rate of fluoroquinolone usage suggests strategies to reduce unnecessary antibiotic use in men with prostatitis are warranted. PMID:18456041

  6. Solar heat receiver

    DOEpatents

    Hunt, A.J.; Hansen, L.J.; Evans, D.B.

    1982-09-29

    A receiver is described for converting solar energy to heat a gas to temperatures from 700 to 900/sup 0/C. The receiver is formed to minimize impingement of radiation on the walls and to provide maximum heating at and near the entry of the gas exit. Also, the receiver is formed to provide controlled movement of the gas to be heated to minimize wall temperatures. The receiver is designed for use with gas containing fine heat absorbing particles, such as carbon particles.

  7. Solar heat receiver

    DOEpatents

    Hunt, Arlon J.; Hansen, Leif J.; Evans, David B.

    1985-01-01

    A receiver for converting solar energy to heat a gas to temperatures from 700.degree.-900.degree. C. The receiver is formed to minimize impingement of radiation on the walls and to provide maximum heating at and near the entry of the gas exit. Also, the receiver is formed to provide controlled movement of the gas to be heated to minimize wall temperatures. The receiver is designed for use with gas containing fine heat absorbing particles, such as carbon particles.

  8. Hepatitis B (HBV)

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Hepatitis B (HBV) KidsHealth > For Teens > Hepatitis B (HBV) A A A What's in this article? ... poisons). There are several different types of hepatitis . Hepatitis B is a type that can move from one ...

  9. The terminology of hepatitis*

    PubMed Central

    1973-01-01

    It is proposed that the diseases formerly known as “infectious hepatitis” and “serum hepatitis” be referred to as viral hepatitis type A and viral hepatitis type B, respectively. It is further recommended that the “Australia” antigen be referred to as hepatitis B antigen (HB Ag) and the corresponding antibody as hepatitis B antibody (HB Ab). PMID:4544683

  10. Hepatic osteodystrophy

    PubMed Central

    Gatta, Angelo; Verardo, Alberto; Di Pascoli, Marco; Giannini, Sandro; Bolognesi, Massimo

    2014-01-01

    Summary Metabolic disturbances of bone are frequent in patients with chronic liver disease. The prevalence of osteoporosis among patients with advanced chronic liver disease is reported between 12% and 55%; it is higher in primary biliary cirrhosis. All patients with advanced liver disease should be screened for osteoporosis with a densitometry, especially if the etiology is cholestatic and in the presence of other risk factors. Clinical relevance of hepatic osteodystrophy increases after liver transplantation. After liver transplant, a rapid loss of bone mineral density can be detected in the first 6 months, followed by stabilization and slight improvement of the values. At the time of transplantation, bone density values are very important prognostic factors. Therapy of hepatic osteodystrophy is based primarily on the control of risk factors: cessation of tobacco and alcohol assumption, reduction of caffeine ingestion, exercise, supplementation of calcium and vitamin D, limitation of drugs such as loop diuretics, corticosteroids, cholestyramine. Bisphosphonates have been proposed for the therapy of osteoporosis in patients with liver disease, particularly after liver transplantation. The possible side effects of oral administration of bisphosphonates, such as the occurrence of esophageal ulcerations, are of particular concern in patients with liver cirrhosis and portal hypertension, due to the risk of gastrointestinal hemorrhage from ruptured esophageal varices, although this risk is probably overestimated. PMID:25568651

  11. Testing for hepatitis B infection in prospective chemotherapy patients: a retrospective study.

    PubMed

    Wang, Ying; Luo, Xin-Mei; Yang, Dan; Zhang, Jie; Zhuo, Hong-Yu; Zhang, Jian; Jiang, Yu

    2013-02-14

    To estimate hepatitis B virus (HBV) infection testing rate in cancer patients before chemotherapy with a focus on HBV reactivation. A retrospective study was conducted from January 1, 2009 to June 30, 2010. Inclusion required that patients be naïve to cancer chemotherapy but have indications for it. Patients who did not receive chemotherapy for any reason were excluded. Important clinical information, such as the levels of HBV DNA and serological markers were collected. HBV reactivation was defined as an increase in serum HBV DNA to > 1 log higher than that of the pre-exacerbation baseline, or serum HBV DNA conversion from negative to positive. HBV DNA levels > 1000 copies/mL were defined as HBV DNA positive. The χ² or Fisher's exact test was used for analysis of categorized data. Multiple logistic regression analysis was used to estimate the odd ratio and 95%CI of the HBV screening rate. Of 6646 patients, 5616 (84.5%) received chemotherapy. Only 17.1% of the cancer patients received pre-chemotherapy HBV testing (43.2% for hematological malignancies and 14.9% for solid tumors). Patients who had received rituximab therapy, had elevated aminotransferase levels, or had hematological malignancies were more likely to receive HBV testing. The prevalence of hepatitis B surface antigen (HBsAg) positivity was 13.4%. HBV reactivation (appearance of HBV DNA or an increase in HBV DNA levels by 1 log₁₀ was observed in 33.1% (53/160) of the patients after chemotherapy. Among patients without prophylactic antiviral therapy, the reactivation rate was 43.9% (43/98) in the solid tumor group. Two reactivation cases occurred in patients who were HBsAg negative, but positive for hepatitis B core antibody. HBV reactivation was more likely to occur in patients with lymphoma, high levels of HBV DNA, or hepatitis B e antigen, and in men. Less than 20% of patients received HBV testing before chemotherapy. HBV reactivation would have occurred in about 50% of infected patients with

  12. Men and women, alcohol and aggression.

    PubMed

    Giancola, Peter R; Levinson, Cheri A; Corman, Michelle D; Godlaski, Aaron J; Morris, David H; Phillips, Joshua P; Holt, Jerred C D

    2009-06-01

    The purpose of this study was to examine the acute effects of alcohol on aggressive behavior in men and women in a laboratory setting. Participants were 526 (261 men and 265 women) healthy social drinkers between 21 and 35 years of age. They were randomly assigned to either an alcohol or a placebo group. Aggression was measured using a modified version of the Taylor Aggression Paradigm in which electric shocks are received from, and delivered to, a same gender fictitious opponent during a supposed competitive interpersonal task. Aggression was operationalized as the intensity and duration of shocks that participants administered to their "opponent." Overall, men were more aggressive than women. Alcohol increased aggression for both men and women but this effect was stronger for men. This is one of the first laboratory studies to demonstrate that alcohol increases aggression in women.

  13. Pediatric hepatitis B treatment

    PubMed Central

    Inui, Ayano; Fujisawa, Tomoo

    2017-01-01

    Although the introduction of hepatitis B vaccine has been contributing to the reduction in the prevalence of hepatitis B virus (HBV) carriers worldwide, the treatment of children with chronic HBV infection is a challenge to be addressed. HBeAg seroconversion, which induces low replication of HBV, is widely accepted as the first goal of antiviral treatment in children with chronic hepatitis B. However, spontaneous HBeAg seroconversion is highly expected in children with chronic HBV infection. Therefore, the identification of children who need antiviral treatment to induce HBeAg seroconversion is essential in the management of chronic HBV infection. Guidelines and experts’ opinion show how to identify children who should be treated and how to treat them. If decompensated cirrhosis is absent, interferon-alpha is the first-line antiviral treatment. Nucleos(t)ide analogues (NAs), such as lamivudine, adefovir, entecavir and tenofovir, are also available for the treatment of children, although the approval age differs among them. If decompensated cirrhosis is present, NAs are the first-line antivirals. When the emergence of drug-resistant HBV variants is taken into consideration, entecavir (approved for age 2 years or older) and tenofovir (age 12 years or older), which have high genetic barriers, will play a central role in the treatment of HBV infection. However, the optimal duration of NA treatment and adverse events of long-term NA treatment remain unclear in children. In resource-constrained countries and regions, the financial burden of visiting hospitals, receiving routine blood examination and purchasing antiviral drugs is heavy. Moreover, there is no clear evidence that the induction of HBeAg seroconversion by antiviral treatment prevents the progression of liver disease to cirrhosis and hepatocellular carcinoma in children with chronic HBV infection. It is thus imperative to clarify the clinical impact of antiviral treatment in children with HBV infection. PMID

  14. HPV in men.

    PubMed

    D'Hauwers, K W M; Tjalma, W A A

    2008-01-01

    To collect information about HPV in men and the (possible) correlation with HVP infection in women. Review of the literature. An overview of HPV-related penile and anal malignancies in men and the risk factors of acquiring HPV. In men HPV is also partially responsible for anogenital malignancies. Although the prevalence of HPV-related malignancies in men is much lower than in women, it is useful to gain more knowlege. Especially knowing if men are really the HPV reservoir and transmitters for women can make a difference in deciding whether men should also be screened for HPV and if they are good candidates for vaccination.

  15. "Macho men" and preventive health care: implications for older men in different social classes.

    PubMed

    Springer, Kristen W; Mouzon, Dawne M

    2011-06-01

    The gender paradox in mortality--where men die earlier than women despite having more socioeconomic resources--may be partly explained by men's lower levels of preventive health care. Stereotypical notions of masculinity reduce preventive health care; however, the relationship between masculinity, socioeconomic status (SES), and preventive health care is unknown. Using the Wisconsin Longitudinal Study, the authors conduct a population-based assessment of masculinity beliefs and preventive health care, including whether these relationships vary by SES. The results show that men with strong masculinity beliefs are half as likely as men with more moderate masculinity beliefs to receive preventive care. Furthermore, in contrast to the well-established SES gradient in health, men with strong masculinity beliefs do not benefit from higher education and their probability of obtaining preventive health care decreases as their occupational status, wealth, and/or income increases. Masculinity may be a partial explanation for the paradox of men's lower life expectancy, despite their higher SES.

  16. Effects of Testosterone Treatment in Older Men.

    PubMed

    Snyder, Peter J; Bhasin, Shalender; Cunningham, Glenn R; Matsumoto, Alvin M; Stephens-Shields, Alisa J; Cauley, Jane A; Gill, Thomas M; Barrett-Connor, Elizabeth; Swerdloff, Ronald S; Wang, Christina; Ensrud, Kristine E; Lewis, Cora E; Farrar, John T; Cella, David; Rosen, Raymond C; Pahor, Marco; Crandall, Jill P; Molitch, Mark E; Cifelli, Denise; Dougar, Darlene; Fluharty, Laura; Resnick, Susan M; Storer, Thomas W; Anton, Stephen; Basaria, Shehzad; Diem, Susan J; Hou, Xiaoling; Mohler, Emile R; Parsons, J Kellogg; Wenger, Nanette K; Zeldow, Bret; Landis, J Richard; Ellenberg, Susan S

    2016-02-18

    Serum testosterone concentrations decrease as men age, but benefits of raising testosterone levels in older men have not been established. We assigned 790 men 65 years of age or older with a serum testosterone concentration of less than 275 ng per deciliter and symptoms suggesting hypoandrogenism to receive either testosterone gel or placebo gel for 1 year. Each man participated in one or more of three trials--the Sexual Function Trial, the Physical Function Trial, and the Vitality Trial. The primary outcome of each of the individual trials was also evaluated in all participants. Testosterone treatment increased serum testosterone levels to the mid-normal range for men 19 to 40 years of age. The increase in testosterone levels was associated with significantly increased sexual activity, as assessed by the Psychosexual Daily Questionnaire (P<0.001), as well as significantly increased sexual desire and erectile function. The percentage of men who had an increase of at least 50 m in the 6-minute walking distance did not differ significantly between the two study groups in the Physical Function Trial but did differ significantly when men in all three trials were included (20.5% of men who received testosterone vs. 12.6% of men who received placebo, P=0.003). Testosterone had no significant benefit with respect to vitality, as assessed by the Functional Assessment of Chronic Illness Therapy-Fatigue scale, but men who received testosterone reported slightly better mood and lower severity of depressive symptoms than those who received placebo. The rates of adverse events were similar in the two groups. In symptomatic men 65 years of age or older, raising testosterone concentrations for 1 year from moderately low to the mid-normal range for men 19 to 40 years of age had a moderate benefit with respect to sexual function and some benefit with respect to mood and depressive symptoms but no benefit with respect to vitality or walking distance. The number of participants was

  17. Effects of Testosterone Treatment in Older Men

    PubMed Central

    Snyder, P.J.; Bhasin, S.; Cunningham, G.R.; Matsumoto, A.M.; Stephens-Shields, A.J.; Cauley, J.A.; Gill, T.M.; Barrett-Connor, E.; Swerdloff, R.S.; Wang, C.; Ensrud, K.E.; Lewis, C.E.; Farrar, J.T.; Cella, D.; Rosen, R.C.; Pahor, M.; Crandall, J.P.; Molitch, M.E.; Cifelli, D.; Dougar, D.; Fluharty, L.; Resnick, S.M.; Storer, T.W.; Anton, S.; Basaria, S.; Diem, S.J.; Hou, X.; Mohler, E.R.; Parsons, J.K.; Wenger, N.K.; Zeldow, B.; Landis, J.R.; Ellenberg, S.S.

    2016-01-01

    BACKGROUND Serum testosterone concentrations decrease as men age, but benefits of raising testosterone levels in older men have not been established. METHODS We assigned 790 men 65 years of age or older with a serum testosterone concentration of less than 275 ng per deciliter and symptoms suggesting hypoandrogenism to receive either testosterone gel or placebo gel for 1 year. Each man participated in one or more of three trials — the Sexual Function Trial, the Physical Function Trial, and the Vitality Trial. The primary outcome of each of the individual trials was also evaluated in all participants. RESULTS Testosterone treatment increased serum testosterone levels to the mid-normal range for men 19 to 40 years of age. The increase in testosterone levels was associated with significantly increased sexual activity, as assessed by the Psychosexual Daily Questionnaire (P<0.001), as well as significantly increased sexual desire and erectile function. The percentage of men who had an increase of at least 50 m in the 6-minute walking distance did not differ significantly between the two study groups in the Physical Function Trial but did differ significantly when men in all three trials were included (20.5% of men who received testosterone vs. 12.6% of men who received placebo, P=0.003). Testosterone had no significant benefit with respect to vitality, as assessed by the Functional Assessment of Chronic Illness Therapy–Fatigue scale, but men who received testosterone reported slightly better mood and lower severity of depressive symptoms than those who received placebo. The rates of adverse events were similar in the two groups. CONCLUSIONS In symptomatic men 65 years of age or older, raising testosterone concentrations for 1 year from moderately low to the mid-normal range for men 19 to 40 years of age had a moderate benefit with respect to sexual function and some benefit with respect to mood and depressive symptoms but no benefit with respect to vitality or

  18. Hepatitis after liver transplantation: the role of the known and unknown viruses.

    PubMed

    Pessoa, M G; Terrault, N A; Ferrell, L D; Detmer, J; Kolberg, J; Collins, M L; Viele, M; Lake, J R; Roberts, J P; Ascher, N L; Wright, T L

    1998-11-01

    This study was designed to determine the cause of posttransplantation hepatitis in patients undergoing transplantation for liver disease of nonviral cause; the role of acquired hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis G virus (HGV) in posttransplantation hepatitis; and the course of posttransplantation hepatitis of unknown cause. Two hundred forty-three patients underwent transplantation for nonviral liver diseases (mean age, 48 years; 103 men, 140 women). Serological and virological assays for HBV and HCV were performed pretransplantation to exclude preexisting infection and posttransplantation to investigate the cause of posttransplantation hepatitis. Histology was graded on all available biopsy specimens; posttransplantation hepatitis was assessable in 150 patients. Posttransplantation hepatitis was present in 29% (44 of 150) of the patients after a median follow-up of 47 months (range, 1 to 101 months). Actuarial survival was significantly lower in patients with posttransplantation hepatitis compared with patients without (71% v 89% at 5-year follow-up; P = .03). HCV and HBV were identified posttransplantation in 14% and 9% of patients with hepatitis, respectively. After the exclusion of HCV and HBV infection, 22% (33 of 150) of the patients had posttransplantation hepatitis of unknown cause. HGV was present in 58% of these patients, but HGV was equally prevalent in patients without posttransplantation hepatitis. When patients with HBV and HCV were excluded, there was no difference in survival between patients with posttransplantation hepatitis compared with patients without (P = .08, log-rank test). Posttransplantation hepatitis was present in approximately 30% of the patients undergoing transplantation for nonviral diseases, with a median follow-up of 47 months. Known hepatitis viruses (HBV, HCV) were present in one fourth of the patients with posttransplantation hepatitis; 22% (33 of 150) of the patients had hepatitis of unknown cause

  19. Evaluation of hepatitis C, hepatitis B, and HIV virus Serology pandemic in thalassemia patients of Shahid Mohammadi Hospital of Bandar Abbas, Iran.

    PubMed

    Aminianfar, Mohammad; Khani, Farrokh; Ghasemzadeh, Iman

    2017-03-01

    Thalassemia patients are prone to the hepatitis C, B, and HIV virus, due to their constant need to receive blood transfusions. Therefore, this research was aimed to determine the epidemic of the aforementioned diseases in thalassemia patients of Shahid Mohammadi Hospital of Bandar Abbas, Iran. This cross-sectional study was carried out on thalassemia patients visiting the Thalassemia Hospital of Bandar Abbas from March 21, 2014, to March 22, 2015. Checklists were used to collect the data. HBS-Ag, HCV-Ab, and HIV-Ab tests have been registered for hepatitis B, hepatitis C, and HIV virus, respectively. The data were analyzed using SPSS 19 by Mann-Whitney U test, chi-square test, and independent samples t-test. Among 587 records administered into the research, 280 individuals (47.7 %) were men and (52.3 %) were female. The average age of participants was 18.01 ± 9.31 years. The youngest was 1 years old, and the oldest was 46 years old. Four patients under the study (0.7 %) were positive for HBV; 60 (10.2 %) were HCV positive. However, no one in the study was diagnosed HIV positive. In the case of spread, there was no significant difference regarding age and sex in HBV patients. However, in HCV patients, significant differences were found (p=0.044 for gender and p=0.001 for age). In thalassemia, hepatitis C had the highest rate of spread. According to the screening, it was much anticipated that the trend should be falling, but the results show the contrary. Hence, it is recommended that more precise methods such as PCR be used.

  20. [Severe aplastic anaemia in six children after non-A-E hepatitis without hepatic failure].

    PubMed

    Tschiedel, E; Gierenz, N; Wieland, R; Wulff, B; Ballauff, A

    2010-08-01

    Aplastic anaemia can coincide with non-A-E hepatitis. Treatment follows a standardised study protocol of the German Society of Paediatric Oncology and Haematology (GPOH). Patients receive immunosuppression and/or bone marrow transplantation. We present six cases of aplastic anaemia after non-A-E hepatitis with different courses. In four of these children illness first presented with acute gastroenteritis. Five out of six children fully recovered, two of these with immunosuppression alone, three after bone marrow transplantation. One patient died due to complications of the bone marrow transplantation. In two patients steroid therapy was carried out to treat the hepatitis. This did not have any effect on the course of their aplastic anemia. We emphasise this common combination of aplastic anemia following non-A-E hepatitis. This overview underlines the necessity of regular blood testing after non-A-E hepatitis. Often gastroenteritis seems to precede illness thus perhaps indicating an infectious trigger.

  1. Integration of hepatitis B vaccination into national immunisation programmes. Viral Hepatitis Prevention Board.

    PubMed Central

    Van Damme, P.; Kane, M.; Meheus, A.

    1997-01-01

    Hepatitis B is a major public health problem even though safe and effective vaccines have been available for over 10 years. Because hepatitis B infection is largely asymptomatic with long term complications occurring after many years it has not received the attention it deserves. Strategies to immunise those at high risk have failed to control the disease. Delegates to the World Health Assembly of the World Health Organisation recommended in May 1992 that all countries should integrate hepatitis B vaccination into their national immunisation programmes by 1997. Some western European countries remain unconvinced that the burden of disease warrants the expense of universal vaccination. However, epidemiological data and economic evaluation show that universal hepatitis B vaccination is cost effective in countries with low endemicity and that it will control hepatitis B, reinforcing the necessity for action. PMID:9112852

  2. Motivators and barriers for HIV testing among men who have sex with men in Sweden.

    PubMed

    Persson, Kristina Ingemarsdotter; Berglund, Torsten; Bergström, Jakob; Eriksson, Lars E; Tikkanen, Ronny; Thorson, Anna; Forsberg, Birger C

    2016-12-01

    To explore motivators and barriers to HIV testing and to assess the factors associated with testing among men who have sex with men. Previous research has considered fear, worries and structural barriers as hindrances to HIV testing among men who have sex with men. However, few studies have included assessments of actual HIV testing when exploring barriers or motivators for such testing. The design of the study was a stratified cross-sectional online survey (n = 2373). Factor analysis was conducted to analyse the barriers and motivators for HIV testing. Logistic regression analysis was conducted to assess predictors for HIV testing. Many men who have sex with men test for HIV regularly, and specific reasons for testing were having unprotected sex or starting/ending a relationship. A lack of awareness and a perception of being at low risk for exposure were common reasons for never being tested. Fear and anxiety as well as barriers related to the use of test services remain important hindrances for testing. Predictors associated with having been tested within the past 12 months were: younger age (15-25 years old compared with 47+); knowledge on where to take an HIV test on short notice as well as having talked with a counsellor, having received condoms for free, or having had unprotected anal intercourse with casual partners within the last 12 months. Easily accessible test services offering testing and counselling on short notice should be available for all men who have sex with men. Outreach activities, distribution of free condoms and testing at venues where men who have sex with men meet are important prevention add-ons that can contribute to increased awareness about HIV and testing. Test services must ensure confidentiality and health care professionals who meet men who have sex with men for testing need competency with regards to men who have sex with men sexual health needs. © 2016 John Wiley & Sons Ltd.

  3. Hepatic hydrothorax.

    PubMed

    Baikati, Kiran; Le, Duong L; Jabbour, Ibrahim I; Singhal, Shashideep; Anand, Sury

    2014-01-01

    Hepatic hydrothorax is defined as a pleural effusion in patients with liver cirrhosis in the absence of cardiopulmonary disease. The estimated prevalence among patients with liver cirrhosis is approximately 5-6%. The pathophysiology involves the passage of ascitic fluid from the peritoneal cavity to the pleural space through diaphragmatic defects. The diagnosis is made from clinical presentation and confirmed by diagnostic thoracentesis with pleural fluid analysis. The initial medical management is sodium restriction and diuretics, but liver transplantation provides the only definitive therapy. For patients who are not transplant candidates and those who await organ availability, other therapeutic modalities that are to be considered include transjugular intrahepatic portosystemic shunt placement, videoassisted thoracoscopic surgery repair, pleurodesis, and vasoconstrictors (eg, octreotide and terlipressin). The primary therapeutic goals are to reduce ascitic fluid production and improve symptoms to bridge the time for liver transplantation.

  4. Men's Health: Violence Prevention

    MedlinePlus

    ... Men's Health This information in Spanish ( en español ) Violence prevention for men Get help for violence in ... whole community. Return to top Get help for violence in your life Are you a victim of ...

  5. Men and Sexual Trauma

    MedlinePlus

    ... Longer: Men Recovering from Incest and Other Sexual Child Abuse by Mike Lew, Foreword by Ellen Bass. (1990). ... Heroic Men: A Man's Guide to Recovering from Child Abuse by Daniel Jay Sonkin and Lenore E. A. ...

  6. Sexual Problems in Men

    MedlinePlus

    Many men have sexual problems. They become more common as men age. Problems can include Erectile dysfunction Reduced or lost interest in sex ... problems may also be factors. Occasional problems with sexual function are common. If problems last more than ...

  7. Men's Reproductive Health

    MedlinePlus

    ... NICHD Research Information Clinical Trials Resources and Publications Men's Reproductive Health: Overview Skip sharing on social media ... Content Reproductive health is an important component of men's overall health and well-being. Too often, males ...

  8. Benefits of curing hepatitis C infection.

    PubMed

    Marinho, Rui T; Vitor, Sofia; Velosa, Jose

    2014-03-01

    The hepatitis C virus (HCV) infection is one of the most important chronic viral infections worldwide and affects 3% of the world population, approximately 170-200 million people. The consequences of chronic infection are liver cirrhosis and hepatocellular carcinoma, which develop in 20-30% of the patients, leading to hepatic failure, need for liver transplantation and death. The hepatitis C virus is a RNA virus that is prevalent worldwide and is classified by the World Health Organization (International Agency for Research on Cancer) as one of the six oncogenic viruses. Hepatocellular carcinoma is one of the most important cancers and is fifth worldwide, but third in men in terms of mortality. Hepatitis C kills approximately 350,000 people every year, surpassing HIV infection in many countries as a cause of death. Hepatitis C virus can kill in different ways: it can cause cirrhosis, cancer or severe liver disease in people co-infected with HIV. Hepatitis C treatment started in the mid 1980s with a 6% efficacy rate among patients taking thrice-weekly injections of human interferon. This therapy had numerous side effects. The efficacy of hepatitis C treatment has increased, and currently, the efficacy of the so-called direct antiviral agents (DAAs) is 80-90%. The benefits of a cure are enormous and include a lifetime negative serum HCV RNA, disappearance of HCV in the liver, regression of cirrhosis, decreased risk of developing hepatocellular carcinoma, disappearance of oesophageal varices, no more risk of HCV transmission to sexual partners or children, and increased survival. At present, hepatitis C can be considered a curable disease.

  9. Hepatitis A in Poland in 2013.

    PubMed

    Baumann-Popczyk, Anna

    2015-01-01

    The aim of the study is to assess the epidemiological situation of hepatitis A in Poland in 2013 compared to previous years. The evaluation was carried out on the basis of the results of the analysis of data from the annual bulletin "Infectious diseases and poisonings in Poland in 2013" and "Vaccinations in Poland in 2013", the information from individual diseases forms and epidemiological investigations forms for hepatitis A outbreaks, sent by sanitary-epidemiological stations to the Department of Epidemiology of NIZP-PZH. In 2013, 48 cases of hepatitis A were registered in Poland. The incidence per 100,000 inhabitants was 0.12, and in particular provinces it ranged from 0.05 in the Kujawsko-Pomorskie province to 0.26 in the Wielkopolska province. The incidence of hepatitis A for men and women was at a similar level and amounted to 0.13 and 0.12/100,000. In 2013 imported cases accounted for 45.8% of the total number of hepatitis A cases. There were three outbreaks, where the total of 13 people fell ill. 2013 saw a slight decrease in the number of cases compared to the previous year. Besides, there were no significant changes in the hepatitis A epidemiological situation. In Poland, there is still very low endemicity. Since several years, there has been a decline in the number of people vaccinated against hepatitis A. All of this affects the accumulation of a fairly large population of people susceptible to the infection, which may increase incidence. Although the current hepatitis A epidemiological situation in Poland is good, it still requires monitoring, analysis and constant observation within the structured epidemiological surveillance.

  10. Data-fusion receiver

    SciTech Connect

    Gabelmann, Jeffrey M.; Kattner, J. Stephen; Houston, Robert A.

    2006-12-19

    This invention is an ultra-low frequency electromagnetic telemetry receiver which fuses multiple input receive sources to synthesize a decodable message packet from a noise corrupted telemetry message string. Each block of telemetry data to be sent to the surface receiver from a borehole tool is digitally encoded into a data packet prior to transmission. The data packet is modulated onto the ULF EM carrier wave and transmitted from the borehole to the surface and then are simultaneously detected by multiple receive sensors disbursed within the rig environment. The receive sensors include, but are not limited to, electric field and magnetic field sensors. The spacing of the surface receive elements is such that noise generators are unequally coupled to each receive element due to proximity and/or noise generator type (i.e. electric or magnetic field generators). The receiver utilizes a suite of decision metrics to reconstruct the original, non noise-corrupted data packet from the observation matrix via the estimation of individual data frames. The receiver will continue this estimation process until: 1) the message validates, or 2) a preset "confidence threshold" is reached whereby frames within the observation matrix are no longer "trusted".

  11. Hybrid receiver study

    NASA Technical Reports Server (NTRS)

    Stone, M. S.; Mcadam, P. L.; Saunders, O. W.

    1977-01-01

    The results are presented of a 4 month study to design a hybrid analog/digital receiver for outer planet mission probe communication links. The scope of this study includes functional design of the receiver; comparisons between analog and digital processing; hardware tradeoffs for key components including frequency generators, A/D converters, and digital processors; development and simulation of the processing algorithms for acquisition, tracking, and demodulation; and detailed design of the receiver in order to determine its size, weight, power, reliability, and radiation hardness. In addition, an evaluation was made of the receiver's capabilities to perform accurate measurement of signal strength and frequency for radio science missions.

  12. Domestic violence against men.

    PubMed

    Barber, Christopher F

    This article reviews the literature relating to domestic violence against men and examines some of the reasons why men are reluctant to report violent episodes. The article focuses on men as the victims and women as the perpetrators of domestic violence and identifies gaps in service provision. The role of the nurse in supporting male victims is also discussed.

  13. Mens' attitudes about abortion in Uganda.

    PubMed

    Moore, Ann M; Jagwe-Wadda, Gabriel; Bankole, Akinrinola

    2011-01-01

    Abortion is illegal in Uganda except to save the life of the woman. Nevertheless, the practice is quite common: about 300,000 induced abortions occur annually among Ugandan women aged 15-49 (Singh et al., 2005) and a large proportion of these women require treatment for post-abortion complications. In the male-dominant culture of Uganda, where men control most of the financial resources, men play a critical part in determining whether women receive a safe abortion, or appropriate treatment if they experience abortion complications. This study examines men's roles in determining women's access to a safer abortion and post-abortion care. It draws on in-depth interviews carried out in 2003 with 61 women aged 18-60 and 21 men aged 20-50 from Kampala and Mbarara, Uganda. Respondents' descriptions of men's involvement in women's abortion care agreed that men's stated attitudes about abortion often prevented women from involving them in either the abortion or post-abortion care. Most men believe that if a woman is having an abortion, it must be because she is pregnant with another man's child, although this does not correspond with women's reasons for having an abortion--a critical disjuncture revealed by the data between men's perceptions of, and women's realities regarding, reasons for seeking an abortion. If the woman does experience post-abortion complications, the prevailing attitude among men in the sample was that they cannot support a woman in such a situation seeking care because if it had been his child, she would not have had a covert abortion. Since money is critical to accessing appropriate care, without men's support, women seeking an abortion may not be able to access safer abortion options and if they experience complications, they may delay care-seeking or may not obtain care at all. Barriers to involving men in abortion decision-making endanger women's health and possibly their lives.

  14. Depression in hepatitis B and C, and its correlation with hepatitis drugs consumption (interfron/lamivodin/ribaverin).

    PubMed

    Alian, Shahriar; Masoudzadeh, Abbas; Khoddad, Talayeh; Dadashian, Amir; Ali Mohammadpour, Reza

    2013-01-01

    Chronic infection of hepatitis B and hepatitis C are considered as the most important infectious diseases, which lead to drastic consequences such as liver dysfunction. Depression is a psychiatric disorder which is concomitantly present in these patients, and decreases the patients' quality of life. It may lead to suicide, homicide or intentional transmission of infectious to others. Medical treatment with interferon can also lead to depression which is comparable to the depression caused by disease. We performed a cross sectional study on 205 patients with hepatitis B and hepatitis C infection. We aimed to determine the prevalence of depression via Beck Depression Inventory (BDI), and its correlates with hepatitis drugs. Of 205 patients, 154 cases had hepatitis B and 51 cases had hepatitis C infection. The frequency of depression was 68% in hepatitis B and 86% in hepatitis C infected patients (p<0.05). The frequency of mild depression was 14%, moderate depression was 57.3% and severe depression was 28.7% (p<0.05). Depression frequency in Interferon recipients was 100%, in interferon-ribavirin recipients was 94.4%, in lamivudine recipients was 64%, and in patients that receive no drug was 66.7%. Depression prevalence was significantly higher among those on interferon therapy (p<0.05). There is a high prevalence of depression among patients with hepatitis B and hepatitis C infection, especially patients on interferon therapy. Hence these patients should be repeatedly evaluated for depression. None.

  15. Depression in Hepatitis B and C, and Its Correlation With Hepatitis Drugs Consumption (Interfron/Lamivodin/Ribaverin)

    PubMed Central

    Alian, Shahriar; Masoudzadeh, Abbas; Khoddad, Talayeh; Dadashian, Amir; Ali Mohammadpour, Reza

    2013-01-01

    Objective: Chronic infection of hepatitis B and hepatitis C are considered as the most important infectious diseases, which lead to drastic consequences such as liver dysfunction. Depression is a psychiatric disorder which is concomitantly present in these patients, and decreases the patients’ quality of life. It may lead to suicide, homicide or intentional transmission of infectious to others. Medical treatment with interferon can also lead to depression which is comparable to the depression caused by disease. Methods: We performed a cross sectional study on 205 patients with hepatitis B and hepatitis C infection. We aimed to determine the prevalence of depression via Beck Depression Inventory (BDI), and its correlates with hepatitis drugs. Results: Of 205 patients, 154 cases had hepatitis B and 51 cases had hepatitis C infection. The frequency of depression was 68% in hepatitis B and 86% in hepatitis C infected patients (p<0.05). The frequency of mild depression was 14%, moderate depression was 57.3% and severe depression was 28.7% (p<0.05). Depression frequency in Interferon recipients was 100%, in interferon-ribavirin recipients was 94.4%, in lamivudine recipients was 64%, and in patients that receive no drug was 66.7%. Depression prevalence was significantly higher among those on interferon therapy (p<0.05). Conclusion: There is a high prevalence of depression among patients with hepatitis B and hepatitis C infection, especially patients on interferon therapy. Hence these patients should be repeatedly evaluated for depression. Declaration of Interest: None. PMID:24644496

  16. Hepatitis Information for the Public

    MedlinePlus

    ... Hepatitis Contact Us Anonymous Feedback Quick Links to Hepatitis … A | B | C | D | E Viral Hepatitis Home ... Local Partners & Grantees Policy and Programs Resource Center Hepatitis Information for the Public Recommend on Facebook Tweet ...

  17. Syphilis and MSM (Men Who Have Sex with Men)

    MedlinePlus

    ... Transmitted Diseases (STDs) Syphilis & MSM (Men Who Have Sex With Men) - CDC Fact Sheet Language: English (US) ... among gay, bisexual, and other men who have sex with men (MSM). MSM Fact Sheet | View Images ...

  18. Right to Receive.

    ERIC Educational Resources Information Center

    Oborn, Richard

    The concept of a United States citizen's right to receive information is acquiring increased judicial recognition. This report traces the evolution of that right from its philosophical basis in the United States Consitution, through its interpretation by the Supreme Court, up to the current concern that the public receive certain economic…

  19. Flight termination receiver catalog

    NASA Astrophysics Data System (ADS)

    1993-02-01

    This catalog provides reference information on ultra-high frequency flight termination receivers used at various U.S. missile ranges and test facilities. It is not intended to be a comprehensive review of all available flight termination receivers. Inclusion in this catalog does not constitute approval or endorsement for use at any government installation. Information in this catalog was extracted from manufacturers' specifications.

  20. Hepatitis B and concomitant hepatic steatosis

    PubMed Central

    Lim, Chong Teik

    2017-01-01

    Hepatic steatosis is becoming more common in Asia with prevalence becoming as common as Western countries. Concomitant Hepatitis B and hepatic steatosis is increasingly encountered in clinical practice. The interaction between the two concomitant conditions at both molecular level and clinical outcome remains to be explored. The present review is aimed at summarizing the existing literature on the complex interaction of the two-concomitant disease. PMID:28251117

  1. Flight termination receiver catalog

    NASA Astrophysics Data System (ADS)

    1984-07-01

    This catalog provides reference information on ultrahigh-frequency flight termination receivers used at various U.S. missile ranges and test facilities. It is not intended to be a comprehensive review of all available flight termination receivers, and inclusion of hardware in this catalog does not constitute approval or endorsement for use at any government installation. Use of a specific receiver at a missile range or test facility requires the approval of the Commander of that installation. Approval for use of a particular receiver on a given missile at one installation does not constitute automatic approval for use of the same receiver on other missiles at the same installation or on the same missile at other installations. The information in this catalog has been extracted from manufacturers' specifications. It is provided as reference material only and is not intended as an endorsement of any model.

  2. Hepatitis Due to Equine Abortion Virus. Comparison Between the Liver Histology in Human, Canine, Duckling, and Equine Viral Hepatitis1

    PubMed Central

    Corrêa, W. M.; Nilsson, M. R.

    1966-01-01

    Five livers of equine fetuses, aborted due to the action of equine abortion virus, five livers from men, two of whom died of epidemic hepatitis and three obtained by needle biopsies, 5 livers of dogs with infectious canine hepatitis and 7 livers of ducklings that had hepatitis, were studied histopathologically. The foals' livers were studied by several staining methods and the others by H. E. only. The results indicate that the lesions are quite similar in the four species with the appearance of nuclear inclusion bodies only in foals and dogs. The strong staining properties of the nuclear inclusion bodies in infectious canine hepatitis and the weak staining properties of the equine virus abortion reveal that the protein-DNA association is different resulting in a different electropolarity. The lesions in foals are of two main types, one a Necrotic-Mosaic Type in which the hepatocyte degeneration is irregularly distributed within the hepatic lobules and the other an Hyperplastic Type in which marked regeneration occurs. In the Hyperplastic Type the practical absence of plasmocytes in foals' livers might suggest that if the newborn is a female, abortions may occur later in life because the virus remained alive in colts which were born in an immune tolerance state. Histologically the picture in the livers of aborted foals assume features of a viral hepatitis similar to the viral hepatitis in men, dogs and ducklings. ImagesFig. 1.Fig. 2.Fig. 3.Fig. 4.Fig. 5.Fig. 6.Fig. 7.Fig. 8.Fig. 9. PMID:4225286

  3. Viral hepatitis as an occupational disease in Poland.

    PubMed

    Bilski, Bartosz

    2011-07-01

    In medical terms, occupational diseases are defined as health disorders specifically associated with the working environment of people and their occupational activity. From the medical and legal perspectives, the vast majority of European countries consider particular diseases to be of occupational origin if they are mentioned in the current list of occupational diseases and caused by exposure to factors in the working environment that are harmful to health. The aim of this study was to analyze the occurrence of cases of viral hepatitis certified as an occupational disease in Poland during 1979-2009. This article presents the medical, economic, and legal aspects of the epidemiology of hepatitis as an occupational disease in Poland. Publically available statistical data on certified occupational diseases in Poland and data contained in individual "occupational disease diagnosis cards" (based on data used in Poland statistical form), regarding certified cases of hepatitis among health care professionals, which were collected by the Department of Occupational Hygiene of the Polish Public Health Service, were analyzed in this study. In Poland, the highest number of cases of hepatitis certified as an occupational disease was observed in 1987. A gradual reduction in the number of cases of hepatitis as an occupational disease has been noted since then. Currently, hepatitis C as an occupational disease is certified more frequently than hepatitis B. In Poland, the number of women with hepatitis certified as an occupational disease is higher than that of men. However, among health care professionals, particularly nurses, this difference is insignificant because women outnumber the men. The existence of such a situation is due to the significant quantitative predominance of women over men among medical personnel, especially among nurses. Immunization of health care professionals against the hepatitis B virus (HBV), introduced in Poland in 1988, was an important factor

  4. Women and men.

    PubMed

    Bartle, D

    1989-01-01

    If equal employment opportunities were a reality, one would expect all salaries to be more or less randomly distributed between the genders. The data does not show random distribution. Of the awards studied in depth, 11 of the 18 showed a statistically significant different salary between women and men. Two awards had a marginal probability of significance, and five had a probability of significance of less than five per cent. The data shows clearly the need for EEO initiatives for women within the health service and identifies the areas of greatest concern. The many questions raised through this general analysis of the data will guide further research and the development of an EEO management plan that is specific to the needs of the Palmerston North Area Health Board. Also highlighted is the need for similar statistics showing the composition of the workforce by ethnicity and disability. Only when this has been obtained and analysed can specifically targeted EEO programmes be developed to meet the workforce needs of the Board. Other Boards interested in receiving a statistical analysis of their workforce by gender should contact Patrick Mulcahy at the National Health Statistics Centre, Private Bag 2, Upper Willis Street, Wellington, phone (04) 844-167.

  5. CALUTRON RECEIVER STRUCTURE

    DOEpatents

    Roush, J.L.

    1959-09-01

    A receiver is described for collecting isotopes in a calutron The receiver has several compartments, formed by a sertes of parallel metal plates and an open front. Each plate has flanges which space it from the other plates and a flexible extension pressing against a common supporting red to maintain the plate in assembled relation when all but the last rod is removed. The plates may be removed individualy from the front of the receiver, cleaned ard replaced without disturbing the alignment of the other plates.

  6. 30-micron heterodyne receiver

    NASA Technical Reports Server (NTRS)

    Kostiuk, Theodor; Spears, David L.

    1987-01-01

    Advantages and constraints of remote measurements using heterodyne spectroscopy near 30 microns are discussed. The state of the art of wideband HgCdTe photomixers and PbSnSe diode-laser local oscillators being developed for FIR heterodyne receivers is described. The first compact 30-micron heterodyne radiometer was built, and initial results at 28-microns show about 2-percent mixer efficiency for a 500-MHz-bandwidth receiver. Factors limiting receiver performance are discussed, along with the projected sensitivity of new interdigitated-electrode HgCdTe photoconductor mixers being developed for operation up to 200 microns.

  7. Hepatitis C (image)

    MedlinePlus

    Hepatitis C is a virus-caused liver inflammation which may cause jaundice, fever and cirrhosis. Persons who are most at risk for contracting and spreading hepatitis C are those who share needles for injecting drugs ...

  8. Hepatitis virus panel

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/003558.htm Hepatitis virus panel To use the sharing features on this page, please enable JavaScript. The hepatitis virus panel is a series of blood tests used ...

  9. Hepatitis B Test

    MedlinePlus

    ... IgM; anti-HBe; Hepatitis B e Antibody; HBV DNA Formal name: Hepatitis B Virus Testing Related tests: ... produced by the virus, and others detect viral DNA . The main uses for HBV tests include: To ...

  10. Hepatitis B Vaccination Protection

    MedlinePlus

    Fact Sheet Hepatitis B Vaccination Protection Hepatitis B virus (HBV) is a pathogenic microorganism that can cause potentially life- threatening disease in humans. HBV infection is transmitted through exposure ...

  11. Delta agent (Hepatitis D)

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000216.htm Hepatitis D (Delta agent) To use the sharing features on this page, please enable JavaScript. Hepatitis D is a viral infection caused by the ...

  12. Hepatic (Liver) Function Panel

    MedlinePlus

    ... related side effects. The hepatic function panel evaluates: Alanine aminotransferase (ALT). This enzyme, found in the liver, ... MORE ON THIS TOPIC Mononucleosis Hepatitis Blood Test: Alanine Aminotransferase (ALT, or SGPT) Blood Test: Aspartate Aminotransferase ( ...

  13. Hemostasis and Hepatic Surgery.

    PubMed

    Eeson, Gareth; Karanicolas, Paul J

    2016-04-01

    Operative blood loss is a major source of morbidity and even mortality for patients undergoing hepatic resection. This review discusses strategies to minimize blood loss and the utilization of allogeneic blood transfusion pertaining to oncologic hepatic surgery.

  14. EVALUATION OF MICROCURRENT ELECTRICAL NERVE STIMULATION (MENS) EFFECTIVENESS ON MUSCLE PAIN IN TEMPOROMANDIBULAR DISORDERS PATIENTS

    PubMed Central

    Zuim, Paulo Renato Junqueira; Garcia, Alicio Rosalino; Turcio, Karina Helga Leal; Hamata, Marcelo Matida

    2006-01-01

    The effect of Microcurrent Electrical Nerve Stimulation (MENS) was evaluated and compared with occlusal splint therapy in temporomandibular disorders (TMD) patients with muscle pain. Twenty TMD patients were divided into four groups. One received occlusal splint therapy and MENS (I); other received splints and placebo MENS (II); the third, only MENS (III) and the last group, placebo MENS (IV). Sensitivity derived from muscle palpation was evaluated using a visual analogue scale. Results were submitted to analysis of variance (p<0.05). There was reduction of pain level in all groups: group I (occlusal splint and MENS) had a 47.7% reduction rate; group II (occlusal splint and placebo MENS), 66.7%; group III (MENS), 49.7% and group IV (placebo MENS), 16.5%. In spite of that, there was no statistical difference (analysis of variance / p<0.05) between MENS and occlusal splint therapy regarding muscle pain reduction in TMD patients after four weeks. PMID:19089032

  15. Evaluation of microcurrent electrical nerve stimulation (MENS) effectiveness on muscle pain in temporomandibular disorders patients.

    PubMed

    Zuim, Paulo Renato Junqueira; Garcia, Alicio Rosalino; Turcio, Karina Helga Leal; Hamata, Marcelo Matida

    2006-01-01

    The effect of Microcurrent Electrical Nerve Stimulation (MENS) was evaluated and compared with occlusal splint therapy in temporomandibular disorders (TMD) patients with muscle pain. Twenty TMD patients were divided into four groups. One received occlusal splint therapy and MENS (I); other received splints and placebo MENS (II); the third, only MENS (III) and the last group, placebo MENS (IV). Sensitivity derived from muscle palpation was evaluated using a visual analogue scale. Results were submitted to analysis of variance (p<0.05). There was reduction of pain level in all groups: group I (occlusal splint and MENS) had a 47.7% reduction rate; group II (occlusal splint and placebo MENS), 66.7%; group III (MENS), 49.7% and group IV (placebo MENS), 16.5%. In spite of that, there was no statistical difference (analysis of variance / p<0.05) between MENS and occlusal splint therapy regarding muscle pain reduction in TMD patients after four weeks.

  16. Eltrombopag in chronic hepatitis C

    PubMed Central

    Mihăilă, Romeo-Gabriel; Cipăian, Remus-Călin

    2014-01-01

    Chronic hepatitis C is a public health problem worldwide. Unfortunately, not all patients may benefit from antiviral therapy due to thrombocytopenia. Its causes are represented by portal hypertension and platelet sequestration in the spleen, decreased serum levels or activity of thrombopoietin, the bone marrow suppression induced by hepatitis C virus and a possible adverse effect of interferon. Thrombopoietin receptor analogs may contribute to increase platelet counts in these patients. Eltrombopag binds to another region of the thrombopoietin receptor compared to endogenous thrombopoietin and stimulates the proliferation and maturation of megakaryocytes and the platelet production in a dose-dependent manner. Eltrombopag has proven its effectiveness for the treatment of patients with primary immune thrombocytopenia. Its indication for other hemopathies or situations (like thrombocytopenia secondary to chemo- or radiotherapy, acute leukemia, myelodysplastic syndroms, acquired and hereditary bone marrow failure, and platelet donors) is under study. Eltrombopag may be particularly useful in patients with advanced chronic hepatitis or liver cirrhosis who require antiviral treatment. We present a minireview on the results of treatment with eltrombopag in patients chronically infected with hepatitis C virus, highlighting the benefits and mentioning possible adverse effects. In some studies eltrombopag increased the number of virological responses after clasical antiviral treatment of patients with chronic hepatitis C and reduced the transfusional requirements of those who had to be subjected to invasive surgery. Eltrombopag is a solution for many of these patients, which allows them receiving antiviral therapy and sometimes getting a sustained virological response, but they must be well monitored to prevent possible thromboembolic or bone marrow complications or liver failure occurrence. PMID:25253952

  17. Exploring U.S. men's birth intentions.

    PubMed

    Lindberg, Laura Duberstein; Kost, Kathryn

    2014-04-01

    While recently there have been renewed interest in women's childbearing intentions, the authors sought to bring needed research attention to understanding men's childbearing intentions. Nationally representative data from the 2006-2010 National Survey of Family Growth (NSFG) was used to examine pregnancy intentions and happiness for all births reported by men in the 5 years preceding the interview. We used bivariate statistical tests of associations between intention status, happiness about the pregnancy, and fathers' demographic characteristics, including joint race/ethnicity and union status subgroups. Multivariate logistic regressions were used to calculate adjusted odds ratios of a birth being intended, estimated separately by father's union status at birth. Using comparable data and measures from the male and female NSFG surveys, we tested for gender differences intentions and happiness, and examined the sensitivity of our results to potential underreporting of births by men. Nearly four out of ten of births to men were reported as unintended, with significant variation by men's demographic traits. Non-marital childbearing was more likely to be intended among Hispanic and black men. Sixty-two percent of births received a 10 on the happiness scale. Happiness about the pregnancy varied significantly by intention status. Men were significantly happier than women about the pregnancies, with no significant difference in intention status. Potential underreporting of births by men had little impact on these patterns. This study brings needed focus to men's childbearing intentions and improves our understanding of the context of their role as fathers. Men need to be included in strategies to prevent unintended pregnancy.

  18. Exploring U.S. Men's Birth Intentions

    PubMed Central

    Lindberg, Laura Duberstein; Kost, Kathryn

    2013-01-01

    Objectives While recently there have been renewed interest in women's childbearing intentions, the authors sought to bring needed research attention to understanding men's childbearing intentions. Methods Nationally representative data from 2006-2010 National Survey of Family Growth was used to examine pregnancy intentions and happiness for all births reported by men in the five years preceding the interview. We used bivariate statistical tests of associations between intention status, happiness about the pregnancy, and fathers' demographic characteristics, including joint race/ethnicity and union status subgroups. Multivariate logistic regressions were used to calculate adjusted odds ratios of a birth being intended, estimated separately by father's union status at birth. Using comparable data and measures from the male and female NSFG surveys, we tested for gender differences intentions and happiness, and examined the sensitivity of our results to potential underreporting of births by men. Results Nearly four out of ten of births to men were reported as unintended, with significant variation by men's demographic traits. Non-marital childbearing was more likely to be intended among Hispanic and black men. Sixty-two percent of births received a 10 on the happiness scale. Happiness about the pregnancy varied significantly by intention status. Men were significantly happier than women about the pregnancies, with no significant difference in intention status. Potential underreporting of births by men had little impact on these patterns. Conclusions This study brings needed focus to men's childbearing intentions and improves our understanding of the context of their role as fathers. Men need to be included in strategies to prevent unintended pregnancy. PMID:23793481

  19. Ultrasonic pulser-receiver

    DOEpatents

    Taylor, Steven C.

    2006-09-12

    Ultrasonic pulser-receiver circuitry, for use with an ultrasonic transducer, the circuitry comprising a circuit board; ultrasonic pulser circuitry supported by the circuit board and configured to be coupled to an ultrasonic transducer and to cause the ultrasonic transducer to emit an ultrasonic output pulse; receiver circuitry supported by the circuit board, coupled to the pulser circuitry, including protection circuitry configured to protect against the ultrasonic pulse and including amplifier circuitry configured to amplify an echo, received back by the transducer, of the output pulse; and a connector configured to couple the ultrasonic transducer directly to the circuit board, to the pulser circuitry and receiver circuitry, wherein impedance mismatches that would result if the transducer was coupled to the circuit board via a cable can be avoided.

  20. Cryogenic microwave channelized receiver

    SciTech Connect

    Rauscher, C.; Pond, J.M.; Tait, G.B.

    1996-07-01

    The channelized receiver being presented demonstrates the use of high temperature superconductor technology in a microwave system setting where superconductor, microwave-monolithic-integrated-circuit, and hybrid-integrated-circuit components are united in one package and cooled to liquid-nitrogen temperatures. The receiver consists of a superconducting X-band four-channel demultiplexer with 100-MHz-wide channels, four commercial monolithically integrated mixers, and four custom-designed hybrid-circuit detectors containing heterostructure ramp diodes. The composite receiver unit has been integrated into the payload of the second-phase NRL high temperature superconductor space experiment (HTSSE-II). Prior to payload assembly, the response characteristics of the receiver were measured as functions of frequency, temperature, and drive levels. The article describes the circuitry, discusses the key issues related to design and implementation, and summarizes the experimental results.

  1. Ceramic Solar Receiver

    NASA Technical Reports Server (NTRS)

    Robertson, C., Jr.

    1984-01-01

    Solar receiver uses ceramic honeycomb matrix to absorb heat from Sun and transfer it to working fluid at temperatures of 1,095 degrees and 1,650 degrees C. Drives gas turbine engine or provides heat for industrial processes.

  2. Solar energy receiver

    DOEpatents

    Schwartz, Jacob

    1978-01-01

    An improved long-life design for solar energy receivers provides for greatly reduced thermally induced stress and permits the utilization of less expensive heat exchanger materials while maintaining receiver efficiencies in excess of 85% without undue expenditure of energy to circulate the working fluid. In one embodiment, the flow index for the receiver is first set as close as practical to a value such that the Graetz number yields the optimal heat transfer coefficient per unit of pumping energy, in this case, 6. The convective index for the receiver is then set as closely as practical to two times the flow index so as to obtain optimal efficiency per unit mass of material.

  3. Receiver Gain Modulation Circuit

    NASA Technical Reports Server (NTRS)

    Jones, Hollis; Racette, Paul; Walker, David; Gu, Dazhen

    2011-01-01

    A receiver gain modulation circuit (RGMC) was developed that modulates the power gain of the output of a radiometer receiver with a test signal. As the radiometer receiver switches between calibration noise references, the test signal is mixed with the calibrated noise and thus produces an ensemble set of measurements from which ensemble statistical analysis can be used to extract statistical information about the test signal. The RGMC is an enabling technology of the ensemble detector. As a key component for achieving ensemble detection and analysis, the RGMC has broad aeronautical and space applications. The RGMC can be used to test and develop new calibration algorithms, for example, to detect gain anomalies, and/or correct for slow drifts that affect climate-quality measurements over an accelerated time scale. A generalized approach to analyzing radiometer system designs yields a mathematical treatment of noise reference measurements in calibration algorithms. By treating the measurements from the different noise references as ensemble samples of the receiver state, i.e. receiver gain, a quantitative description of the non-stationary properties of the underlying receiver fluctuations can be derived. Excellent agreement has been obtained between model calculations and radiometric measurements. The mathematical formulation is equivalent to modulating the gain of a stable receiver with an externally generated signal and is the basis for ensemble detection and analysis (EDA). The concept of generating ensemble data sets using an ensemble detector is similar to the ensemble data sets generated as part of ensemble empirical mode decomposition (EEMD) with exception of a key distinguishing factor. EEMD adds noise to the signal under study whereas EDA mixes the signal with calibrated noise. It is mixing with calibrated noise that permits the measurement of temporal-functional variability of uncertainty in the underlying process. The RGMC permits the evaluation of EDA by

  4. Advanced Solar Receivers

    NASA Technical Reports Server (NTRS)

    Owen, W. A.

    1984-01-01

    Low thermal efficiencies in solar receivers are discussed in terms of system design. It is recommended that careful attention be given to the overall thermal systems design, especially to conductive losses about the window and areas of relatively thin insulation. If the cavity design is carefully managed to insure a small, minimally reradiating aperture, the goal of a very high efficiency cavity receiver is a realistic one.

  5. OCD RADIO ALERT RECEIVERS.

    DTIC Science & Technology

    for methods of operating a radioalert system were established in conjunction with OCD representatives. Four types of operation were selected. Three...models each of these four receiver types were fabricated and tested. The total of 12 laboratory models were delivered to OCD . Test equipment...suitable for demonstrating the two most promising receiver types was also assembled, and delivered to OCD . A preliminary analysis of the cost of mass

  6. Project Echo: Receiving System

    NASA Technical Reports Server (NTRS)

    Ohm, E. A.

    1961-01-01

    A tracking horn-reflector antenna, a maser preamplifier (and standby parametric preamplifier), and a special FM demodulator were combined to form a low-noise receiving system which made possible the establishment of a high-quality voice circuit via the Echo I passive satellite. This paper describes the 2390-Mc receiving system located at the Bell Telephone Laboratories facility in Holmdel, New Jersey.

  7. [Chronological analysis of individually linked data for patients with intractable disease receiving public financial aid for treatment].

    PubMed

    Shibazaki, Satomi; Nagai, Masaki; Fuchigami, Hiroshi; Nishina, Motoko; Ohta, Akiko; Kawamura, Takashi; Ohno, Yoshiyuki

    2005-12-01

    Nationwide surveys of intractable disease patients receiving public financial aid for treatment were performed by Research Committee for Epidemiology of Intractable Disease (Ministry of Health and Welfare, Japan) 4 times in the past, in 1984, 1988, 1992 and 1997. The purpose of the present study was to clarify the features of continuance with intractable disease patients receiving public financial aid for treatment. Individual information collected by each nationwide survey was linked using the disease, the residence, the sex, and the birth date. The proportion of intractable disease patients according to receipt duration, kind of medical insurance, sex and age was calculated with reference to the disease and an estimation of the receipt persistence rate was calculated for every year. Moreover, in consideration of variation in the data, average receipt persistence rates over years were also calculated. According to observation on individual patient's follow up, the proportion for which financial aid was discontinued within four years was 25%, while 70% continued receiving aid for at least four years and some 55% for eight or nine years. The proportion of those who continue receiving support long-term is high about the so-called autoimmune diseases, such as systemic lupus erythematosus, Behçet's disease, and the aortic syndrome. In contrast, with diseases having a poor prognosis, such as fulminant hepatitis, amyloidosis, and amyotrophic lateral sclerosis, periods of continuance are short. The proportion needing long-term continuation is higher in women than in men, especially with diseases which have long been eligible for support. However, with diseases for which receipt was started recently, there is a tendency for persistence to be higher in men than in women. With reform of insurance systems, including the medical system for intractable diseases, it is predicted that receipt continuation will change with alteration of social factors, and it is necessary to

  8. Hepatitis A FAQs

    MedlinePlus

    ... now routinely vaccinate all children, travelers to certain countries, and persons at risk for the disease. Many experts believe Hepatitis A vaccination has dramatically affected rates of the disease in the United States. Transmission / Exposure How is Hepatitis A spread? Hepatitis A ...

  9. Treating hepatitis C.

    PubMed

    Hanson, Karmen

    2014-10-01

    (1) New treatments for hepatitis C are curing more people than before. (2) Baby boomers make up an estimated 75 percent of all cases of hepatitis C. (3) Medicare and some insurance plans cover screening for hepatitis C as a preventive service without a copayment.

  10. Hepatitis E Pathogenesis

    PubMed Central

    Lhomme, Sébastien; Marion, Olivier; Abravanel, Florence; Chapuy-Regaud, Sabine; Kamar, Nassim; Izopet, Jacques

    2016-01-01

    Although most hepatitis E virus (HEV) infections are asymptomatic, some can be severe, causing fulminant hepatitis and extra-hepatic manifestations, including neurological and kidney injuries. Chronic HEV infections may also occur in immunocompromised patients. This review describes how our understanding of the pathogenesis of HEV infection has progressed in recent years. PMID:27527210

  11. Hepatitis C.

    PubMed

    Burra, Patrizia

    2009-02-01

    Hepatitis C virus (HCV) is a leading cause of end-stage liver disease worldwide and the most common indication for liver transplantation in the United States and Europe. HCV nearly always recurs in liver-transplanted patients, and 10 to 25% of them develop cirrhosis within 5 to 10 years. One of the strategies suggested to limit virological HCV recurrence is pretransplant antiviral treatment, but studies are warranted on the pharmacokinetics of antiviral drugs in cirrhotic patients, the benefits of fixed or escalating antiviral drug dosage schedules, the duration of the treatment, and the indications for using growth factors. Several risk factors are associated with a more aggressive recurrent HCV and early allograft failure, such as an older donor age. The relationship between immunosuppression and fibrosis progression in HCV recurrence remains uncertain. Concerning the antiviral treatment, treating established recurrent disease with a combination of interferon and ribavirin has been the mainstay of management to date, but when it is best to start and how to manage the side effects are still controversial issues. Antiviral treatment should be started once the disease has been confirmed by a biopsy when the fibrosis develops, providing that ongoing acute or chronic rejection, biliary obstruction, vascular damage, autoimmune diseases and sepsis, and any other standard contraindications for antiviral therapy, have been excluded. HCV recurrence after liver transplantation may well lead to graft failure and become an indication for retransplantation, but this is done in a relatively small number of cases, accounting for only 3 to 5% of retransplanted patients, since retransplantation is associated with much worse results than primary liver transplant procedures. We must be prepared for the fact that increasing numbers of HCV-positive recipients with allografts failing due to recurrent HCV will be asking to be retransplanted-and we do not know yet how to respond to this

  12. Men's sex-dominance inhibition: do men automatically refrain from sexually dominant behavior?

    PubMed

    Kiefer, Amy K; Sanchez, Diana T

    2007-12-01

    Men receive conflicting messages about their sexual roles in heterosexual relationships. Men are socialized to initiate and direct sexual activities with women; yet societal norms also proscribe the sexual domination and coercion of women. The authors test these competing hypotheses by assessing whether men inhibit the link between sex and dominance. In Studies 1a and b, using a subliminal priming procedure embedded in a lexical decision task, the authors demonstrate that men automatically suppress the concept of dominance following exposure to subliminal sex primes relative to neutral primes. In Studies 2 and 3, the authors show that men who are less likely to perceive sexual assertiveness as necessary, to refrain from dominant sexual behavior, and who do not invest in masculine gender ideals are more likely to inhibit dominant thoughts following sex primes. Implications for theories of automatic cognitive networks and gender-based sexual roles are discussed.

  13. Targeting Hepatic Fibrosis in Autoimmune Hepatitis.

    PubMed

    Montano-Loza, Aldo J; Thandassery, Ragesh B; Czaja, Albert J

    2016-11-01

    Hepatic fibrosis develops or progresses in 25 % of patients with autoimmune hepatitis despite corticosteroid therapy. Current management regimens lack reliable noninvasive methods to assess changes in hepatic fibrosis and interventions that disrupt fibrotic pathways. The goals of this review are to indicate promising noninvasive methods to monitor hepatic fibrosis in autoimmune hepatitis and identify anti-fibrotic interventions that warrant evaluation. Laboratory methods can differentiate cirrhosis from non-cirrhosis, but their accuracy in distinguishing changes in histological stage is uncertain. Radiological methods include transient elastography, acoustic radiation force impulse imaging, and magnetic resonance elastography. Methods based on ultrasonography are comparable in detecting advanced fibrosis and cirrhosis, but their performances may be compromised by hepatic inflammation and obesity. Magnetic resonance elastography has excellent performance parameters for all histological stages in diverse liver diseases, is uninfluenced by inflammatory activity or body habitus, has been superior to other radiological methods in nonalcoholic fatty liver disease, and may emerge as the preferred instrument to evaluate fibrosis in autoimmune hepatitis. Promising anti-fibrotic interventions are site- and organelle-specific agents, especially inhibitors of nicotinamide adenine dinucleotide phosphate oxidases, transforming growth factor beta, inducible nitric oxide synthase, lysyl oxidases, and C-C chemokine receptors types 2 and 5. Autoimmune hepatitis has a pro-fibrotic propensity, and noninvasive radiological methods, especially magnetic resonance elastography, and site- and organelle-specific interventions, especially selective antioxidants and inhibitors of collagen cross-linkage, may emerge to strengthen current management strategies.

  14. [Epidemiology of viral hepatitis].

    PubMed

    Kaić, Bernard; Vilibić-Cavlek, Tatjana; Filipović, Sanja Kurecić; Nemeth-Blazić, Tatjana; Pem-Novosel, Iva; Vucina, Vesna Visekruna; Simunović, Aleksandar; Zajec, Martina; Radić, Ivan; Pavlić, Jasmina; Glamocanin, Marica; Gjenero-Margan, Ira

    2013-10-01

    Understanding the country-specific epidemiology of disease, which may vary greatly among countries, is crucial for identifying the most appropriate preventive and control measures. An overview of the local epidemiology of viral hepatitis in Croatia is given in this paper. The overall prevalence of hepatitis B in Croatia is low (less than 2% HBsAg carriers in the general population). Hepatitis B incidence and prevalence began to decline significantly following the introduction of universal hepatitis B vaccination in 1999. Information on HBsAg seroprevalence is derived from routine testing of certain subpopulations (pregnant women, blood donors) and seroprevalence studies mostly targeted at high-risk populations. Universal childhood vaccination against hepatitis B remains the main preventive measure. We recommend testing for immunity one to two months after the third dose of hepatitis B vaccine for health-care workers. The incidence and prevalence of hepatitis C have also been declining in the general population. The main preventive measures are ensuring safety of blood products, prevention of drug abuse, and harm reduction programs for intravenous drug users. Hepatitis A incidence has declined dramatically since fifty years ago, when thousands of cases were reported annually. In the last five years, an average of twenty cases have been reported per year. The reduction of hepatitis A is a consequence of improved personal and community hygiene and sanitation. Hepatitis D has not been reported in Croatia. The risk of hepatitis D will get to be even smaller as the proportion of population vaccinated against hepatitis B builds up. Hepatitis E is reported only sporadically in Croatia, mostly in persons occupationally in contact with pigs and in travelers to endemic countries. In conclusion, Croatia is a low prevalence country for hepatitides A, B and C. Hepatitis D has not been reported to occur in Croatia and there are only sporadic cases of hepatitis E. Since hepatitis

  15. Prevalence of human immunodeficiency virus and hepatitis C virus among French prison inmates in 2010: a challenge for public health policy.

    PubMed

    Semaille, C; Le Strat, Y; Chiron, E; Chemlal, K; Valantin, M A; Serre, P; Caté, L; Barbier, C; Jauffret-Roustide, M

    2013-07-11

    We evaluated prevalence of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) among prison inmates in France in 2010, in a cross-sectional single-day study based on a two-stage design. Sampling favoured larger establishments and included all types of prisons. Establishments were stratified by geographical region. Estimates were adjusted by post-stratification of the total population of inmates in France. From 60,975 inmates in all 188 prisons on the sampling day, 2,154 were selected from 27 prisons, and 1,876 questionnaires completed. HIV prevalence was estimated at 2.0% (95% confidence interval (CI): 0.9–4.2), 2.6% (95% CI: 0.7–8.8) in women and 2.0% (95% CI: 0.9–4.3) in men; 75% of inmates were receiving treatment for HIV. HCV prevalence was estimated at 4.8% (95% CI: 3.5–6.5) and was higher for women (11.8%; 95% CI: 8.5–16.1) than men (4.5%; 95% CI: 3.3–6.3). Almost half of HCV-infected inmates had chronic hepatitis C and 44% were receiving or had received treatment. HIV and HCV prevalence was six times higher than in the general population, and 2.5% of inmates had viraemic hepatitis C. The moment of incarceration provides an ideal opportunity for testing and treating, limiting spread of HCV and improving patients' prognosis.

  16. [Latest Treatment of Viral Hepatitis--Overcoming Hepatitis C and Reactivation of Hepatitis B].

    PubMed

    Tanaka, Yasuhito

    2016-02-01

    Hepatitis B virus (HBV) and hepatitis C virus (HCV), discovered as causative viruses of post-transfusion hepatitis, become persistent infections, leading to chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). For HCV, recent IFN-free direct-acting antiviral (DAA) therapies have increased sustained virological response (SVR) rates and reduced adverse events. IFN-based therapies, still the standard of care in Asian countries, are influenced by IL28B genetic variants and the liver fibrosis stage, but the DAA combinations obscure the influence of these factors. These new therapies can eradicate HCV and prevent HCC development. On the other hand, it is difficult to eradicate HBV completely. Although HBV infection can be prevented by vaccination, reactivation of HBV following anti-cancer chemotherapy and immunosuppressive therapy is a well-known complication. HBV reactivation has been reported to be associated with anti-CD20 monoclonal antibody rituximab-containing chemotherapy and TNF-α inhibitor-containing immunosuppressive therapy in HBV-resolved patients. Our prospective observational study revealed that monthly monitoring of HBV DNA was useful for preventing HBV reactivation-related hepatitis among B-cell non-Hodgkin lymphoma patients with resolved HBV infection following rituximab-steroid-chemo, suggesting that preemptive therapy guided by serial HBV DNA monitoring should be recommended. Recently, highly sensitive HBsAg detection by Lumipulse HBsAg-HQ may be useful for several clinical applications. The sensitivity of this assay (5 mIU/mL) was approximately 10-fold higher than Abbott ARCHITECT, but still lower than HBV-DNA assays. The convenient HBsAg-HQ may be useful for detecting occult HBV infection and HBV reactivation in relatively low-risk groups except for those receiving rituximab-steroid-chemo. [

  17. Hepatitis A Virus Vaccine Escape Variants and Potential New Serotype Emergence

    PubMed Central

    Pérez-Sautu, Unai; Costafreda, M. Isabel; Caylà, Joan; Tortajada, Cecilia; Lite, Josep; Bosch, Albert

    2011-01-01

    Six hepatitis A virus antigenic variants that likely escaped the protective effect of available vaccines were isolated, mostly from men who have sex with men. The need to complete the proper vaccination schedules is critical, particularly in the immunocompromised population, to prevent the emergence of vaccine-escaping variants. PMID:21470474

  18. Chronic hepatitis C: treatment, complications, and long-term outcomes in a population of Latino veterans

    PubMed Central

    Santiago-Rolon, Amarilys; Purcell, Dagmary; Grigg, Nicole; Toro, Doris H.

    2016-01-01

    Objectives Chronic hepatitis C (CHC) is a major public health problem in Puerto Rico. It is the most common cause of chronic liver disease and the most frequent indication for liver transplantation in the United States." Our main objectives were to estimate the seroprevalence of CHC infection, to describe the demographic and histological parameters of the infection in our sample population, and to evaluate the treatment outcomes in Puerto Rican veterans. Methods To determine overall seroprevalence, we reviewed all the hepatitis C cases (encompassing from January 1, 2002, to December 31, 2009) of the VA Caribbean Healthcare System, Department of Veterans Affairs. The records of only those individuals who received treatment with pegylated interferon and ribavirin were reviewed to determine risks factors for infection, response rates, adverse events, and outcomes. Results During the study period, there were a total of 1,496 patients identified as being infected with HCV, for an estimated seroprevalence of 2.3%. Of these, approximately 10% (137) were treated with combination therapy and were included in this study. The mean age was 58 (±6.4); 96.4% were men. The most common genotype was type 1. The responses to treatment were generally poor, with only 48.4% of the patients achieving Ssustained virological response. Discussion Though the seroprevalence of chronic hepatitis C in the Latino veteran population of Puerto Rico is high, relatively few patients have received treatment, most probably because of the contraindications of the medications used. Combination therapy with pegylated interferon plus weight-based ribavirin was inefficient and plagued with side effects; as a whole, this therapy was not found to be overly beneficial to our patients. New emerging and approved therapies will change this paradigm, allowing the treatment of a larger population without the side effects of the studied therapy. PMID:26932282

  19. Changes in quality of life and sexual health are associated with low-dose peginterferon therapy and disease progression in patients with chronic hepatitis C

    PubMed Central

    Snow, Kristin K.; Bonkovsky, Herbert L.; Fontana, Robert J.; Kim, Hae-Young; Sterling, Richard K.; Di Bisceglie, Adrian M.; Morgan, Timothy R.; Dienstag, Jules L.; Ghany, Marc G.

    2010-01-01

    Background/Aim We assessed the effects of long-term peginterferon therapy and disease progression on health-related quality of life (HRQOL), symptoms, and sexual health in patients with chronic hepatitis C (CHC) and advanced fibrosis or cirrhosis. Methods 517 HALT-C Trial patients received peginterferon alfa-2a (90 μg/week); 532 received no additional treatment for 3.5 years. Patients were followed for outcomes of death, hepatocellular carcinoma and hepatic decompensation. Sexual health, SF-36 scores, and symptoms were serially assessed by repeated measures analyses of covariance. Results Patients with cirrhosis (n=427) reported lower general well-being and more fatigue (p<0.001) than patients with fibrosis (n=622). Physical scores declined significantly over time, independent of treatment, and patients with cirrhosis reported lower scores. Vitality scores were lower in those with cirrhosis, and treated patients experienced a greater decline over time than untreated patients; HRQOL rebounded after treatment ended. Patients with a clinical outcome had significantly greater declines in all SF-36 and symptom scores. Among men, sexual health scores were significantly worse in treated patients and in those with a clinical outcome. Conclusions Clinical progression of CHC and maintenance peginterferon therapy led to worsening of symptoms, HRQOL, and, in men, sexual health in a large patient cohort followed over 4 years. PMID:20070284

  20. Hepatitis Infection in the Treatment of Opioid Dependence and Abuse

    PubMed Central

    Kresina, Thomas F; Sylvestre, Diana; Seeff, Leonard; Litwin, Alain H; Hoffman, Kenneth; Lubran, Robert; Clark, H Westley

    2008-01-01

    Many new and existing cases of viral hepatitis infections are related to injection drug use. Transmission of these infections can result directly from the use of injection equipment that is contaminated with blood containing the hepatitis B or C virus or through sexual contact with an infected individual. In the latter case, drug use can indirectly contribute to hepatitis transmission through the dis-inhibited at-risk behavior, that is, unprotected sex with an infected partner. Individuals who inject drugs are at-risk for infection from different hepatitis viruses, hepatitis A, B, or C. Those with chronic hepatitis B virus infection also face additional risk should they become co-infected with hepatitis D virus. Protection from the transmission of hepatitis viruses A and B is best achieved by vaccination. For those with a history of or who currently inject drugs, the medical management of viral hepatitis infection comprising screening, testing, counseling and providing care and treatment is evolving. Components of the medical management of hepatitis infection, for persons considering, initiating, or receiving pharmacologic therapy for opioid addiction include: testing for hepatitis B and C infections; education and counseling regarding at-risk behavior and hepatitis transmission, acute and chronic hepatitis infection, liver disease and its care and treatment; vaccination against hepatitis A and B infection; and integrative primary care as part of the comprehensive treatment approach for recovery from opioid abuse and dependence. In addition, participation in a peer support group as part of integrated medical care enhances treatment outcomes. Liver disease is highly prevalent in patient populations seeking recovery from opioid addiction or who are currently receiving pharmacotherapy for opioid addiction. Pharmacotherapy for opioid addiction is not a contraindication to evaluation, care, or treatment of liver disease due to hepatitis virus infection. Successful

  1. Hepatitis B-Related Concerns and Anxieties Among People With Chronic Hepatitis B in Australia

    PubMed Central

    Hajarizadeh, Behzad; Richmond, Jacqui; Ngo, Naomi; Lucke, Jayne; Wallace, Jack

    2016-01-01

    Background The psychological wellbeing of people with chronic hepatitis B (CHB) may be negatively affected due to the chronic and transmissible nature of the disease, and possible serious complications (e.g. cirrhosis and liver cancer). There are limited data investigating concerns and anxieties among people living with CHB. Objectives This study examined feelings about having hepatitis B among people with CHB, including hepatitis B-related concerns and anxieties. Patients and Methods Using convenience sampling, people with CHB attending four public liver clinics and one general practice in three Australian jurisdictions between April and September 2013 completed a self-administered questionnaire about their feelings about having hepatitis B. Results Ninety-three people completed the survey. Mean age was 45 years, 57% were men, and 93% were born overseas (75% from Asia). Seventy-six percent of participants reported having hepatitis B-related concerns and anxieties. The most common concerns were of developing liver cancer (57%), and infecting other people (53%). Thirty-five percent of participants were unwilling to talk to anyone about their hepatitis B while 25% changed how they lived as a result of having hepatitis B. Lower educational level was associated with feeling scared of hepatitis B (adjusted Odds Ratio [OR]: 4.04; 95%CI: 1.09, 14.90; P = 0.04), and an unwillingness to talk to anyone about hepatitis B (adjusted OR: 4.41; 95%CI: 1.09, 17.83; P = 0.04). Very good English proficiency was associated with a higher likelihood of participants changing how they lived (adjusted OR: 12.66; 95%CI: 2.21, 72.42; P < 0.01), and seeing life differently as a result of having hepatitis B (adjusted OR: 21.10; 95%CI: 3.70, 120.19; P < 0.01). Health professionals were the key person for 34% of participants in helping them cope with having hepatitis B, while 18% reported that no one supported them. Conclusions Hepatitis B-related concerns and anxieties are prevalent among

  2. Booster dose vaccination for preventing hepatitis B.

    PubMed

    Poorolajal, Jalal; Hooshmand, Elham

    2016-06-07

    Antibodies against hepatitis B surface antigen (HBsAg) wane over time following hepatitis B immunisation; hence, it is unclear whether people vaccinated in three-dose or four-dose schedules of the hepatitis B vaccine are still immune when the hepatitis B surface antibody (anti-HBs) level in their body is undetectable, or lower than the level usually considered protective. This question may potentially be answered indirectly by measuring the anamnestic immune response to a booster dose of vaccine. The term 'booster' (or revaccination) refers to an additional dose of hepatitis B vaccine (HBV) given some time post-primary vaccination to induce immune memory and improve protection against hepatitis B virus (HBV) infection. To assess the benefits and harms of booster dose hepatitis B vaccination, more than five years after the primary vaccination, for preventing HBV infection in healthy individuals previously vaccinated with the hepatitis B vaccine, and with hepatitis B surface antibody (anti-HBs) levels below 10 mIU/mL. We searched the Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Science Citation Index Expanded, conference databases, and reference lists of articles to January 2016. We also contacted authors of articles. In addition, we searched ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing trials (May 2016). Randomised clinical trials addressing anamnestic immune response to a booster dose of hepatitis B vaccine, more than five years after the primary vaccination, in apparently healthy participants, vaccinated in a three-dose or four-dose schedule of the hepatitis B vaccine during the primary vaccination, without receiving an additional dose or immunoglobulin. Both review authors decided if the identified studies met the inclusion criteria or not. Primary outcomes included the proportion of participants

  3. Hepatitis B vaccination.

    PubMed

    Romanò, Luisa; Paladini, Sara; Galli, Cristina; Raimondo, Giovanni; Pollicino, Teresa; Zanetti, Alessandro R

    2015-01-01

    Hepatitis B virus is a worldwide leading cause of acute and chronic liver disease including cirrhosis and hepatocellular carcinoma. Effective vaccines have been available since the early '80s and vaccination has proved highly successful in reducing the disease burden, the development of the carrier state and the HB-related morbidity and mortality in the countries where vaccination has been implemented.   Neutralizing (protective) antibodies (anti-HBs) induced by vaccination are targeted largely towards the amino acid hydrophilic region, referred to as the common a determinant which is present on the outer protein coat or surface antigen (HBsAg), spanning amino acids 124-149. This provides protection against all HBV genotypes (from A to H) and is responsible for the broad immunity afforded by hepatitis B vaccination. Thus, alterations of residues within this region of the surface antigen may determine conformational changes that can allow replication of the mutated HBV in vaccinated people. An important mutation in the surface antigen region was identified in Italy some 25 years ago in infants born to HBsAg carrier mothers who developed breakthrough infections despite having received HBIG and vaccine at birth. This virus had a point mutation from guanosine to adenosine at nucleotide position 587, resulting in aa substitution from glycine (G) to arginine (R) at position 145 in the a determinant. Since the G145R substitution alters the projecting loop (aa 139-147) of the a determinant, the neutralizing antibodies induced by vaccination are no longer able to recognize the mutated epitope. Beside G145R, other S-gene mutations potentially able to evade neutralizing anti-HBs and infect vaccinated people have been described worldwide. In addition, the emergence of Pol mutants associated with resistance to treatment with nucleos(t)ide analogues can select viruses with crucial changes in the overlapping S-gene, potentially able to alter the S protein immunoreactivity. Thus

  4. Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content

    PubMed Central

    Zhang, Bo; Ding, Fang; Chen, Tian; Xia, Liang-Hua; Qian, Juan; Lv, Guo-Yi

    2014-01-01

    AIM: To establish and validate a simple quantitative assessment method for nonalcoholic fatty liver disease (NAFLD) based on a combination of the ultrasound hepatic/renal ratio and hepatic attenuation rate. METHODS: A total of 170 subjects were enrolled in this study. All subjects were examined by ultrasound and 1H-magnetic resonance spectroscopy (1H-MRS) on the same day. The ultrasound hepatic/renal echo-intensity ratio and ultrasound hepatic echo-intensity attenuation rate were obtained from ordinary ultrasound images using the MATLAB program. RESULTS: Correlation analysis revealed that the ultrasound hepatic/renal ratio and hepatic echo-intensity attenuation rate were significantly correlated with 1H-MRS liver fat content (ultrasound hepatic/renal ratio: r = 0.952, P = 0.000; hepatic echo-intensity attenuation r = 0.850, P = 0.000). The equation for predicting liver fat content by ultrasound (quantitative ultrasound model) is: liver fat content (%) = 61.519 × ultrasound hepatic/renal ratio + 167.701 × hepatic echo-intensity attenuation rate -26.736. Spearman correlation analysis revealed that the liver fat content ratio of the quantitative ultrasound model was positively correlated with serum alanine aminotransferase, aspartate aminotransferase, and triglyceride, but negatively correlated with high density lipoprotein cholesterol. Receiver operating characteristic curve analysis revealed that the optimal point for diagnosing fatty liver was 9.15% in the quantitative ultrasound model. Furthermore, in the quantitative ultrasound model, fatty liver diagnostic sensitivity and specificity were 94.7% and 100.0%, respectively, showing that the quantitative ultrasound model was better than conventional ultrasound methods or the combined ultrasound hepatic/renal ratio and hepatic echo-intensity attenuation rate. If the 1H-MRS liver fat content had a value < 15%, the sensitivity and specificity of the ultrasound quantitative model would be 81.4% and 100%, which still

  5. Pathogenesis of Hepatic Encephalopathy

    PubMed Central

    Ciećko-Michalska, Irena; Szczepanek, Małgorzata; Słowik, Agnieszka; Mach, Tomasz

    2012-01-01

    Hepatic encephalopathy can be a serious complication of acute liver failure and chronic liver diseases, predominantly liver cirrhosis. Hyperammonemia plays the most important role in the pathogenesis of hepatic encephalopathy. The brain-blood barrier disturbances, changes in neurotransmission, neuroinflammation, oxidative stress, GABA-ergic or benzodiazepine pathway abnormalities, manganese neurotoxicity, brain energetic disturbances, and brain blood flow abnormalities are considered to be involved in the development of hepatic encephalopathy. The influence of small intestine bacterial overgrowth (SIBO) on the induction of minimal hepatic encephalopathy is recently emphasized. The aim of this paper is to present the current views on the pathogenesis of hepatic encephalopathy. PMID:23316223

  6. Characteristics of an outpatient chronic hepatitis B virus infection cohort

    PubMed Central

    de Assis, Danyenne Rejane; Tenore, Simone de Barros; Pinho, João Renato Rebello; Lewi, David Salomão; Ferreira, Paulo Roberto Abrão

    2015-01-01

    ABSTRACT Objective: To characterize a chronic hepatitis B cohort based on initial and follow-up clinical evaluations. Methods: A retrospective and descriptive analysis of clinical and laboratory data from chronic HBsAg adult carriers, without HIV, unexposed to treatment, with at least two outpatient visits, between February 2006 and November 2012. Fisher´s exact test, χ², Wilcoxon, Spearman, multiple comparisons and Kappa tests were applied, the level of significance adopted was 5%, with a 95% confidence interval. Results: 175 patients with mean age of 42.95±12.53 years were included: 93 (53.1%) were men, 152 (86.9%) were negative for hepatitis B e-antigen (HBeAg), 3 (1.7%) had hepatitis C coinfection, 15 (8.6%) had cirrhosis, and 2 (1.1%) had hepatocellular carcinoma. Genotype A predominated. Sixty-six patients (37.7%) had active hepatitis, 6 (3.4%) presented immune tolerance, and 38 (21.7%) were inactive carriers. Exacerbations and/or viral breakthrough were detected in 16 patients (9.1%). In 32 patients (18.3%), hepatitis B virus DNA remained persistently elevated and alanine aminotransferase levels were normal, whereas in 17 (9.7%), there was low hepatitis B virus DNA and alterated alanine aminotransferase. If only initial alanine aminotransferase and hepatitis B virus DNA values were considered, 15 cases of active hepatitis would not have been detected. Advanced fibrosis was more common in HBeAg-positive patients, and it was significantly associated with transaminases, hepatitis B virus DNA, and age. Conclusion: Many patients had active hepatitis, but almost 25%, who were HBeAg non-reactive, were only identified because of combined analyses of the hepatitis B virus DNA and transaminases levels, sometimes associated with histological data, after clinical follow-up. PMID:26154539

  7. Efficacy and safety of lamivudine or tenofovir plus intramuscular hepatitis B immunoglobulin in prevention of hepatitis B virus reinfection after liver transplant.

    PubMed

    Nassiri-Toosi, Mohssen; Kasraianfard, Amir; Ahmadinejad, Zahra; Dashti, Habibollah; Moini, Majıd; Najafi, Atabak; Salimi, Javad; Jafarian, Ali

    2015-04-01

    Hepatitis B immunoglobulin prophylaxis in combination with antiviral drugs is recommended for prevention of hepatitis B virus reinfection after liver transplant. However, there is no consensus on a standard prophylactic method, and controversy exists over the duration, dose, and route of administration. We conducted a prospective study to evaluate the safety and effectiveness of intramuscular hepatitis B immunoglobulin in combination with lamivudine and/or tenofovir and discontinuation of hepatitis B immunoglobulin after 1 year for prevention of hepatitis B virus reinfection. Patients with hepatitis Brelated liver cirrhosis who had undergone primary liver transplants were enrolled. The prophylactic protocol involved intraoperative intramuscular hepatitis B immunoglobulin at 10 000 IU, tapering to 5000 IU daily for the first 6 days, weekly for a month, every 2 weeks for the next month, and monthly for a year after liver transplant, in combination with antiviral drugs. From January 2002 until March 2014, two hundred sixty-eight liver transplants were performed. Forty-four patients (16.4%) who underwent liver transplants due to hepatitis B-related liver failure were enrolled. Five patients had hepatocellular carcinoma; 20 had both hepatitis D and hepatitis B virus infection. The median age was 47 years (range, 26-59 y) with a median model for end stage liver disease score of 20. Thirty-three patients were men (76%). Sixty-one percent of patients were negative for hepatitis B virus DNA at the time of transplant. The median follow-up was 13.6 months (range, 0-142 mo). Only 1 patient (2.3%) experienced hepatitis B virus reinfection (at 44.7 months posttransplant), which was successfully treated with tenofovir. Five patients died (11.4%) during the follow-up from nonhepatitis B causes. Intramuscular hepatitis B immunoglobulin in combination with lamivudine or tenofovir and discontinuation of hepatitis B immunoglobulin after 1 year posttransplant may provide safe and cost

  8. High hepatitis B and low hepatitis C prevalence in Roma population in eastern Slovakia.

    PubMed

    Veselíny, Eduard; Janicko, Martin; Drazilová, Sylvia; Siegfried, Leonard; Pastvová, Lýdia; Schréter, Ivan; Kristian, Pavol; Viág, Ladislav; Jarcuska, Pavol; Valková, Ivana; Cáriková, Katarína; Senajová, Gabriela; Fedacko, Ján; Pella, Daniel; Mareková, Mária; Gecková, Andrea Madarasová; Jarcuska, Peter

    2014-03-01

    Viral hepatitis B and C prevalence in the Roma population of eastern Slovakia is largely unknown. This study aimed to explore the prevalence and associated risk factors of chronic viral hepatitis B and C among Roma living in segregated communities in eastern Slovakia. Data from the cross-sectional HepaMeta study conducted in Slovakia in 2011 among Roma living in rural communities were used. Participants were tested for the presence of HBsAg, anti-HBc IgG and anti-HCV. The risk factors were assessed mainly via a structured questionnaire/interview. Altogether 452 Roma were screened, and 11 were excluded due to missing data. A total of 441 patients were included (mean age 34.7 +/- 9.14 years; 35.2% men). 12.5% of participants were HBsAg positive, 40.4% anti-HBc IgG positive while negative for HBsAg and 47.2% of participants were negative for all serological markers of hepatitis B. Hepatitis C prevalence was very low (0.7%), while 2 out of 3 anti-HCV positive participants were coinfected with hepatitis B. Risk factors for hepatitis B infection were male sex, higher age, tattoo, and previous imprisonment. No difference was found in intravenous drug use, blood transfusions and sexual behaviour. More than half of the Roma residing in eastern Slovakia have been infected at one point in life with the hepatitis B virus, and 12.5% are HBsAg positive. Hepatitis C prevalence is very low, which is probably due to very low intravenous drug use.

  9. Meningococcal ACWY Vaccines (MenACWY and MPSV4)

    MedlinePlus

    ... such as hearing loss, brain damage, kidney damage, amputations, nervous system problems, or severe scars from skin ... old, have received MenACWY previously, or anticipate requiring multiple doses. MPSV4 vaccine is recommended for adults older ...

  10. Natural history of hepatitis B in perinatally infected carriers

    PubMed Central

    Boxall, E; Sira, J; Standish, R; Davies, P; Sleight, E; Dhillon, A; Scheuer, P; Kelly, D

    2004-01-01

    Objectives: To establish natural seroconversion rates and incidence of hepatic pathology in perinatally infected hepatitis B carriers. Methods: Seventy three perinatally infected hepatitis B carriers identified through maternal screening were evaluated. Fifty three were born to parents from the Indian subcontinent, nine were Oriental, six were Afro-Caribbean, and five were white. Median follow up was 10.24 (range 2.02–20.16) years. Results: Only three of the children followed up had cleared hepatitis B surface antigen during this period, and 30% of the children had seroconverted to anti-HBe. Seroconversions to anti-HBe were observed in Asian (18/50) and white (4/5) children, but not in Oriental or Afro-Caribbean children. More girls (40%) than boys (23%) had seroconverted, but the difference was not significant. All children were asymptomatic with normal physical examination, growth, and development. Almost half (48%) of the hepatitis B e antigen (HBeAg) positive children had normal hepatic transaminases and liver function. Thirty five liver biopsies were performed in children with active virus replication (HBeAg or hepatitis B virus DNA positive) who were being considered for antiviral treatment as part of a clinical trial and were scored using the Ishak method. Two thirds (62%) of the children had mild hepatitis, 60% had mild fibrosis, and 18% had moderate to severe fibrosis. There was a weak correlation between histological evidence of hepatitis and hepatic transaminase activity, implying that biochemical monitoring of hepatic disease activity may be ineffective. Conclusions: These asymptomatic hepatitis B virus carrier children remain infectious in the medium to long term with notable liver pathology. They should receive antiviral treatment to reduce infectivity and to prevent further progression of liver disease. Hepatic transaminases alone are not a reliable marker of liver pathology, and liver histology is essential before consideration for antiviral

  11. Highly directional acoustic receivers

    NASA Astrophysics Data System (ADS)

    Cray, Benjamin A.; Evora, Victor M.; Nuttall, Albert H.

    2003-03-01

    The theoretical directivity of a single combined acoustic receiver, a device that can measure many quantities of an acoustic field at a collocated point, is presented here. The formulation is developed using a Taylor series expansion of acoustic pressure about the origin of a Cartesian coordinate system. For example, the quantities measured by a second-order combined receiver, denoted a dyadic sensor, are acoustic pressure, the three orthogonal components of acoustic particle velocity, and the nine spatial gradients of the velocity vector. The power series expansion, which can be of any order, is cast into an expression that defines the directivity of a single receiving element. It is shown that a single highly directional dyadic sensor can have a directivity index of up to 9.5 dB. However, there is a price to pay with highly directive sensors; these sensors can be significantly more sensitive to nonacoustic noise sources.

  12. Central solar energy receiver

    DOEpatents

    Drost, M. Kevin

    1983-01-01

    An improved tower-mounted central solar energy receiver for heating air drawn through the receiver by an induced draft fan. A number of vertically oriented, energy absorbing, fin-shaped slats are radially arranged in a number of concentric cylindrical arrays on top of the tower coaxially surrounding a pipe having air holes through which the fan draws air which is heated by the slats which receive the solar radiation from a heliostat field. A number of vertically oriented and wedge-shaped columns are radially arranged in a number of concentric cylindrical clusters surrounding the slat arrays. The columns have two mirror-reflecting sides to reflect radiation into the slat arrays and one energy absorbing side to reduce reradiation and reflection from the slat arrays.

  13. Effectiveness of hepatitis A vaccination as post-exposure prophylaxis.

    PubMed

    Parrón, Ignasi; Planas, Caritat; Godoy, Pere; Manzanares-Laya, Sandra; Martínez, Ana; Sala, Maria Rosa; Minguell, Sofia; Torner, Nuria; Jané, Mireia; Domínguez, Angela

    2017-02-01

    Hepatitis A (HA) has been a vaccine-preventable disease since 1995. In Catalonia, a universal combined hepatitis A+B vaccination program of preadolescents was initiated at the end of 1998. However, outbreaks are reported each year and post-exposure prophylaxis (PEP) with hepatitis A virus (HAV) vaccine or immunoglobulin (IG) is recommended to avoid cases. The aim of this study was to assess the effectiveness of HAV vaccine and IG in preventing hepatitis A cases in susceptible exposed people. A retrospective cohort study of contacts of HA cases involved in outbreaks reported in Catalonia between January 2006 and December 2012 was made. The rate ratios and 95% confidence intervals (CI) of HA in susceptible contacts receiving HAV or IG versus those without PEP were calculated. There were 3550 exposed persons in the outbreaks studied: 2381 received one dose of HAV vaccine (Hepatitis A or hepatitis A+B), 190 received IG, and 611 received no PEP. 368 exposed subjects received one dose of HAV vaccine and IG simultaneously and were excluded from the study. The effectiveness of PEP was 97.6% (95% CI 96.2-98.6) for HAV vaccine and 98.3% (95% CI 91.3-99.9) for IG; the differences were not statistically significant (p = 0.36). The elevated effectiveness of HAV vaccination for PEP in HA outbreaks, similar to that of IG, and the long-term protection of active immunization, supports the preferential use of vaccination to avoid secondary cases.

  14. The Development and Feasibility of a Brief Risk Reduction Intervention for Newly HIV-Diagnosed Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Sikkema, Kathleen J.; Hansen, Nathan B.; Kochman, Arlene; Santos, Jonathan; Watt, Melissa H.; Wilson, Patrick A.; DeLorenzo, Allyson; Laudato, Jay; Mayer, Gal

    2011-01-01

    Men who have sex with men (MSM) represent more than half of all new HIV infections in the United States. Utilizing a collaborative, community-based approach, a brief risk reduction intervention was developed and pilot tested among newly HIV-diagnosed MSM receiving HIV care in a primary care setting. Sixty-five men, within 3 months of diagnosis,…

  15. The Development and Feasibility of a Brief Risk Reduction Intervention for Newly HIV-Diagnosed Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Sikkema, Kathleen J.; Hansen, Nathan B.; Kochman, Arlene; Santos, Jonathan; Watt, Melissa H.; Wilson, Patrick A.; DeLorenzo, Allyson; Laudato, Jay; Mayer, Gal

    2011-01-01

    Men who have sex with men (MSM) represent more than half of all new HIV infections in the United States. Utilizing a collaborative, community-based approach, a brief risk reduction intervention was developed and pilot tested among newly HIV-diagnosed MSM receiving HIV care in a primary care setting. Sixty-five men, within 3 months of diagnosis,…

  16. Hepatitis B antigen and viral hepatitis type B in India*

    PubMed Central

    John, T. Jacob; Carman, Robert H.; Hill, Peter G.

    1974-01-01

    Surveys were conducted to determine the occurrence of overt hepatitis manifested by jaundice in groups of hospital patients who had survived their initial illness. Of those who had been given blood that had not been screened for the presence of hepatitis B antigen (HB Ag) 9.4% reported that they had had jaundice during the 6 months following transfusion. During a similar period jaundice was reported by only 1.1% of those who had received blood found to be negative for HB Ag by the cross-over electrophoresis test. This difference is highly significant. Jaundice was reported by 25.5% of recipients of HB Ag-positive blood. Of a control population of hospitalized but non-transfused patients 2.2% reported jaundice within 6 months of hospitalization. The risk of overt hepatitis from HB Ag in transfused blood is high in southern India and is similar to that in temperate countries where the occurrence of antigen carriers, and presumably of immune status, are lower than in the tropics. PMID:4549611

  17. Hanson receives Macelwane Medal

    NASA Astrophysics Data System (ADS)

    Ravishankara, A. R.; Hanson, David R.

    At the 1996 Spring Meeting in Baltimore, Maryland, David R. Hanson received the 1996 James B. Macelwane Medal, which recognizes significant contributions to the geophysical sciences by a young scientist of outstanding ability. The medal citation and Hanson's response are given here.

  18. Zero-power receiver

    SciTech Connect

    Brocato, Robert W.

    2016-10-04

    An unpowered signal receiver and a method for signal reception detects and responds to very weak signals using pyroelectric devices as impedance transformers and/or demodulators. In some embodiments, surface acoustic wave devices (SAW) are also used. Illustrative embodiments include satellite and long distance terrestrial communications applications.

  19. Submillimeter wave heterodyne receiver

    NASA Technical Reports Server (NTRS)

    Chattopadhyay, Goutam (Inventor); Manohara, Harish (Inventor); Siegel, Peter H. (Inventor); Ward, John (Inventor)

    2011-01-01

    In an embodiment, a submillimeter wave heterodyne receiver includes a finline ortho-mode transducer comprising thin tapered metallic fins deposited on a thin dielectric substrate to separate a vertically polarized electromagnetic mode from a horizontally polarized electromagnetic mode. Other embodiments are described and claimed.

  20. Received Pronunciation and "Realphonetik."

    ERIC Educational Resources Information Center

    Shibles, Warren

    1995-01-01

    This article argues that British Received Pronunci