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1
Gerlach, Jochen. "Sequenzanalysen von Hepatitis-B-Virusvarianten bei fulminanter Hepatitis B und Hepatitis D." [S.l.] : [s.n.], 1999. http://www.sub.uni-hamburg.de/disse/321/Gerlach.pdf.
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Valente, Vanderleia Barbaro. "Estudo da distribuição dos marcadores sorológicos das hepatites B e C entre doadores de sangue do Hemocentro de Ribeirão Preto, SP." Universidade de São Paulo, 2002. http://www.teses.usp.br/teses/disponiveis/17/17139/tde-29052003-193717/.
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Este estudo, que envolveu todos os doadores de sangue (25.891) que compareceram pela primeira vez ao Hemocentro de Ribeirão Preto, de junho de 1996 a junho de 2001, teve os seguintes objetivos: 1) Estudar a positividade de marcadores sorológicos das hepatites B e C em testes da triagem dos doadores. 2) Analisar o fluxo dos doadores positivos para os marcadores das hepatites B e C ao Ambulatório de Hepatites (AH) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. 3) Estimar a prevalência de infecção atual ou pregressa pelos vírus das hepatites B e C entre os doadores, através da análise dos resultados de testes confirmatórios para essas doenças. 4) Avaliar a importância da determinação da transaminase glutâmico-pirúvica (TGP) como marcador indireto de infecção pelos vírus das hepatites B e/ou C. Foram levantados dados registrados no Hemocentro, no Núcleo de Vigilância Epidemiológica (NVE) e no AH, coletando-se informações referentes ao doador, ao tipo de doação e ao resultado de teste da triagem sorológica (HBsAg, anti-HBc, anti-HCV, TGP, anti-HIV, anti-HTLV, doença de Chagas e sífilis). Foram estudados ainda: os resultados dos testes de repetição realizados no Hemocentro dos doadores positivos para os marcadores das hepatites B e C na triagem sorológica; o comparecimento ao NVE; e a confirmação, no AH, dos resultados para esses marcadores. A população dos doadores foi composta majoritariamente por homens (83,6%) e indivíduos de 26 a 45 anos de idade (64,0%). Predominaram as doações vinculadas (85,4%), e as maiores motivações foram solicitação e estímulo familiar ou de amigos. Os valores da prevalência, nos testes da triagem sorológica, foram iguais a 0,63% (IC95%: 0,54 0,72), para o HBsAg e 1,15% (IC95%: 1,02 1,28), para o anti-HCV. O total de doadores positivos que deveriam ser avaliados no AH, sofreu uma perda de 55,5% entre os suspeitos de ter hepatite B e de 58,7% entre os suspeitos de ter hepatite C, totalizando 266 doadores perdidos quanto ao acompanhamento. Os valores da prevalência, nos testes confirmatórios, foram iguais a 0,22% (IC95%: 0,16 0,28), para a hepatite B, e 0,31% (IC95%: 0,24 0,38), para a hepatite C. As co-positividades entre os valores de TGP e os marcadores de hepatites, nos testes de triagem sorológica, foram de 8,8%, para o vírus C, e de 0,5%, para o vírus B, indicando que a determinação dessa enzima não auxilia na seleção de doadores em bancos de sangue.This study, which involved all blood donors (25.891) that attended the Blood Center of Ribeirão Preto for the first time from June 1996 to June 2001 had the following objectives: 1) To study the positiveness for hepatitis B and C serologic markers in donors screening tests. 2) To analyze the flow of positive donors for hepatitis B and C markers to the Hepatitis Ambulatory (HA) in the Clinical Hospital of the Faculty of Medicine of Ribeirão Preto of the University of São Paulo. 3) To estimate the predominance of present or former infection by hepatitis B and C viruses among donors, by analyzing results of screening tests that confirm these diseases. 4) To evaluate the importance of determining the glutamic-piruvic transaminase (GTP) as an indirect marker of infection by hepatitis B and C viruses. Registered data from the Blood Center as well as from the Epidemiological Surveillance Nucleus (ESN) and HA were used with the purpose of collecting information about donors, type of donation and results in serologic screening tests (HBsAg, anti-HBc, anti-HCV, GTP, anti-HIV, anti-HTLV, Chagas disease and syphilis). In addition, a study was performed on the results in repetition tests that took place in the Blood Center of positive donors for hepatitis B and C markers in serologic tests as well as on their attendance at the ESN and the confirmation in the HA of the results for these markers. The population of donors was composed in its majority by men (83,6%) and individuals from 26 to 45 year-old (64,0%). Linked donations predominated (85,4%), and the greatest reasons for donation arose from solicitation and stimulus coming from family and friends. The value of prevalence in serologic screening tests was 0,63% (IC95%: 0,54 0,72) for HBsAg and 1,15% (IC95%: 1,02 1,28) for anti-HCV. The total of positive donors that should have been evaluated in the HA suffered a loss of 55,5% among the suspects of having hepatitis B and of 58,7% among the suspects of having hepatitis C, reaching a total of 266 donors lost during follow-up. The value of prevalence in confirmatory tests was 0,22% (IC95%: 0,16 0,28) for hepatitis B and 0,31% (IC95%: 0,24 0,38) for hepatitis C. The copositiveness between GPT and hepatitis markers in serologic screening tests was 8.8% for hepatitis C virus and 0.5% for hepatitis B virus, indicating that determination of this enzyme is not helpful in selection of donors in blood banks.
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Umeda, Makoto. "Hepatitis B virus infection in lymphatic tissues in inactive hepatitis B carriers." Kyoto University, 2007. http://hdl.handle.net/2433/135682.
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Arauz-Ruiz, Patricia. "Molecular epidemiology of hepatitis A and hepatitis B virus in central America /." Stockholm : Repro Print, 2002. http://diss.kib.ki.se/2002/91-7349-208-6/.
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Luo, Ying. "Hepatitis B virus specific immune response after liver transplantation for chronic hepatitis B /." Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B3697724X.
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Luo, Ying, and 羅英. "Hepatitis B virus: specific immune response after liver transplantation for chronic hepatitis B." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B3697724X.
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Kandpal, Manish. "Role of defective hepatitis B virus in wild-type hepatitis B virus replication." Thesis, IIT Delhi, 2017. http://localhost:8080/xmlui/handle/12345678/7247.
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Lu, Lei. "Effects of antiviral therapies on hepatitis B virus relicaptive intermediates in chronic hepatitis B." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42182359.
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Silva, Filho Hermes Pedreira da. "Estudo Molecular dos Vírus B e C das Hepatites nas Regiões Norte e Nordeste do Brasil." reponame:Repositório Institucional da FIOCRUZ, 2010. https://www.arca.fiocruz.br/handle/icict/4219.
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Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, Brasil
Infecções pelos vírus B e C das hepatites constituem um significante problema de saúde pública em todo mundo. Mais de 350 milhões de pessoas estão cronicamente infectadas pelo VHB e 170 milhões pelo VHC. No Brasil, a prevalência de pessoas infectadas pelo VHB varia de baixa endemicidade (<2%) até alta, (>7%), e estima-se que 1,5% da população esteja infectada pelo VHC (WHO). Estudos recentes tem demonstrado consideráveis variações entre os isolados do VHB, confirmando a diversidade de genótipos do vírus circulantes e o surgimento de mutações no genoma viral que podem ter impacto na resposta terapêutica e imune. Informações sobre a diversidade genética do VHB serão de grande valor para determinar fatores de risco associados a disseminação do vírus e auxiliar na adoção de medidas de prevenção e terapêutica. A infecção pelo VHC tornou-se um sério problema de saude pública desde que não existe uma vacina disponível e o tratamento é extremamente caro para os órgãos públicos como desgastante para o paciente. Este trabalho utilizou as ferramentas moleculares e de epidemiologia no estudo destes vírus para caracterizar molecularmente os vírus B e C das hepatites nas Regiões Norte e Nordeste, particularmente na Bahia, através de sequenciamento de DNA e análises filogenéticas. Amostras de pacientes provenientes da Bahia, Acre, Rondonia, Amazonas, Maranhão e Tocantins foram analisadas. As amostras foram oriundas de outros estudos e de centros de referência para tratamento das hepatites, sendo avaliadas 635 amostras para o VHC e 335 de VHB. Sequencias das regiões pré-S/S e pré- Core/Core do VHB e NS5b, 5UTR, E1 e Core do VHC foram utilizadas para classificação genotípica e análise filogenetica. Os genótipos mais frequentes para o VHB foram A (57%), D (10%) e F(33%) na Bahia e nas amostras da região Norte. Nós encontramos em nosso estudo 55,6% de pacientes co-infectados com VHB/Delta. Não foi possível estabelecer uma ligação genótipo específico com a evolução da infecção, e determinar a presença de mutantes relacionados à resposta terapêutica e ao escape imunológico. Com relação ao VHC, a subtipagem dos isolados foi realizada através do sequenciamento da região NS5b e 5UTR (n=230). Os sub-genótipos mais frequentes foram 1a(45,6%), 1b (46,9%), 3a (6,5%) e 2a/b(0,8%). As regiões E1 e Core também foram sequenciadas e no futuro serão utilizadas para avaliar possiveis mutações. O presente estudo mostra que a aplicação de protocolos de sequenciamento, bioinformática e filogenia são indispensáveis para a compreensão da epidemiologia molecular dos vírus das hepatites.
Infections with hepatitis B and C viruses constitute a significant public health problem worldwide. More than 350 million people are chronically infected with HBV and 170 million by HCV. In Brazil, HBV remains endemic despite widespread vaccination with prevalence of infection ranging from (<2%) low endemicity, until high (>7%) in different regions. Prevalence of HCV infection in Brazil has been estimated at 1.5%. Recent studies have shown considerable genetic variation among HBV isolates, confirming the diversity of circulating genotypes of the virus and the emergence of mutations in the viral genome that may impact on therapeutic and immune response. Information on the genetic diversity of HBV is useful for molecular epidemiology to determine risk factors associated with the spread of the virus and to inform prevention strategies and for monitoring therapy. Because there is no vaccine available to prevent HCV infection and treatment is extremely expensive for public agencies, HCV is an emerging public health problem. The treatment efficiency is directly related to viral genotype. In this study molecular epidemiology tools were used to characterize HBV and HCV in the North and Northeast, particularly in Bahia, through DNA sequencing and phylogenetic analysis. Samples from Bahia, Acre, Rondônia, Amazonas, Maranhão and Tocantins were analyzed. The samples were collected in collaboration with other studies and centers of references for hepatitis treatments. 635 samples from HCV infected patients and 335 samples from HBV infected were evaluated. Sequences of the regions pre-S / S, HBV core / pre-core, NS5B, 5UTR, HCV Core and E1 were used for genotypic classification and phylogenetic analysis. The most frequent HBV genotypes were A (57%), D (10%) and F (33%) in Bahia and in the samples from the North region. Fifty five percent of the patients from Rondônia were coinfected with HBV and HDV. In this study, we were unable to establish a connection with the particular genotype evolution of the infection and determine the presence of mutants related to therapeutic response and immune escape. In the North region co-infection with HBV genotype F and D virus is strongly associated with poor outcome of the disease as informed by the physicians and literature. Regarding HCV, the subtyping of isolates was performed by sequencing the NS5B region and 5UTR (n=230). The sub-genotypes more frequent were 1a (45.6%), 1b (46.9%), 3a (6.5%) and 2a / b (0.8%). The Core and E1 regions were also sequenced and in the future could be used to evaluate possible mutations. This study shows that the implementation of protocols for sequencing, bioinformatics and phylogenetic are essential for understanding the molecular epidemiology of hepatitis.
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駱淑芳 and Suk-fong Anna Lok. "Replication of hepatitis B virus in Chinese patients with chronic hepatitis B virus infection." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1990. http://hub.hku.hk/bib/B31981392.
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Kidd-Ljunggren, Karin. "Genetic variability in hepatitis B virus." Lund : Depts. of Infectious Diseases and Medical Microbiology, University of Lund, 1995. http://books.google.com/books?id=KDZsAAAAMAAJ.
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Ho, Ka-nung Stephen. "Assay for hepatitis B virus (HBV) DNA in serum : recent advances in methodology and its clinical relevance in renal allograft recipients with HBV infection /." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21161276.
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Lu, Lei, and 呂雷. "Effects of antiviral therapies on hepatitis B virus relicaptive intermediates in chronic hepatitis B." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B42182359.
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Wong, Ka-ho Danny, and 王嘉豪. "Quantitation of hepatitis B virus covalently closed circular DNA in chronic hepatitis B patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B29938855.
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Peres, Alessandro Afonso. "Hepatite B oculta em pacientes transplantados renais." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2004. http://hdl.handle.net/10183/8719.
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Introdução. Hepatite B oculta é caracterizada pela presença do HBV-DNA em pacientes que não expressam o antígeno B de superfície (HBsAg) e é relatada com maior freqüência em pacientes infectados pelo vírus da hepatite C (HCV). Nesse estudo avaliamos a prevalência de hepatite B oculta em transplantados renais infectados ou não pelo HCV e avaliamos a função hepática nos diferentes grupos. Material e métodos. Amostras de soro de 101 pacientes transplantados renais foram avaliadas para testes de função hepática, marcadores sorológicos e reação de polimerização em cadeia (PCR) para o HBV-DNA. Todos os pacientes eram HBsAg negativos e havia 51 pacientes anti- HCV reagentes e 50 pacientes não reagentes. A pesquisa do HBV-DNA foi feita por técnica de PCR aninhado para os genes S e “core”. Resultados. A pesquisa do gene S do HBV-DNA resultou positiva em 2 pacientes, sendo um do grupo anti-HCV reagente e o outro do grupo não reagente. A pesquisa do gene da região do “core” foi positiva em um paciente do grupo anti-HCV não reagente. A análise demonstrou que os pacientes do grupo anti-HCV reagente apresentam maior tempo de tratamento dialítico (50,8 + 34,6 e 32,02 + 20,87; p<0,001). Da mesma forma o grupo anti-HCV reagente apresentou valores mais elevados de aminotransferases: ALT: 34.5 ± 26.7 x 20.9 ± 10.0; (P < 0.001); AST: 31.7 ± 17.7 x 24.9 ± 14.9; (P < 0.05); gama glutamiltranspeptidase : 66.1 ± 82.4 x 33.4 ± 44.6; (P < 0.02) e fosfatase alcalina : 307.9 ± 397.7 x 186.9 ± 63.4; (P< 0.04). Os níveis de ciclosporina sérica também mais elevados também foram encontrados no grupo anti-HCV reagente 170.9 ± 69.8 and 135.0 ± 48.1 respectivamente (P < 0.02). No modelo de análise multivariada evidenciou-se que apenas a presença de infecção pelo HCV é determinante das alterações nas provas de função hepática. Conclusão. Hepatite B oculta foi um achado infreqüente na nossa população de pacientes transplantados renais, não tendo sido encontrada diferença na sua prevalência em pacientes infectados ou não pelo HCV. Pacientes anti-HCV reagentes apresentam alterações significativas das provas de função hepática e dos níveis sangüíneos de ciclosporina.Background: Occult hepatitis B (HB) is characterized by the presence of HBV-DNA in patients who do not present HB surface antigen (HBsAg) detectable in sera. This condition is frequently described in patients with hepatitis C virus (HCV) infection and its clinical implications are uncertain. Since transplant patients were at risk for hepatitis B and/or C infection by blood transfusions, dialysis treatment and the transplant procedure itself we aimed to evaluate the prevalence of occult HB either with or without HCV infection. Patients and Methods: One hundred and one HBsAg negative renal transplant patients were evaluated. Fifty-one were anti-HCV reagents (Elisa III). Sera was analyzed for the presence of the S and core genes of the HBV-DNA by a nested PCR technique. Serological markers of HBV infection, liver function testes and ciclosporine through levels were also analysed. Results: The core gene of the HBV-DNA was identified in one HCV infected patient and in one anti-HCV negative who also presented the S gene (prevalence: 2% and 1% for each gene respectivelly). HCV infected patients presented longer pre-transplant dialysis time (50.8 ± 34.6 versus 32.0 ± 20.9; p<0,001). Results of liver function tests were also increased in the HCV infected group: ALT: 34.5 ± 26.7 x 20.9 ± 10.0; (P < 0.001); AST: 31.7 ± 17.7 x 24.9 ± 14.9; (P < 0.05); GGT: 66.1 ± 82.4 x 33.4 ± 44.6; (P < 0.02) and alkaline phosphatase: 307.9 ± 397.7 x 186.9 ± 63.4; (P< 0.04). Ciclosporine through levels were also significantly higher in HCV infected patients 170.9 ± 69.8 and 135.0 ± 48.1 respectivelly (P < 0.02). Multivariate analysis revealed that only HCV infection was determinant of the increased results of the LFTs. Conclusion: We found that occult hepatitis B is infrequent condition in our population of renal transplant patients and that HCV infection seems not to be a risk factor. In accordance with our previous work HCV we showed that infected renal transplant patients present evidence of liver damage and altered metabolism evidenced by the elevated liver function testes a higher ciclosporine through levels.
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Ciaccia, Maria Celia Cunha. "Aspectos epidemiológicos, sorológicos e moleculares das hepatites A, B e C em crianças e adolescentes matriculados em creches e escolas do ensino infantil e fundamental da rede municipal na cidade de Santos." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-14012013-120337/.
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As hepatites virais continuam sendo uma preocupação em nível de saúde pública no Brasil e no Mundo, tanto pelo número de indivíduos atingidos, como pela possibilidade de complicação das formas agudas e crônicas. Segundo a Organização Mundial de Saúde (OMS), 170 milhões de pessoas são portadoras crônicas de hepatite C e 350 milhões portadoras crônicas de hepatite B. No Brasil, a estimativa de portadores de hepatite B crônica é de aproximadamente 600 mil pessoas e de hepatite C crônica, 1,5 milhão. Quanto à hepatite aguda A foram confirmados no país, em 2010, 5943 casos. O objetivo deste estudo foi conhecer a prevalência de marcadores sorológicos dos vírus das hepatites A, B e C em crianças e adolescentes matriculados em creches e escolas de ensino infantil e fundamental da rede municipal na cidade de Santos; conhecer os aspectos moleculares dos vírus das hepatites B e C, identificando o genótipo dos dois agentes e estudar modo de aquisição nos casos com sorologias positivas. Tratou-se de um estudo transversal realizado no período de 28 de Junho a 14 de Dezembro de 2007 onde foram coletadas 4680 amostras de sangue colhidas através de punção capilar e ao mesmo tempo aplicado um questionário nos familiares das crianças e adolescentes. Os exames sorológicos foram realizados utilizando a técnica de ELISA. O estudo molecular foi realizado pela técnica de reação em cadeia de polimerase \"in House\". A idade da população estudada variou de 7 meses a 18 anos e 1 m. A prevalência geral do anti-HVA IgG reagente foi de 9,7% e desses 74,6% foi anti-HVA IgM reagente. A prevalência de anti-HVA IgG foi maior entre as crianças mais velhas, meninas, aquelas que brincavam em córregos, sem esgoto em sua moradia, de pais com baixa instrução, de baixa renda familiar e aquelas que não eram moradoras da Orla. A prevalência de anti-HVA IgM, não foi diferente entre as diferentes categorias, exceção feita à faixa etária (pico no primeiros anos e posterior queda) e morro e Zona Noroeste foi mais baixa. A prevalência geral do anti-HBc reagente foi de 0,1%, do AgHBs de 0,02% e do anti-HVC foi de 0,02%. Conclui-se que a prevalência geral em crianças dos marcadores sorológicos para hepatites A, B e C na cidade de Santos foi baixa, quando comparada com os dados de literatura. Apesar dos nossos dados confirmarem uma mudança no perfil epidemiológico da hepatite A, as medidas preventivas atuais quanto ao saneamento, grau de instrução, habitação, ainda permanece com uma deficiência em Santos, cidade balneária com o maior porto do Brasil. A vacinação para hepatite B foi altamente eficaz com a baixa prevalência encontrada dos marcadores sorológicos. A utilização do papel de filtro em estudos epidemiológicos para hepatite A foi eficaz. Entretanto para o vírus da hepatite C ainda necessita de estudos comparativos utilizando sangue venoso, uma vez que a prevalência de crianças infectadas com hepatite C foi muito baixa na cidade de Santos.Viral hepatitis are still a concern in the public health level in Brazil and around the Word, due both to the number of affected subjects and the possibility of complication in the acute and chronic forms. According to the World Health organization (WHO), 170 million people are chronic carriers of hepatitis C and 350 million chronic carriers of hepatitis B. In Brasil, the estimate of people with chronic hepatitis B is approximately 600 thousand people and chronic hepatitis C, 1,5 million. It has been confirmed in the country, in 2010, 5943 cases of acute hepatitis A. The The aim of this study was to learn the prevalence of serological markers of hepatitis A, B and C virus in children and teenagers enrolled at the municipal education network in the city of Santos, to learn molecular aspects of hepatitis B and C, identifying the genotype of the two agents and to study the acquisition mode in cases with positive serology. Cross-sectional study carried out over the period from June 28 to December 14, 2007, in which 4680 fingerprick blood samples were collected; at the same time, a survey questionnaire was applied to the family members of the children and teenagers. The serological tests were performed using the ELISA technique. The molecular analysis was performed using the technique of polymerase chain reaction \"in House\". Age of the population studied ranged from 7 months to 18 years and 1 month. . The general prevalence of serological markers anti-HAV IgG reagent was 9.7% and between them 74,7% was anti-HAV IgM reagent. There was higher prevalence among older children, females, those who used to play in streams near their home, the absence of a sewage system in home, parents with low education, low household income and among those who did not live in the seashore. The prevalence of anti-HAV IgM was not different between the categories, except for the age (peak in the early years and subsequent fall) and lower on the Hills and Northweast Zone. The general prevalence of anti-HBc reagent was 0,1%, AgHBs was 0,02% and anti-HCV was 0,02%. It is concluded that, in children, the general prevalence of serological markers for hepatitis A, B and C in the city of Santos was low when compared with literature data. Although our data confirm a change in the epidemiological profile of hepatitis A, the current preventive measures regarding sanitation, education level and housing still remain with a deficiency in Santos, the coastal city with the largest harbor in Brazil. Vaccination for hepatitis B was highly effective because it found a low prevalence of serological markers. The use of filter paper in epidemiological studies for hepatitis A was effective. However for the vírus of hepatitis C still requires comparative studies using venous blood because the prevalence of infected children was very low in the city of Santos.
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Otto, Verena Theresia [Verfasser]. "Monoklonalität Hepatitis B surface Antigen-positiver Leberzellareale bei chronischer Hepatitis-B-Virus-Infektion / Verena Otto." Bonn : Universitäts- und Landesbibliothek Bonn, 2017. http://d-nb.info/1139118781/34.
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Marusawa, Hiroyuki. "Latent hepatitis B virus infection in healthy individuals with antibodies to hepatitis B core antigen." Kyoto University, 2000. http://hdl.handle.net/2433/180879.
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Otto, Verena [Verfasser]. "Monoklonalität Hepatitis B surface Antigen-positiver Leberzellareale bei chronischer Hepatitis-B-Virus-Infektion / Verena Otto." Bonn : Universitäts- und Landesbibliothek Bonn, 2017. http://d-nb.info/1139118781/34.
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Sharma, Aditya. "Cost-effectiveness of Hepatitis A and Hepatitis B Vaccination for Jail Inmates." Yale University, 2008. http://ymtdl.med.yale.edu/theses/available/etd-08272007-114829/.
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Despite evidence that viral hepatitis poses a significant risk to public health, universal vaccination has not yet been implemented. The risk for viral hepatitis infection is particularly high among injection drug users and other individuals who do not attend regular health care visits. Jails provide a structural opportunity to vaccinate these high risk individuals. HAV and HBV vaccines administered on an accelerated three week schedule could dramatically decrease the lifetime risk for contracting viral hepatitis among jail detainees. Assuming that 75% of detainees would accept vaccination, 33% have previous exposure to HAV, 25% have previous exposure to HBV, and independent future healthcare costs were US $317,000, the US health care system would save $12 per individual with a vaccinate upon entry program in comparison to no intervention. This savings translates into an economic benefit amounting to about US$ 5,000,000 saved if all new jail inmates in a given year were immunized. A vaccination upon entry program for HAV/HBV in jails should be widely implemented with coordination between the corrections system and public health agencies to reduce the growing cost of viral hepatitis infection.
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Lo, Kin-hang Ken. "Relationship of serological markers, basic core promoter and precore mutations to genotypes of Hepatitis B virus." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43781287.
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Fung, Tak-kwan James. "Development of anti-HBs in patients with chronic hepatitis B after liver transplantation using lamivudine prophylaxis the possible role of adoptive immunity transfer /." Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B31980934.
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Seto, Wai-kay Walter, and 司徒偉基. "Virologic and serologic kinetics in the natural history and treatment of chronic hepatitis B." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48671071.
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This thesis investigated how virologic and serologic kinetics of the hepatitis B virus (HBV) could influence the natural history and treatment of chronic hepatitis B (CHB). Virologic kinetics were described in the first five studies, with serologic kinetics being described in the next five.
The first study delineated the HBV DNA profiles of 1,400 treatment-naive Asian CHB patients. Increasing viremia was noted with increasing age, highlighting the large therapeutic demand in Asian patients with hepatitis B e antigen (HBeAg)-negative CHB. The second study analyzed the association between viral load and liver histology in 319 patients, showing HBV DNA levels to have strong association with HBeAg-negative disease severity.
The next three studies investigated the efficacy of baseline and on-treatment HBV DNA levels in predicting clinical outcomes in 117, 165 and 222 patients on telbivudine, lamivudine plus adefovir and entecavir respectively. Absolute on-treatment HBV DNA levels at week 12 or 24 predicted favorable outcome with telbivudine and lamivudine / adefovir therapy, while excellent viremic suppression with very low rate of resistance development was shown in the entecavir study.
The following three studies examined the role of serum HBsAg measurements in different disease phases of CHB. First, histology specimens of 140 HBeAg-positive patients were analyzed together with HBsAg levels. High HBsAg titers (>25,000 IU/mL) were found to be predictive of insignificant fibrosis. In the next study involving 300 treatment-naive HBeAg-negative patients stratified by their viral loads, combination of low HBsAg and HBV DNA levels predicted significant HBsAg decline. This is followed by a study comparing HBsAg levels of 203 CHB patients achieving HBsAg seroclearance with 203 age- and sex-matched controls over a 3-year period. Serum HBsAg <200 IU/mL and a significant annual HBsAg reduction were found to be predictive of HBsAg seroclearance.
The penultimate study investigated the usage of two novel HBV serologic markers, linearized HBsAg and hepatitis B core-related antigen, in 329 CHB patients achieving HBsAg seroclearance with a conventional HBsAg assay. More than 40% of patients had seropositivity to one or both serologic tests. Finally, the last study of this thesis investigated and compared the changes in serum HBsAg, intrahepatic HBV DNA and covalently closed circular DNA (cccDNA) after 1 year of nucleoside analogue therapy. Minimal changes in both serum HBsAg and intrahepatic cccDNA were noted after 1 year of therapy, but in patients with a significant decline in serum HBsAg levels, there was a corresponding significant reduction in cccDNA.
This series of studies illustrated how the monitoring of serum HBV DNA and HBsAg levels could assist in optimizing management strategies for CHB.published_or_final_version
Medicine
Master
Doctor of Medicine
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Bangera, Sudhakar Sheena. "Review of hepatitis B treatment : in practice and in development /." Thesis, Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk/hkuto/record.jsp?B24873147.
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Williams, Stephen John. "Chronic hepatitis B virus infection : prevention and treatment." Thesis, The University of Sydney, 1989. https://hdl.handle.net/2123/26390.
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Hepatitis B virus (HBV) infection is an increasing public health problem in Australia particularly in certain 'high-risk' subgroups of the population. In order to establish cost-effective screening and vaccination programs directed towards the control and possible eradication of HBV infection, accurate information is needed about the modes of spread and the numbers of "at risk" individuals in particular community subgroups. In addition, treatment strategies must be developed for established HBV carriers since at least 35% of such individuals will die directly related to complications of the disease. This Thesis is the compilation of a series of investigations into familial transmission of chronic HBV infection, the efficacy of alpha interferon treatment of chronic active hepatitis (CAH) B and the effects of such treatment on hepatic drug metabolism. The results have important implications for prevention of HBV infection by screening and vaccination programs, for the selection of patients for inclusion in treatment trials and for the methods by which such treatments can be monitored for responses, and they provide new information about clinically-relevant effects of interferon treatment on the metabolism of other drugs.
An overview of the virology of hepatitis B virus (HBV), the biology of HBV infection and the resultant disease states is presented in Chapter 1.
In Chapter 2, a prospective study examining the incidence of and factors determining intrafamily HBV transmission in a mixed Caucasian and Asian population is presented. Household contacts of both Asian and Caucasian HBV carriers were clearly demonstrated as being at high-risk for HBV infection. Several factors were identified to be associated with a higher rate of transmission of HBV infection within families; namely, if the index case was Asian rather than Caucasian, had an HBsAg-positive mother rather than an HBsAg-positive father, was HBeAg-positive rather than HBeAg-negative , and had chronic rather than acute HBV infection.
In Chapter 3, the first Australian study of alpha interferon (rIFN-aA) in the treatment of CAH-B is reported. While rlFN-aA was demonstrated to have inhibitory effects on HBV replication, the overall response rate was disappointing and not significantly different from the spontaneous seroconversion rate observed in the control group. A major goal of the present study was to establish whether serological changes of HBV infection, that could be induced by interferon, were associated with changes in hepatic function or affected the natural history of this otherwise progressive chronic liver disease. The results provide an important contribution to new knowledge in that although sustained HBV serological improvement was obtained in only 35% of treated patients, this change in the biological state of the virus-host interaction provided a beneficial change in the natural history of chronic liver disease as assessed clinically, biochemically and by direct morphologic examination. In addition, the results presented in Chapter 4 have a novel bearing on whether changes in chronic hepatitis B disease activity improve hepatic metabolic function. Sequential determinations of a simplified 2 point antipyrine clearance (CLAP) test indicated that HBeAg seroconversion was associated consistently with a quantitatively important increase in CLAp while reactivation led to a deterioration in hepatic metabolic function as indicated by the CLAp test. In addition, the CLAp test was a more sensitive and specific indicator of hepatic metabolic function compared to more conventional tests of liver function (serum albumin and bilirubin concentrations, and prothrombin time).
Part C describes studies in which the effects of interferon on hepatic drug metabolism have been examined. In human studies in vivo, antipyrine and theophylline were employed as substrates for the cytochrome P-450dependent mixed function oxidase system. The study described in Chapter 6 provides the first direct evidence that interferon inhibits hepatic drug metabolism in humans; a significant reduction in antipyrine clearance was demonstrated following a single intramuscular injection of interferon. In Chapter 7 the clinical relevance of the observed effect of interferon on antipyrine metabolism was confirmed by the demonstration that interferon also impairs theophylline elimination. This demonstrated one of the most profound therapy-induced inhibitions of drug metabolism yet observed in man. In addition, the effect of interferon on hepatic drug metabolism appears to be relatively selective for some cytochrome P-450 isozymes, specifically that concerned with N-demethylation of theophylline.
The mechanism for the interferon-mediated impairment of hepatic oxidative drug metabolism observed in the human in vivo studies was then explored by experiments in animals. The isolated perfused rat liver model was utilized to study effects on the intact liver, while hepatic microsomal androstenedione hydroxylation pathways were measured as a probe to assess interferon effects on individual cytochrome P-450 isozymes. The results demonstrated that the effect of IFN on drug metabolism is, at least in rats, species specific. Moreover, the reduction in total hepatic P-450 content produced by lFN appeared to result from a generalized lowering of P-450 isozymes rather than being specific for individual forms. The apparent discrepancy between these findings and the observation in humans that human rlFN-ocA depressed the P-450 isozyme(s) responsible for the Ndemethylation pathway of theophylline metabolism to a greater degree than the 8-hydroxylation pathway may be due to species differences or to the specific types of interferon studied. In any event it is likely that the clearance of many other xenobiotics as well as endogenous substances metabolized by P-450 may be impaired by interferon and future studies should be directed towards examining the effects of interferons on other such clinically-relevant compounds. Moreover, the results of the present study indicate that lFN-treated rats should be a good model with which to obtain clearance data for such compounds.
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Machiya, Tichaona. "Knowledge, attitudes and practices of healthcare workers at the Princess Marina Hospital in Botswana, regarding hepatitis B prevention and control." Thesis, University of Limpopo (Medunsa Campus), 2011. http://hdl.handle.net/10386/457.
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Thesis (MPH))University of Limpopo (Medunsa Campus), 2011.Introduction: Hepatitis B virus (HBV) is a highly infectious virus responsible for considerable morbidity and mortality world wide. Chronic HBV carriers can transmit HBV parenterally in a hospital setting putting healthcare workers (HCWs) and their patients at risk of infection. Aim and objectives: This study aimed to investigate knowledge, attitudes and practices towards prevention and control of HBV amongst nurses, doctors and laboratory personnel. Objectives were to determine: (a) the knowledge; (b) the attitudes; (c) the practices of nurses, doctors and laboratory personnel; (d) if there are any associations between (1) knowledge and practice, and (2) attitudes and practice; (e) the predictors of HBV vaccination uptake. Materials and Methods: This was a cross-sectional descriptive study. Self-administered questionnaires were distributed to doctors, laboratory staff and nurses at Princess Marina Hospital. Results: Two hundred questionnaires were distributed and a total of 117 were returned, giving an overall response rate of 58.5%. More doctors had good knowledge (38.9% [7/18]), followed by 20% (4/20) of laboratory staff and 11.4% (9/79) of nurses. Most staff (100% [20/20] of laboratory staff; 97.5% [77/79] of nurses; 94.4% [17/18] of doctors) had positive attitudes. More laboratory staff (100 [20/20]) displayed good practices, followed by nurses (94.9% [75/79]); and lastly doctors (88.9% [16/18]). There were no significant associations between knowledge or attitudes and practices. Vaccination was inadequate, with 50.9% (59/116) of HCWs having received at least one dose, and of these only 61% (36/59) receiving all 3 doses. Needle stick injuries occurred in 31.6% (37/117), while 33.9% (39/115) reported blood or body fluid splashes. None of the HCWs accessed PEP after exposure. Being a laboratory worker (OR: 148.4) or doctor (OR: 125.7) were the only predictors of vaccination uptake. Conclusion: There is need to increase knowledge of HCWs, vaccination availability, vaccination uptake, PEP, and reduce the exposures of HCWs.
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Neto, Gaspar Lisboa. "Influência da infecção pregressa pelo vírus da hepatite B em portadores de hepatite C crônica: análise histológica." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5134/tde-02072009-095040/.
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INTRODUÇÃO: Os vírus das hepatites B (VHB) e C (VHC) são os principais causadores de hepatopatia crônica em todo mundo. Ambos compartilham vias semelhantes de transmissão. Em pacientes portadores crônicos de VHC com sorologia compatível com infecção pregressa pelo VHB (anti-HBcAg[+] e HBsAg [-]), o VHB DNA residual tem sido detectado por técnicas de biologia molecular altamente sensíveis no soro, em células linfomononucleares de sangue periférico e em hepatócitos (como cccDNA), de forma que o anti-HBcAg tem sido associado a pior prognóstico, tanto histológico quanto terapêutico. OBJETIVOS: Analisar a associação entre infecção pregressa pelo VHB nos portadores crônicos do VHC e o dano histológico hepático, além das características epidemiológicas, clínicas e laboratoriais destes pacientes em região de baixa prevalência para o VHB. MÉTODOS: A prevalência do anti-HBcAg foi avaliada em 574 pacientes portadores crônicos de VHC atendidos durante o ano de 2006 no ambulatório de Hepatites Virais do DMIP-HC FMUSP. Deste grupo, foram selecionados 215 pacientes (98 de 112 com anti-HBcAg[+] e 117 de 462 monoinfectados pelo VHC) para análise comparativa. Ainda, 145 indivíduos foram submetidos à análise estatística multivariada, por metodologia de Regressão Logística sequencial, para identificação de possíveis preditores de fibrose avançada. RESULTADOS: Foram avaliados 98 pacientes com marcadores sorológicos de infecção pregressa pelo VHB. Quarenta e seis indivíduos (47%) possuíam o anti-HBcAg de forma isolada. O principal fator de risco relacionado à infecção viral foi hemotransfusão (31,6%). Contudo, a freqüência de UDI foi maior no grupo com infecção pregressa pelo VHB, em relação aos 117 indivíduos monoinfectados pelo VHC (p<0,05). Não houve diferença estatisticamente significativa quanto ao estadiamento (p=0,40) ou à graduação necroinflamatória histológica (APP, p=0,70) entre esses dois grupos. O tempo de infecção e a taxa de progressão de fibrose também foram semelhantes (p=0,99 e p=0,61, respectivamente). A presença do anti-HBcAg não foi considerada preditora de fibrose hepática avançada (p=0,11), porém identificamos como variáveis independentes o tabagismo acentuado (OR 4,40; IC95%: 1,30-14,87), aumento da ALT (OR 1,01; IC95%: 1,00-1,03), de gamagt (OR 1,01; IC95%: 1,00-1,01) e leucopenia (OR 7,75; IC95%: 2,13-28,23). CONCLUSÃO: A prevalência de infecção pregressa pelo VHB em portadores de infecção crônica pelo VHC foi de 20%, sendo este valor compatível com outros estudos realizados em regiões de endemicidade semelhante. A freqüência do marcador anti-HBcAg isolado foi alta neste grupo, refletindo uma possível supressão da imunidade humoral contra o VHB frente a resposta dirigida ao VHC. A infecção pregressa pelo VHB não parece acentuar ou acelerar o dano histológico hepático no nosso meio.INTRODUCTION: Hepatitis B (HBV) and C (HCV) virus are the main causers of chronic hepatic disease worldwide. Both viruses share similar transmission routes. In chronic HCV infected patients with serological markers of resolved HBV infection (anti-HBcAg [+] and HBsAg [-]), residual HBV-DNA has been detected through highly sensible techniques in serum, PBMC and hepatocytes (as cccDNA). In fact, anti-HBcAg has been associated with worse prognoses, severe histological liver damage and less sustained virological response to HCV treatment. OBJECTIVE: Assess the relationship between previous HBV infection (anti-HBcAg [+]; HBsAg [-]) in patients with chronic hepatitis C (HCV) and histological damage, considering epidemiological, clinical and laboratorial characteristics of this group in a region of low prevalence for HBV. METHODS: Anti-HBcAg prevalence was evaluated in 574 patients seen during a period of one year in a tertiary center (University of Sao Paulo General Hospital, Sao Paulo, Brazil). Of this group, 215 subjects addressed selection criteria and have been selected for evaluation (98 of 112 carriers of anti-HBcAg and 117 of 462 infected only by HCV). 145 individuals have undergone analysis for identification of predictors of advanced fibrosis through univariate and multivariate stepwise logistic regression. RESULTS: Nineteen-eight subjects with serological markers of previous HBV infection were evaluated. Forty-six (47%) patients had anti-HBcAg in isolated form. The main risk factor for infection was blood transfusion (31,6%). However, the IDU frequency was greater in this group (p<0.05). There was no difference regarding histological staging (fibrosis ranging from 0 to 4, p=0.40) or grading (portal inflammation, p=0.70) compared with subjects infected only by HCV with no markers of HBV infection. The rate of fibrosis progression (in units per year) and the infection length was similar in these two groups (p=0,61 and p=0,99, respectively). Anti-HBcAg was not considered a predictor for advanced fibrosis (p=0.11). However, we identified tobacco smoking (OR 4.40; CI 95%: 1.30-14.87), increased ALT (OR 1.01; CI 95%: 1.00-1.03), increased -gt (OR 1.01; CI 95%: 1.00-1.01) and leucopenia (OR 7.75; CI 95%: 2.13-28.23) as independent variables. CONCLUSION: The prevalence of resolved HBV infection in subjects with chronic hepatitis C was 20%. This result was equivalent to other studies carried out in regions of similar endemicity. The frequency of the isolated anti-HBcAg was higher in this group, reflecting a possible suppression of the humoral immunity against HBV caused by an active immune response directed to HCV. Former and resolved HBV infection does not seem to increase or accelerate histological damage in our geographical area.
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Oliveira, Célia Figueiredo de. "Detecção de marcadores sorológicos para hepatite A, B e C associados ao perfil epidemiológico em uma população de estudantes universitários no interior de São Paulo-SP." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311371.
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Orientadores: Neiva Sellan Lopes Gonçales, Fernando Lopes Gonçales JúniorDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: As hepatites virais constituem um importante problema de saúde pública. São doenças provocadas por agente etiológicos com tropismo primário pelo tecido hepático com características epidemiológicas, clínicas e laboratoriais semelhantes com importantes particularidades. O objetivo desta pesquisa foi determinar a prevalência das hepatites A, B e C em estudantes universitários utilizando marcadores sorológicos. Avaliar seus fatores de risco, o nível de conhecimento dos estudantes sobre as vias de transmissão e prevenção e caracterizar a proteção vacinal pelo marcador anti-HBs. O estudo foi realizado em 685 estudantes universitários. Foi aplicado um questionário para avaliar os aspectos sócio-econômicos, epidemiológicos e laboratoriais dos estudantes quanto às hepatites A, B e C. Foi coletado sangue para análise dos marcadores sorológicos anti-HBc, anti-HBs, HBsAg, Anti-HCV, anti-VHA IgG. A prevalência da hepatite A foi de 19,5%, da hepatite B 1,17% e da hepatite C 0,15%. O marcador sorológico anti-HBs com títulos superiores a 10mUI/ml, o qual confere soroproteção, estava presente em 61,2% dos universitários. A análise dos questionários mostrou que os fatores de risco relevantes entre a população estudada foram: o contato com material biológico em atividades laboratoriais (45,1%), com pacientes (38,6%), acupuntura (14,8%), tatuagem (13,5%), droga inalatória (8,09%) e droga injetável (0,73%). Quanto ao comportamento sexual, 71,5% já tiveram de 1 a 3 relacionamentos regulares e 42,9% usavam preservativos e 7,7% nunca fizeram uso. Dos estudantes universitários analisados, 88,7% relataram ter conhecimento das vias de transmissão e prevenção das hepatites. A análise dos dados mostra que é de extrema importância quando os estudantes universitários iniciam sua jornada acadêmica, independente do curso ser da área da saúde deveriam ser vacinados (vacina para VHA e VHB) uma vez que se trata de uma população exposta aos fatores de risco para aquisição de hepatites. Seria interessante incluir no calendário escolar, palestras que possibilite sempre a atualização sobre o conhecimento das hepatites principalmente sobre transmissão parenteral e sexual, da prevenção, da importância do conhecimento do seu status vacinal
Abstract: The objective this study was to determinate the prevalence of the hepatitis A, B and C among graduate students using serological markers. To evaluate their risk factors, the knowledgement level of the students about the transmission pathways and prevention and to characterize the vaccine-related protection by the anti-Hbs marker. Six hundred eighty five graduate students were enrolled in this study. The students were submitted to enquiry about to evaluate the socio economic, epidemiological and laboratorial aspects of the students concerning hepatitis A, B and C. Peripheral blood was collected from students to perform the following serological marker: anti-HBc, anti-HBs, HBsAg, anti-HCV and HAV IgG. The prevalence of hepatitis A was 19.5%, hepatitis B was 1.17% and hepatitis C was 0.15%. The anti-HBs marker with titles higher than 10 mUI/mL which is consistent with protection was present in 61.2% of the students. The analysis of enquires showed that the relevant risk factors among the studied cohort were: contact to biological materials during laboratorial proceedings (45.1%), contact to patients (38.6%), acupuncture (14.8%), tattoo (13.5%), inhalatory drug (8.09%) and injectable drugs (0.73%). Whereas sexual practices, 71.5% already had from 1 to 3 regular relationship, 42.9% of them used condom and 7.7% had never used. Among the students enrolled in this study, 88.7% reported to have knowledge about the transmission pathways and prevention of the hepatitis. The data analysis showed that is extremely important to the students to have access to lectures concerning general knowledge about hepatitis and about pathways of transmission, prevention and about the importance of vaccine-related prophylaxis. Access to that lectures should begin when the students start their academic journey, independently if the course is or not included among health courses. In addition, vaccination should be included in their academic programming
Mestrado
Ciencias Basicas
Mestre em Clinica Medica
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Yuen, Man-fung. "Role of hepatitis B virus genotypes B and C on chronic liver disease in the Chinese." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B33710089.
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Malinga, Lesibana Anthony. "Molecular characterization of the hepatitis B virus X gene." Thesis, University of Limpopo ( Medunsa Campus ), 2010. http://hdl.handle.net/10386/417.
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Thesis ( M Med (Virological Pathology))--University of Limpopo, 2010.Introduction: Hepatitis B virus (HBV) is a serious problem worldwide causing various liver diseases such as chronic hepatitis and hepatocellular carcinoma (HCC). The pathogenesis of HBV related HCC is not well established. Hepatitis B X protein (HBx) plays an important role in the pathogenesis of HCC. HBx coded by HBV X gene enhances several cellular pathways in hepatocytes which may lead to HCC. The genetic variability of other HBV genomic regions plays a significant role in diagnosis, vaccine development and drug resistance. However, the genetic variability of HBV X gene is not well understood. In addition the dual basal core promoter mutations found within the X gene have been implicated in the inhibition of hepatitis B e antigen (HBeAg) expression. Studies focusing on HBV X gene are scarce in South Africa. Consequently HBV X gene variability may reveal interesting mutations and substitutions that are important in chronic liver diseases or HCC. This study aimed at characterising HBV X gene at a molecular level isolated from patients with different serological profiles. Methods: This was an exploratory study which used 20 stored sera (-70°C) collected from adult patients at Dr George Mukhari hospital, Pretoria. The samples were already tested for HBsAg, anti-HBs, anti-HBc and HBeAg serological markers (Elecsys, Roche Diagnostics, Penzburg, Germany). HBV DNA extraction was performed from serum using High Pure Viral Nucleic Acid Assay (Roche Diagnostics, Penzburg, Germany). Nested PCR assay was used for the amplification of 465 nucleotide HBV X gene. Sequencing of PCR positive samples was done using spectruMedix SCE2410 genetic analysis system. Six samples selected, were cloned into the pGEM®-T Easy vector system (Promega, Madison, USA). Three clones of each sample were selected and their plasmids purified using Pure Yield™ Plasmid Miniprep System (Promega, Madison, USA). The plasmid DNA was recovered using optimised nested PCR assay and sequenced. A total of 38 sequences were generated from the study and compared with reference strains retrieved from GenBank. Phylogenetic analysis based on HBV X gene sequences was done using MEGA 4 software to determine different genotype clusters. vi Results: HBV X gene was successfully detected and amplified in 20 study samples. The sequenced HBV X gene products revealed mutations and insertions. Particularly a six nucleotide insertion, GCATGG between nucleotides 1611 and 1618 which was detected in five samples. In addition, the six cloned samples confirmed the six nucleotide insertion and other mutations associated with inhibition of hepatitis B e antigen (HBeAg) detected in the study. The substitutions within HBx were detected in the N (1-50 amino acids) and C (51-154) terminals by comparing our sequences with archival sequences from GenBank. Important substitutions found within the N and C terminals were S31A, P38S, A42P, F73L, H94Y, P101S, K118T, D119N, I127T/N, K130M and V131I. These substitutions are associated with various biological functions and pathogenesis. Other substitutions with unknown functions detected in the study include A2G, A3G, A4G, C6W, P42S and V116L. Further mutations of T1753M, A1762T and G1764A associated with inhibition of HBeAg expression were detected in most samples and only one sample had C1766T mutation. Phylogenetic analysis resulted in A, C and D HBV genotypes. Five samples and 11 clones clustered with genotype D, two samples and four clones clustered with genotype C and finally 13 samples and 3 clones clustered with genotype A. Conclusion: HBV X gene was successfully characterised using various molecular methods. HBx substitutions detected are involved in various pathogenic effects and may present a risk of HCC for patients infected with HBV. Genotype D samples displayed most mutations/substitutions and this can be regarded as an important genotype with high risk of HCC. The detection of a six nucleotide insertion (GCATGG) in 5 samples may emerge as a new variant of genotype D. Furthermore triple mutations of T1753M/A1762T/G1764A within basal core promoter region were detected mostly in HBeAg negative samples. However further analysis of HBV X gene variability is needed.
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Brandão, Natália Alberto Alves. "Prevalência e fatores associados às infecções pelos vírus das hepatites B e C em pacientes HIV positivos, atendidos na rede pública de Goiânia - Goiás." Universidade Federal de Goiás, 2013. http://repositorio.bc.ufg.br/tede/handle/tede/3534.
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Hepatitis B and C viruses are responsible for the most common chronic viral infections worldwide. The prevalence of these viruses is higher among HIV-infected individuals, due to common route of transmission. Coinfections HBV / HIV and HCV / HIV seems to be associated with a worst liver disease prognosis. Studies evaluating these coinfections in the mid-western Brazil are scarce. Objectives: To estimate the prevalence and the risk factors associated with HBV and HCV coinfections in HIV-positive patients in Goiânia – Goiás. Methods: A cross-sectional study was conducted including 495 adults, recruited from the Centro de Referência em Diagnóstico e Terapêutica de Goiânia in 2011. After signing the informed consent, participants were interviewed and material was collected for research markers for HBV (anti-HBc, HBsAg, anti-HBs and HBV DNA) and HCV (anti-HCV and HCV RNA). Prevalence of HBV and HCV infection was estimated. Univariate and multivariate analysis to evaluate factors associated with positivity for both viruses were performed. Odds and adjusted odds ratios were calculated with 95% confidence intervals (CI95%) and a significance level of p<0.05. Results: Participants mean age was 40.2 years (standard deviation =10. 4) with a male predominance (73.9%). Injecting drugs usage was reported by 3.6% of participants. The prevalence of markers for hepatitis B exposure was 33.5% (CI95% 29.4-37.9). Nineteen patients (3.8%, CI95% 2.4-6.0) were diagnosed as hepatitis B carriers. Prevalence of anti-HCV was 9.7% (CI95% 7.3-12.7). The distribution of HCV genotypes was: 1a (72.7%), 3 (13.6%) and 1b (9.1%). Coinfection by the three viruses was 4.4% (CI95% 2.9-6.8). Male, age ≥ 40 years, previous history of sexually transmitted disease (STD) and homo or bisexuality were associated with exposure to HBV. History of injecting drugs and STD were associated with HCV seropositivity. Over half of the coinfected patients were not aware of being HBV or HCV positive. Conclusion: Seromarkers for previous HBV and/or HCV infections are common among individual HIV positives in Goiânia. A significant proportion of them are unaware of their serological status. These findings suggest the need for better screening and guidance improvements for this population
Os vírus das hepatites B (HBV) e C (HCV) são responsáveis pelas infecções crônicas virais mais comuns em todo o mundo. A prevalência dessas infecções é maior entre indivíduos infectados pelo HIV, devido às vias comuns de transmissão desses vírus. As coinfecções HBV/HIV e HCV/HIV parecem estar associadas a um pior prognóstico da doença hepática. Estudos avaliando essas coinfecções, na região centro-oeste do Brasil, são escassos. Objetivos: Estimar a prevalência e analisar fatores sócio-demográficos e comportamentais associados às infecções pelo HBV e HCV em pacientes HIV positivos. Métodos: Estudo transversal, com inclusão de 495 pacientes adultos, recrutados no Centro de Referência em Diagnóstico e Terapêutica de Goiânia, em 2011. Após assinatura do termo de consentimento livre e esclarecido, os participantes foram entrevistados e coletouse material para pesquisa de marcadores para o HBV (anti-HBc, HBsAg, anti-HBs e HBV DNA) e HCV (anti-HCV e HCV RNA). Estimou-se a prevalência das infecções pelo HBV e HCV. Foi realizada análise uni e multivariada para avaliar fatores associados com a positividade para os dois vírus. Foram calculados os Odds Ratios brutos e ajustados com respectivos intervalos de 95% de confiança (IC95%) e nível de significância de p<0,05. Resultados: A média de idade dos participantes foi de 40,2 anos (desvio padrão=10,4), com predomínio de homens (73,9%). O relato de uso de drogas injetáveis foi feito por 3,6% dos participantes. A prevalência de exposição ao vírus da hepatite B foi de 33,5% (IC95% 29,4-37,9). Dezenove pacientes (3,8%, IC95% 2,4-6,0) foram diagnosticados como portadores do vírus da hepatite B. A prevalência de anti-HCV foi 9,7% (IC95% 7,312,7). A distribuição dos genótipos do HCV nessa população foi: 1a (72,7%), 3 (13,6%) e 1b (9,1%). A coinfecção pelos três vírus foi de 4,4% (IC95% 2,9-6,8). Sexo masculino, idade ≥ 40 anos, relato de doença sexualmente transmissível (DST) e homo ou bissexualismo mostraram-se associados à presença de marcadores de exposição ao HBV. Antecedentes de drogas injetáveis e DST mostraram associação com soropositividade para HCV. Cerca da metade dos pacientes coinfectados não sabia ser HBV ou HCV positivos. Conclusões: Marcadores de exposição prévia ao HBV e ao HCV são frequentes entre os pacientes HIV positivos, em Goiânia. Uma parcela significativa dessa população desconhece seu status sorológico, sugerindo a necessidade de medidas de triagem e de orientação mais efetivas.
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Erup, Louise, Alice Lettius, and Elisabeth Mollberg. "Sjuksköterskans bemötande till patienter med hepatit B och hepatit C : En litteraturstudie." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-41342.
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Bakgrund: Hepatit B och hepatit C räknas i dag som de största infektionssjukdomarna i världen med dödlig utgång. Sjukdomarna rapporteras som en världsomfattande börda och mellan år 2018 och 2019 uppgavs 1,9 miljoner människor avlidit. I omvårdnadsarbetet ska sjuksköterskan värna om patienten och arbeta personcentrerat, visa respekt och inte kränka patienten. Patienter med hepatit B och C har uttryckt sig känna av stigmatisering och förutfattade meningar om hur de smittats, de kände även av att bemötandet i omvårdnaden kunde påverkas negativt. Syftet med litteraturstudien var att utforska sjuksköterskors bemötande till patienter med hepatit B och C. Metoden utgick från en allmän litteraturstudie där 13 vetenskapliga artiklar presenterade resultat på hur sjuksköterskor bemöter patienter med blodsmitta. Resultatet visade att sjuksköterskor bemöter patienter med hepatit B och C olika med både positiva och negativa attityder. Det fanns signifikanta samband mellan låg kunskap och ett sämre bemötande. Det berodde bland annat på rädsla och förutfattade meningar som speglades i omvårdnadsarbetet. Det fanns även signifikanta samband mellan korrekt tillämpning i basala hygienrutiner och ett tryggt omvårdnadsarbete för sjuksköterskan. Konklusion: Bemötandet till patienter med hepatit B och C var övergripande positivt men det förekom sjuksköterskor med ett stigmatiserande synsätt och motvillighet till att bemöta dessa patienter.Background: Hepatitis B and C are currently considered to be the largest infectious diseases with lethal repercussions. The diseases are considered a worldwide burden, which between 2018 and 2019, caused the death of an estimated 1,9 million people. In nursing, nurses are meant to shield patients, work on a personal basis with them, show the respect and not offend them. Patients with hepatitis B and C have expressed a feeling of stigmatization and prejudice towards how they were infected. Therefore, they feel their care could be affected in a negative way. The aim of this literature study was to explore nurses’ attitudes towards patients with hepatitis B and C. The method emanated from a literature study where 13 scientific articles showed results for how nurses’ attitudes towards patients with blood diseases varies. The results showed that nurses’ attitudes towards patient infected with hepatitis B and C can be both positive and negative. Statistically significant associations occurred between a lack of knowledge and worsened attitude in nursing, the reason was often because of fear and preconceptions. Findings showed a relation between using correct safe precautions and confidence in nursing. Conclusion: The attitude towards patients with hepatitis B and C was positive over all but there were some nurses with a stigmatized perception and reluctance to handle those patients.
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Lau, Chi Chiu. "Hepatitis B virus and single nucleotide polymorphisms." HKBU Institutional Repository, 2007. http://repository.hkbu.edu.hk/etd_ra/810.
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Kantelhardt, Vera Christin [Verfasser]. "Reevaluation Hepatitis B Core Antikörper negativer Serumproben von Patienten mit chronischer Hepatitis B / Vera Christin Kantelhardt." Gießen : Universitätsbibliothek, 2011. http://d-nb.info/1061195384/34.
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Silva, Leandro Nascimento da. "Prevalência da infecção pelo vírus da hepatite B e situação vacinal em usuários de crack institucionalizados em Goiânia – Goiás." Universidade Federal de Goiás, 2014. http://repositorio.bc.ufg.br/tede/handle/tede/4111.
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license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-02-05T14:16:04Z (GMT) No. of bitstreams: 2 Dissertação - Leandro Nascimento da Silva - 2014.pdf: 6086146 bytes, checksum: 75f020e70d97640ac095871c4913b275 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)
Made available in DSpace on 2015-02-05T14:16:04Z (GMT). No. of bitstreams: 2 Dissertação - Leandro Nascimento da Silva - 2014.pdf: 6086146 bytes, checksum: 75f020e70d97640ac095871c4913b275 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-09-09
Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq
Crack is considered a public health problem in Brazil and in the world because of its impact on social relationships, physical and mental integrity of the user, and the risk associated with infections, such as those caused by the hepatitis B virus (HBV). This study investigated the epidemiology of infection with the hepatitis B virus and immunization status among users of crack institutionalized in Goiania, Brazil. During August 2012 to April 2013, a total of 600 individuals were interviewed, and blood samples collected for the detection of serological markers of HBV (HBsAg, total anti HBc and anti-HBs) by enzyme-linked immune sorbent assay (ELISA). Subsequently a cohort of individuals susceptible to hepatitis B was formed to assess compliance, completion of the vaccination series, and vaccine response against hepatitis B, using an accelerated scheme. Prior exposure to HBV (anti-HBc) was 7.0% (95% CI: 5.22 to 9.32), and 17.7% (95% CI: 14.8 to 20.9) were anti -HBs isolated, suggesting previous vaccination against hepatitis B. The use of crack cocaine through improvised pipes, history of sexually transmitted disease, and exchanging sex for drugs or money were significantly associated with exposure to HBV (p < 0.05). Of the total of individuals who received the first dose of hepatitis B vaccine and eligible to complete the full vaccine scheme (n = 406), 229 (56.4%) and 96 (26.6%) received the second and third doses, respectively. It was possible to evaluate the vaccine response in only 23/96 subjects, and 78% responded with protective titers. The high frequency of risk behaviors, the low frequency of vaccinations, and improper compliance with the vaccination schedule, even using the accelerated scheme, highlights the need for strategies for health education and prevention to reach this population so vulnerable to sexually transmitted infections and parenteral transmission of hepatitis B.
O crack é considerado um problema de saúde pública no Brasil e no mundo devido ao seu impacto nas relações sociais, na integridade física e mental do usuário e no risco associado às infecções, como a causada pelo vírus da hepatite B (HBV). Este estudo investigou a epidemiologia da infecção pelo vírus da Hepatite B e situação vacinal em usuários de crack institucionalizados em Goiânia – Goiás. Durante agosto de 2012 a abril de 2013 um total de 600 indivíduos foram entrevistados e amostras sanguíneas coletadas para detecção dos marcadores sorológicos do HBV (HBsAg, anti-HBc total e anti-HBs) pelo ensaio imunoenzimático (ELISA). Posteriormente foi formada uma coorte de indivíduos suscetíveis a hepatite B para avaliação da adesão, completude do esquema e resposta vacinal contra hepatite B, utilizando-se um esquema super acelerado. A exposição prévia ao HBV (anti-HBc) foi de 7,0% (IC 95%: 5,22-9,32), e 17,7% (IC 95%: 14,8-20,9) apresentaram positividade isolada para o anti-HBs, sugerindo vacinação prévia contra hepatite B. O consumo de crack por meio de lata improvisada como cachimbo, história de doença sexualmente transmissível e troca de sexo por droga ou dinheiro foram significativamente associados à exposição ao HBV (p< 0,05). Do total de indivíduos que recebeu a primeira dose da vacina contra hepatite B e elegíveis para completar o esquema (n=406), 229 (56,4%) e 96 (26,6%) receberam a segunda e terceira doses, respectivamente. Em somente 23/96 indivíduos foi possível avaliar a resposta vacinal, sendo que 78% responderam com títulos protetores. A frequência elevada de comportamentos de risco, a baixa frequência de indivíduos vacinados e adesão ao esquema vacinal, mesmo com esquema super acelerado, evidencia a necessidade de estratégias de educação em saúde e prevenção que alcancem essa população vulnerável as doenças de transmissão sexual e parenteral como a hepatite B.
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Carvalho, Paulie Marcelly Ribeiro dos Santos. "Epidemiologia da hepatite B em indivíduos em situação de rua abrigados em casa de passagem de Goiânia, Goiás." Universidade Federal de Goiás, 2016. http://repositorio.bc.ufg.br/tede/handle/tede/6114.
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Made available in DSpace on 2016-09-05T13:19:07Z (GMT). No. of bitstreams: 2 Dissertação - Paulie Marcelly Ribeiro dos Santos Carvalho - 2016.pdf: 5626599 bytes, checksum: 9af96621473e8d99237c7811c44ef4fc (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-02-18
Infection caused by the hepatitis B virus (HBV) continues to have a major impact on global public health, even while being vaccine-preventable. People living on the streets, homeless, are at high risk for sexually transmitted infections (STIs), including hepatitis B. To investigate the epidemiology of HBV infection among homeless people in Goiania, Goias, from August 2014 to June 2015, 353 individuals served by a public shelter at the capital were interviewed using a structured questionnaire containing questions about socio-demographic characteristics, clinical and risk factors for HBV infection. Next, all were tested for serologic markers of HBV. It was observed the predominance of males (81.3%), mixed race selfdeclared (61%), single (59.8%), low income (70%) and low level of education (53,3%). The global prevalence of HBV was estimated at 21.81% (95% CI 17.82 to 26.41): two individuals were HBsAg / anti-HBc positive, 61 were anti-HBc / anti-HBs, and 16 showed reactivity to only the anti-HBc marker. Additionally, 19.55% (CI: 95%: from 15.75 to 24.00) tested positive for isolated anti-HBs, suggesting immunity to HBV. Analyzing potential risk factors to HBV showed that: age over 50 years, being gay or bisexual, and being mixed race/blackselfdeclared were independently associated of exposure to HBV. The results confirm the vulnerability of this populational subgroup and a high prevalence of exposure to HBV. Still. the low frequency of serological evidence of immunization against HBV, specially among older subjects, makes evident the need of drawing up strategies of vaccination at the support places to homeless.
A infecção causada pelo vírus da hepatite B (HBV) continua apresentando grande impacto na saúde pública mundial, mesmo sendo imunoprevenível. Populações em situação de rua (PSR) apresentam um risco elevado para infecções sexualmente transmissíveis (IST), incluindo a hepatite B. Para investigar a epidemiologia da infecção pelo HBV em indivíduos em situação de rua em Goiânia, Goiás, durante agosto de 2014 a junho de 2015, 353 indivíduos atendidos em um albergue público da capital foram entrevistados utilizando-se um roteiro estruturado, contendo questões sobre características sociodemograficas, clínicas e fatores de risco para a infecção pelo HBV. A seguir, todos foram testados para os marcadores sorológicos do HBV. Observou-se predomínio de indivíduos do sexo masculino (81,3%), de cor/raça parda autodeclarada (61%), solteiros (59,8%), de baixa renda (70%) e baixo nível de escolaridade (53,3%). Estimou-se uma prevalência global para o HBV de 21,81% (IC 95%: 17,82 - 26,41): dois indivíduos foram HBsAg/anti-HBc positivos, 61 foram anti-HBc/anti-HBs e 16 apresentaram reatividade do marcador anti-HBc isolado. Ainda, 19,55% (IC: 95%: 15,75 - 24,00) apresentaram positividade isolada para o anti-HBs, sugerindo imunidade para o HBV. A análise de potenciais fatores de risco para HBV mostrou que: idade > 50 anos, ser homossexual ou bissexual e ser de cor preta/negra autodeclarada foram independentemente associados a exposição ao HBV. Os resultados ratificam a vulnerabilidade desse subgrupo populacional e uma elevada prevalência de exposição ao HBV. Ainda, a baixa freqüência de evidência sorológica de imunização contra o HBV, especialmente nos indivíduos mais velhos, evidencia a necessidade de elaboração de estratégias de vacinação nos locais de apoio a PSR.
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Zhu, Sheng, and 朱晟. "Effect of the health belief model in explaining HBV screening and vaccination health behaviour : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193831.
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Objectives
To systematically review all studies HBV screening and vaccination health behaviour according to the Health Belief Model theoretical framework including perceived susceptibility, severity, barriers and benefits, cues to action and self-efficacy.
Methodology
The literature search used PUBMED, MEDLINE, CINAHL plus, Wan Fang database, and Chinese Journal Net with English and Chinese language. About 73 studies (PUBMED: 33 MEDLINE: 10, CINAHL plus: 3, Wan Fang database: 16, Chinese journal net: 11) in total were identified; after applying the inclusion and exclusion criteria, 11 studies met the criteria and in the final analysis. The target group included high infection rate groups (pregnant women, unprotected sexual behaviour, and immigrant group) and illness groups (chronic Hepatitis B and Hepatitis B virus carriers).
Results and Discussion
HBV screening and vaccination behaviour were determined by perceived the susceptibility, perceived severity, perceived barriers and benefits, and cues to action. The self-efficacy was seldom designed in the questionnaire of the reviewed articles. The Health belief model was a useful model for explaining HBV screening and vaccination behaviour. Screening- and vaccination-related beliefs of the screening and vaccination vary by high risk groups. From the review more attention to self-efficacy and perceived control may improve vaccination uptake. There were contrast results with the social economic characteristics, such as age, gender, income, in determining the HBV screening and vaccination behaviour.
Conclusion and Implication
As the policy maker, health care providers need to develop specific interventions paying attention to the different aspects of the Health Belief Model to improve the perceived of Hepatitis B virus.published_or_final_version
Public Health
Master
Master of Public Health
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Cheung, Ka-yee Cindy. "Occult hepatitis B virus reinfection in liver transplant recipient." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41290562.
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Williams, David James. "Hepatitis B virus core gene deletions." Thesis, University of Glasgow, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.363171.
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Ashton-Rickardt, Philip George. "Immunoreactivity of hepatitis B surface antigen." Thesis, University of Edinburgh, 1988. http://hdl.handle.net/1842/11881.
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Bengsch, Bertram. "CD8+ T Zelldifferenzierung bei der Hepatitis B- und Hepatitis C-Virusinfektion." [S.l. : s.n.], 2007. http://nbn-resolving.de/urn:nbn:de:bsz:25-opus-60765.
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Silva, Edvaldo Ferreira da. "Prevalência de marcadores sorológicos das hepatites A e B em pacientes com hepatite C crônica atendidos no ambulatório de hepatites do serviço de Gastroenterologia Clínica do Hospital das Clínicas da Faculdade de Medicina da Universidade." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/5/5168/tde-04022015-153903/.
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Introdução: Pacientes com infecção crônica pelo VHC e superinfecção pelo vírus da hepatite A (VHA) ou o vírus da hepatite B (VHB), têm maior morbi-mortalidade quando comparados com pacientes que apresentam infecção aguda somente pelo VHA ou VHB. A mortalidade associada à hepatite A aguda pode estar particularmente elevada em pacientes com pré-existência de hepatite crônica causada pelo VHC. Por esta razão, a imunização ativa com vacinas contra o VHA e o VHB vem a ser obrigatória nesta população, e consequentemente esta sorologia deve ser determinada. Objetivos: O objetivo deste trabalho foi avaliar a prevalência de marcadores sorológicos da hepatite A e hepatite B em 1.000 pacientes com infecção crônica pelo VHC atendidos no Ambulatório de Hepatites da Divisão de Gastroenterologia e Hepatologia Clínica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Resultados: O anti-VHA IgG foi positivo em 923 de 1000 pacientes (92,3%). Quando estratificados por idade, o anti-VHA IgG foi encontrado em 61% dos pacientes entre 20 e 29 anos, 70% entre 30 e 39 anos, 85% entre 40 e 49 anos, 94% entre 50 e 59 anos e 99% nos pacientes com mais de 60 anos . O anti-HBc total foi positivo em 244 pacientes (24%). Estratificados por idade, em 4,3% dos pacientes entre 20 e 29 anos, 17% entre 30e 39 anos, 21% entre 40 e 49 anos, 24% entre 50 e 59 anos, e 28% dos pacientes com mais de 60 anos. Dos 244 pacientes anti-HBc IgG positivos, 0,8% são HBsAg positivo, 8,5% anti-HBc IgG isolado e 16% anti-HBs positivo. Conclusões: A prevalência de anti-VHA IgG nod nossos pacientes com hepatite C crônica foi semelhante à da população geral no município de São Paulo. No entanto, o anti-HBc totaI foi maior em nossos pacientes, quando comparada historicamente à população geral dos países ocidentais, sugerindo fatores de risco semelhantes para as hepatites B e C, o que enfatiza a importância dos programas de imunização nesta populaçãoBackground and Aims: Patients with chronic HCV and superinfection by hepatitis A virus (HAV) or hepatitis B virus (HBV) have higher morbidity and mortality when compared with those without HCV. For this reason, HAV and HBV active immunization has become mandatory in this population and hence their serological markers must be determined. The aim of this study was to evaluate the prevalence of serological markers of HAV and HBV infection in patients with chronic HCV. Methods: 1.000 chronic HCV infected patients at the University of Sao Paulo School of Medicine outpatient Liver Clinic were evaluated for the prevalence of serological markers of HAV and HBV infection. Results: Anti-HAV IgG was positive in 923 of 1000 patients (92.3%). When stratified by age, the anti-HAV IgG was found in 61% of patients between 20-29 years, 70% between 30-39 years, 85% between 40-49 years, 94% between 50-59 years, and 99% over 60 years of age. Anti-HBc IgG was positive in 244 patients (24%). Stratified by age, anti-HBc IgG was found in 4.3% of patients between 20-29 years, 17% between 30-39 years, 21% between 40 -49 years, 24% between 50-59 years, and 28% of patients over 60 years of age. Of the 244 anti-HBc IgG positive patients, 0.8% were also HBsAg positive, 8.5% were anti-HBc IgG isolated and 16% were also anti-HBs positive. Conclusions: The prevalence of anti-HAV IgG was similar to the general population in the city of São Paulo. However, anti-HBc IgG was higher in our chronic HCV patients, when compared historically to the general population of western countries, suggesting similar risk factors for HBV and HCV acquisition, so emphasizing the importance of immunization programs in this population. Keywords: Hepatitis C, Chronic; Hepatitis C; Hepacivirus, Prevalence; Hepatitis A; Hepatitis B Título: Prevalência de Marcadores Sorológicos das Hepatites A e B em Pacientes com Hepatite C Crônica atendidos no Ambulatório de Hepatites do Serviço de Gastroenterologia Clínica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - HCFMUSP Background and Aims: Patients with chronic HCV and superinfection by hepatitis A virus (HAV) or hepatitis B virus (HBV) have higher morbidity and mortality when compared with those without HCV. For this reason, HAV and HBV active immunization has become mandatory in this population and hence their serological markers must be determined. The aim of this study was to evaluate the prevalence of serological markers of HAV and HBV infection in patients with chronic HCV. Methods: 1.000 chronic HCV infected patients at the University of Sao Paulo School of Medicine outpatient Liver Clinic were evaluated for the prevalence of serological markers of HAV and HBV infection. Results: Anti-HAV IgG was positive in 923 of 1000 patients (92.3%). When stratified by age, the anti-HAV IgG was found in 61% of patients between 20-29 years, 70% between 30-39 years, 85% between 40-49 years, 94% between 50-59 years, and 99% over 60 years of age. Anti-HBc IgG was positive in 244 patients (24%). Stratified by age, anti-HBc IgG was found in 4.3% of patients between 20-29 years, 17% between 30-39 years, 21% between 40 -49 years, 24% between 50-59 years, and 28% of patients over 60 years of age. Of the 244 anti-HBc IgG positive patients, 0.8% were also HBsAg positive, 8.5% were anti-HBc IgG isolated and 16% were also anti-HBs positive. Conclusions: The prevalence of anti-HAV IgG was similar to the general population in the city of São Paulo. However, anti-HBc IgG was higher in our chronic HCV patients, when compared historically to the general population of western countries, suggesting similar risk factors for HBV and HCV acquisition, so emphasizing the importance of immunization programs in this population
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Rodrigues, Fabiana Perez. "Epidemiologia da Infecção pelo Vírus da Hepatite B em Assentamento Rural em Mato Grosso do Sul, Brasil Central." Universidade Federal de Goiás, 2013. http://repositorio.bc.ufg.br/tede/handle/tede/3785.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
Hepatitis B virus (HBV) infection has been responsible for the largest number of chronic hepatitis illness throughout the world as well as its sequelae: cirrhosis and hepatocellular carcinoma. In Brazil, a low endemic country for hepatitis B, the most of the information on this infection has been limited to urban populations. Data about hepatitis B epidemiology in rural settlement are rare. Thus, the aim of this study was to investigate the epidemiological profile of hepatitis B virus infection in individuals living in a rural settlement (Itamarati I) from Mato Grosso do Sul, Brazil. Initially a cross-sectional study was carried out. Then HBV susceptible individuals were vaccinated against HBV and their vaccine response were evaluated. Participants were recruited following a random selection of their families. All family member aged ≥ 2 years who agreed to take part into the study was recruited by signing an Informed Consent Form. Then, 10-ml-blood sample was taken for detecting HBV markers: HBsAg, anti-HBs and total anti-HBc by using commercial kits. HBsAg positive samples were retested for HBeAg and anti-Hbe markers. Hepatitis B vaccine was offered to all individuals who were identified as susceptible to infection, and quantitative detection of anti-HBs was measured after the third vaccine dose. Statistical Package for the Social Sciences – SPSS for Window 15.0 was used for processing and analyzing data. The present project was approved by the Ethics Committee from Universidade Federal de Mato Grosso do Sul – UFMS. Of all participants, 54.4% were female. The majority (59.7%) were up to 40 years old, 62.7% were married and 78.3% self-declared white. Serological markers of HBV infection were identified in 110 settlers, resulting in an overall prevalence of 24.1% (95% CI: 20.4 to 28.2). Twelve subjects (2.6%) were HBsAg-positive. In 139 (30.5%) individuals were detected only anti-HBs, suggesting previous vaccination. Multiple regression analysis showed that age, social movements and sharing personal hygiene objects were independently associated to HBV. HBV DNA was found in four samples, being classified as genotypes D (3/4) and A (1/4). From those 207 individuals identified as susceptible to HBV infection, 84 received the first vaccine dose, but only 44 complied with the full vaccine regimen. In 28 of them (63.6%) vaccine response was evaluated, and 57.1% showed protective anti-HBs titers. The results of the present study show a high prevalence of hepatitis B in the settlers studied, compared to the urban population in the Midwest Region, and difficulties for vaccination against hepatitis B in this population. These findings ratify the need of the relationship between agricultural and health services and leaders of social movements of settlers for the creation and implementation of health strategies specific to this slice of rural Brazil.
A infecção pelo vírus da hepatite B (HBV) é ainda hoje responsável pelo maior número de casos em todo mundo de doença hepática crônica e suas seqüelas: cirrose e carcinoma hepatocelular. No Brasil, um país considerado de baixa endemicidade para hepatite B, a maioria das informações sobre esta infecção tem se limitado a populações urbanas. Dados sobre a epidemiologia da hepatite B em populações rurais são raros. Assim, o objetivo deste estudo foi investigar o perfil epidemiológico da infecção pelo vírus da hepatite B em indivíduos assentados do Assentamento Itamarati I, Mato Grosso do Sul. Inicialmente, realizou-se um estudo transversal, e a seguir, formou-se uma coorte de indivíduos suscetíveis ao HBV para vacinação contra hepatite B e avaliação da resposta vacinal. Os participantes foram recrutados por meio de sorteio aleatório simples de suas famílias. Em cada domicílio foram entrevistados todos os membros da família com idade ≥ dois anos que concordaram em participar do estudo mediante a assinatura do Termo de Consentimento Livre Esclarecido. Em seguida foram coletados 10 mL de sangue, para a detecção dos marcadores sorológicos do HBV: HBsAg, anti-HBs e anti-HBc Total, utilizando-se kits comerciais. As amostras HBsAg reagentes foram retestadas para os marcadores HBeAg e anti-HBe. A vacina contra hepatite B foi oferecida aos indivíduos identificados como suscetíveis para hepatite B, e a detecção quantitativa do anti-HBs foi realizada após a terceira dose da vacina. Para o processamento e análise dos dados, foi empregado o pacote estatístico SPSS for Windows versão 15.0. O projeto foi aprovado pelo Comitê de Ética da Universidade Federal de Mato Grosso do Sul – UFMS. Do total de participantes, 54,4% era do sexo feminino. A maioria possuía até 40 anos de idade (59,7%), casada/união consensual (62,7%) e se auto-declarou de cor branca (78,3%). Os marcadores sorológicos da infecção pelo HBV foram identificados em 110 assentados, resultando em uma prevalência global de 24,1% (IC 95%: 20,4 - 28,2). Doze indivíduos (2,6%) foram HBsAg positivos. Em 139 assentados (30,5%) detectou-se apenas o anti-HBs, sugerindo vacinação prévia. A análise de regressão múltipla revelou que idade, movimentos sociais e compartilhamento de objetos de higiene pessoal foram independentemente associados ao HBV. Entre as amostras reagentes para o HBsAg, o HBV DNA foi detectado em quatro, sendo identificado os genótipos D (3/4) e A (1/4). Dos 207 indivíduos identificados como susceptíveis a hepatite, 84 receberam a primeira dose da vacina e apenas 44 completaram o esquema vacinal. Destes 28 (63,6%) realizaram o anti-HBs quantitativo, dos quais 57,1% foram respondedores a vacina. Os resultados deste estudo evidenciam uma elevada prevalência para hepatite B nos assentados estudados, comparados a população urbana do Centro-Oeste, e dificuldades para a vacinação contra a hepatite B nesta população; sinalizando, assim, a necessidade da articulação entre serviços agrários e de saúde com lideranças de movimentos sociais de assentados para a criação e implantação de estratégias de saúde específicas para essa fatia da população rural brasileira.
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Caetano, Karlla Antonieta Amorim. "Epidemiologia da infecção pelo vírus da hepatite b em assentados em Goiás: subsídios para ações de prevenção e controle em populações emergentes." Universidade Federal de Goiás, 2014. http://repositorio.bc.ufg.br/tede/handle/tede/3551.
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Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq
Estimates indicate a total of 240 million chronic hepatitis B carriers worldwide. In Brazil, rural settlements present adverse life conditions that favor the acquisition of health problems, such as the hepatitis B virus (HBV). The objective of the present study was to investigate the epidemiology of the infections caused by the hepatitis B and D viruses in people living in settlements in the southwest region of the state of Goiás. This is an observational, analytical, cross-sectional study, with a subsequent cohort of susceptible subjects for vaccination against HBV, assessment of adherence and vaccine response. In the period from May to July of 2011, 467 subjects were selected from seven settlements in the southwest of Goiás. All subjects were interviewed and tested for the detection of the serological markers HBsAg, anti-HBc and anti-HBs, by means of the enzyme-linked immunosorbent assay (ELISA). Reactive HBsAg samples were tested for total anti-HDV and IgM, by means of the ELISA, submitted to the detection of the HBV DNA by semi-nested PCR and genotyped by sequencing. Chemiluminescent microparticle immunoassay was used for the quantitative determination of anti-HBs. The research proposal was approved by the Research Ethics Committee of the Federal University of Goiás. Of the total sample, 52.2% were men, 57.8% were married and 49% had less than five years of education. Most subjects were from cities in the midwest region (81.6%) and were older than 19 years of age (73.7%). Overall prevalence for infection by the HBV was 10.9% (51/467), being 0.8% (4/467) for HBsAg, 7.9% (37/467) for anti-HBc and anti- HBs, and 2.1% (10/467) for anti-HBc. Moreover, 19.3% of the people living in settlements presented isolated positivity for the anti-HBs marker, which indicates they were previously vaccinated against hepatitis B. The four reactive HBV DNA samples were classified as subgenotype A1 (3/4) and D3 (1/4). The male gender (adjusted OR: 2.65; p= 0.007), age (adjusted OR: 1.07; p= 0.000), history of transfusion (adjusted OR: 2.52; p= 0.025) and greater period of time living in the settlements (adjusted OR: 1.10; p= 0.026) were variables associated with the HBV. A total of 181 subjects susceptible to the infection started vaccine against hepatitis B, but only 106 (58.6%; 106/181) completed the vaccine scheme. Of these, it was possible to assess the vaccine response in 77 subjects, and 68.8% (53/77) presented protective titers of anti-HBs. Of those subjects living in the settlements who did not respond to the vaccine, a greater proportion was male, had more than 40 years and was smokers (p< 0.001). No subject presented positivity for the anti-HDV marker. The results of this study evidence the need for effective strategies to prevent hepatitis B in the studied settlements, emphasizing vaccine against hepatitis. In light of the low vaccine response against this infection in older subjects, more immunogenic schemes are suggested, so as to induce a protective vaccine response.
Estima-se em 240 milhões o número de portadores crônicos de hepatite B. No Brasil, as comunidades rurais de assentamentos apresentam condições de vida adversas que favorecem a aquisição de agravos, como do HBV. O objetivo do presente estudo foi investigar a epidemiologia das infecções pelos vírus das hepatites B e D em assentados do sudoeste de Goiás. Trata-se de um estudo observacional, analítico, de corte transversal, em que posteriormente foi formada uma coorte de indivíduos suscetíveis para a vacinação contra HBV, avaliação da adesão e resposta vacinal. No período de maio a julho de 2011, foram recrutados 467 indivíduos de sete assentamentos do sudoeste goiano. Todos foram entrevistados e testados para a detecção dos marcadores sorológicos HBsAg, anti- HBc e anti-HBs pelo ensaio imunoenzimático (ELISA). As amostras HBsAg reagentes foram testadas para o anti-HDV total e IgM, pelo ELISA, submetidas à detecção do HBV DNA por semi-nested PCR e genotipadas por sequenciamento. Para a determinação quantitativa do anti-HBs empregou-se o imunoensaio de micropartículas por quimioluminescência. O presente estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Goiás. Do total, 52,2% eram do sexo masculino, 57,8% casados e 49% possuía menos de cinco anos de estudo. A maioria era natural de municípios da Região Centro-Oeste (81,6%) e possuía mais de 19 anos de idade (73,7%). A prevalência global para a infecção pelo HBV foi de 10,9% (51/467), sendo 0,8% (4/467) para HBsAg, 7,9% (37/467) para anti-HBc e anti-HBs, e 2,1% (10/467) para anti-HBc. Também, 19,3% dos assentados apresentaram positividade isolada para o marcador anti-HBs, indicando vacinação prévia contra hepatite B. As quatro amostras HBV DNA reagentes foram classificadas como subgenótipo A1 (3/4) e D3 (1/4). Observou-se que sexo masculino (OR ajustado: 2,65; p= 0,007), idade (OR ajustado: 1,07; p= 0.000), história de transfusão (OR ajustado: 2,52; p= 0,025) e maior tempo de moradia nos assentamentos (OR ajustado: 1,10; p= 0,026) foram variáveis associadas ao HBV. Um total de 181 assentados suscetíveis à infecção iniciaram a vacinação contra hepatite B, mas apenas 106 (58,6%; 106/181) completaram o esquema vacinal. Desses, em 77 foi possível avaliar a resposta vacinal, sendo que 68,8% (53/77) apresentaram títulos protetores de anti-HBs. Verificou-se uma proporção maior de não respondedores nos assentados do sexo masculino, com mais de 40 anos e tabagistas (p< 0,001). Nenhum indivíduo apresentou positividade para o marcador anti-HDV. Os resultados evidenciam a necessidade de estratégias efetivas de prevenção da hepatite B nos assentamentos estudados, com ênfase na vacinação contra hepatite. Ainda, diante da baixa resposta vacinal contra esta infecção em indivíduos mais velhos, sugere-se esquemas mais imunogênicos, que induzam uma resposta vacinal protetora.
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Assis, Jaqueline Calça. "Prevalência de anti-HBc isolado em amostras do instituto Adolfo Lutz e hepatite B oculta após resposta vacinal em pacientes do ambulatório municipal de hepatites virais." Faculdade de Medicina de São José do Rio Preto, 2016. http://hdl.handle.net/tede/422.
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The presence of anti-HBc alone can have several meanings: false positive, healing immune window, delayed immunity or occult hepatitis B virus infection (OBI). In clinical practice, it is important and necessary to clarify the diagnosis to prevent transmission to the risk population such as hemodialysis patients, blood donors, transplant recipients and co-infected individuals with HIV and/or HCV. Objectives: The aim of the study was to determine the prevalence of anti-HBc alone and occult hepatitis B, respectively, in blood samples from Adolfo Lutz Institute - Regional Laboratory Center X - São José do Rio Preto (IAL - CLR X - SJRP) and patients from Municipal Ambulatory of Viral Hepatitis (AMHV) both from São José do Rio Preto city in the period from January 1st, 2009 to December 31st, 2014. Methods: The study population of IAL - CLR X - SJRP is from the region served by the 15th Health Regional Division (DRS), and the AMHV is a population screened for clarification, monitoring and treatment of viral hepatitis in the city. In this population with anti-HBc alone, patients were immunized against hepatitis B and the individuals without vaccine response were selected for the performance of HBV-DNA research for the diagnosis of occult hepatitis B. Results: During the study period, 6805 samples were evaluated without duplication in IAL - CLR X - SJRP, of these 624 samples had anti-HBc positive, and the prevalence of anti-HBc alone was 17.63% (110/624). In the AMHV, 940 patients anti-HBc isolated were evaluated, from these 816 (86.81%) were vaccinated and after the criterion of disregarding the vaccinated patients who did not have anti-HBs evaluated after vaccination (85 - 10.42%), 731 (89.58%) patients were considered for analysis of the vaccine response, and 568 (77.70%) presented seroconversion with anti-HBs positive and 163 (22.30%) non-seroconverted patients. The research of HBV-DNA was performed in 25.77% (42/163) patients without a vaccine response, finding a prevalence of occult hepatitis B (OBI) of 47.62% (20/42).The presence of antibodies to HIV and HCV was 25.40% and 13.25% in the blood samples IAL - CLR X - SJRP and in AMHV was 1.80% and 0.33%, respectively. Conclusion: The results show the occurrence of antiHBc alone in IAL - CLR X - SJRP and the need of monitoring this population. In AMHV, the vaccination was effective for most cases, which demonstrates the need of vaccine introduction as a routine in anti- HBc alone patients in the overall population. The occult hepatitis B was found in almost half of patients assessed without vaccine response.
A presença do anti-HBc isolado pode ter vários significados: falso positivo, janela imunológica de cura, imunidade tardia ou infecção oculta pelo vírus da hepatite B (IOB). Na prática clínica é importante e necessário o esclarecimento diagnóstico para evitar transmissão em populações de risco como pacientes hemodialisados, doadores de sangue, transplantados e indivíduos coinfectados com HIV e/ou HCV. Objetivo: O objetivo do estudo foi determinar a prevalência de anti-HBc isolado e hepatite B oculta, respectivamente, em amostras de sangue do Instituto Adolfo Lutz - Centro de Laboratório Regional X - São José do Rio Preto (IAL - CLR X - SJRP) e pacientes do Ambulatório Municipal de Hepatites Virais (AMHV) ambos da cidade de São José do Rio Preto, no período de 01 de janeiro de 2009 a 31 de dezembro de 2014. Casuística e Métodos: A população estudada do IAL - CLR X - SJRP é proveniente da região atendida pela Divisão Regional de Saúde (DRS) XV e a do AMHV é uma população triada para esclarecimento, acompanhamento e tratamento das hepatites virais do município. Nesta população com anti-HBc isolado os pacientes foram imunizados contra hepatite B e os indivíduos sem resposta vacinal foram selecionados para realização da pesquisa de HBV-DNA para diagnóstico da hepatite B oculta. Resultados: Durante o período de estudo, foram avaliadas 6805 amostras, sem duplicação, no IAL - CLR X - SJRP, destas, 624 amostras apresentavam anti-HBc reagente, sendo a prevalência de anti-HBc isolado 17,63% (110/624). No AMHV foram analisados 940 pacientes com anti-HBc total isolado destes 816 (86,81%) foram vacinados e depois de aplicado o critério de desconsiderar os pacientes vacinados que não tiveram o anti-HBs avaliado após a vacinação (85 - 10,42%), 731 (89,58%) pacientes foram considerados para análise da resposta vacinal, sendo que 568 (77,70%) apresentaram soroconversão com anti-HBs positivo e 163 (22,30%) pacientes não soroconverteram. A pesquisa do HBV-DNA foi realizada em 25,77% (42/163) dos pacientes sem resposta vacinal, encontrando uma prevalência de hepatite B oculta (IOB) de 47,62% (20/42). A presença de anticorpos contra HIV e HCV foi de 25,40%, 13,25% nas amostras do IAL - CLR X - SJRP e no AMHV foi de 1,80%, 0,33%, respectivamente. Conclusão: Os resultados obtidos demonstram a ocorrência de anti-HBc isolado nas amostras do IAL - CLRX - SJRP e a necessidade de acompanhamento dessa população. No AMHV a vacinação esclareceu a maioria dos casos, o que demonstra a necessidade da introdução da vacina como rotina em pacientes anti-HBc isolado na população geral. A hepatite B oculta foi encontrada em quase metade dos pacientes não respondedores vacinais avaliados.
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Tonetto, Priscila Aparecida. "Analise molecular dos genotipos do virus da hepatite B em pacientes do estado de São Paulo, sudeste do Brasil." [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309353.
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Orientadores: Fernando Lopes Gonçales Junior, Neiva Sellan Lopes GonçalesDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: O vírus da hepatite B (VHB) pode ser classificado em oito principais genótipos (A-H), e essa classificação tem uma distribuição geográfica determinada. Os genótipos do VHB podem influenciar na progressão de doença. O objetivo foi determinar os genótipos e os subtipos do VHB e correlacioná-los com as variáveis clínicas epidemiológicas, laboratoriais e histológicas. Foram determinados os genótipos de 139 amostras de soro de pacientes infectados pelo VHB, coletadas em Campinas, no estado de São Paulo, Brasil. O método para genotipagem utilizado foi o seqüenciamento parcial do gene S do VHB. Os primers utilizados foram desenhados a partir de seqüências do gene S, com genótipo determinado, depositadas no GenBank. Todas as seqüências obtidas foram comparadas com as seqüências depositadas no GenBank para determinação dos genótipos. O genótipo A (55%) do VHB foi o mais predominante na população, seguido pelos genótipos C (3%), D (38%) e F (4%). Entre os pacientes infectados pelos genótipos A e D, observou-se uma provável descendência africana de 18% (14/76) e 11% (6/53), respectivamente. Entre os quatro pacientes infectados pelo genótipo C, dois possuíam descendência asiática e dois eram caucasianos. Todos os pacientes infectados pelo genótipo F eram caucasianos sem ascendência indígena relatada. Aproximadamente 30% dos pacientes eram HBeAg positivo e 70% eram HBeAg negativo. A carga viral do DNA-VHB foi aproximadamente cinco vezes mais alta entre os HBeAg positivo quando comparada aos HBeAg negativo. Os genótipos A e D são os mais prevalentes entre os pacientes, aparentemente em virtude da imigração européia em nossa região
Abstract: Hepatitis B virus (HBV) can be classified into eight major genotypes (A-H) that have mainly a geographic distribution. The HBV genotype may influence disease progression. Our objective was to determine the genotypes and the subtypes of HBV and to correlate them with the with variables clinical epidemiologies, laboratories and histological. Hepatitis B virus genotypes were determined in 139 plasma samples collected in Campinas, in the state of São Paulo, Brazil from HBV-infected patients. A method for genotyping hepatitis B virus by partial HBsAg gene sequencing with primers common to all known genotypes was developed. The results of sequencing corresponded to those found in HBV isolates obtained from GenBank, including all of the known HBV genotypes. HBV genotype A was predominant in our sample, appearing in 76 patients (55%), while genotypes C, D and F was found in 4 (3%), 53 (38%) and 6 (4%) of the patients, respectively. Among the patients infected by genotypes A and D, were observed a probably African descendents of the 18.3% (14/76) and 11.3% (6/53), respectively. Among the genotype C infected patients, 2 (50%) were of Asian descendents and 2 were Caucasians. The genotype F infected patients were all Caucasians without told indigenous origin. About 30% of the patients were HBeAg positive and 70% were HBeAg negative. The viral load of HBV-DNA was about 5 times higher among HBeAg positive than in HBeAg-negative patients. Genotypes A and D were the most prevalent among our HBV-infected patients, apparently a consequence of the types of immigration to our region
Mestrado
Ciencias Basicas
Mestre em Ciências Médicas
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Chen, Augustine, and n/a. "Translational control mechanisms used by the human Hepatitis B virus : an upstream open reading frame modulates expression of the pregenomic RNA." University of Otago. Department of Biochemistry, 2007. http://adt.otago.ac.nz./public/adt-NZDU20080130.123000.
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The human hepatitis B virus (HBV) is a small hepatotropic virus, which affects approximately 350 million chronic sufferers worldwide. It has a compact 3.2 kbp dsDNA genome encoding four major overlapping genes namely core, polymerase, surface and X required for its replication. The virus synthesises a pregenomic RNA (pgRNA) which functions both as an RNA intermediate for reverse transcription into the DNA genome and as the mRNA for the translation of the core (C) and polymerase (P) proteins. The core overlaps the polymerase gene and is translated at a 10 to 1 ratio. The polymerase gene translated from the P AUG codon is preceded by at least 4 upstream AUG codons (uAUGs), namely C AUG, C1 AUG, J AUG and C2 AUG. Various mechanisms have been implicated in the synthesis of the polymerase protein. This led to the currently accepted model which involves leaky scanning and a reinitiation mechanism in polymerase synthesis.
However, multiple sequence alignment of the pgRNA revealed a short upstream open reading frame (uORF) highly conserved at the nucleotide level in all HBV subtypes and mammalian hepadnaviruses. This previously unreported uORF, designated as C0 ORF in this study is also conserved in its position and length. Past studies have either omitted this uORF in their test constructs or ignored its potential role. The C0 ORF has a conserved weak initiation context and is located within the epsilon structure within the 5' leader of the pgRNA, required for viral encapsidation. Importantly, the C0 ORF precedes and overlaps the core ORF, which may suggest an alternative model in which the core and polymerase may be translated and coordinately regulated.
Fusion of the C0 ORF to luciferase showed for the first time that this uORF is translated through the detection of reporter activity (~20% of C) and also visualisation of the fusion protein via western analysis using anti-C0 and anti-luciferase antibodies. Subsequent removal of the C0 ORF implicated a role in repressing downstream core fusion protein synthesis in HepG2 cells. A similar repression was observed on J expression.
To study the effect of C0 on downstream polymerase translation, a pgRNA-like DNA construct was made and subsequent mutations introduced. Mutation of the C0 AUG led to an increase in initiation at the downstream P AUG. Alteration of the existing weak initiation context to an optimal context which favours stronger initiation consistently showed a potential role for C0 ORF in facilitating reinitiation at certain downstream initiation codons including P AUG. Mutations of other uAUGs preceding the P AUG were also done to better understand their roles in regulating polymerase synthesis. The removal of the C AUG markedly increased expression from the P AUG. This study revealed other internal uAUGs in-frame to the C AUG, namely the C1 and C2 AUGs are also effectively translated, further reducing availability of translating ribosomes to downstream P AUG. Indeed the removal of the C1 and C2 AUGs led to a corresponding increase in initiation from the P AUG. Initiation at the internal J AUG was also reported and its removal showed a significant decrease in expression from the P AUG, consistent with the previous model implicating reinitiation at the P initiation site after translation of the short J ORF. The inhibitory role of the 5 uAUGs prior to the P AUG were confirmed when all were removed, giving rise to translation almost equal to that at C AUG.
Taken together, these results suggest a new model in which the HBV C0 ORF plays a key role in controlling core and polymerase synthesis by repressing core translation and making available more ribosomes to downstream AUGs possibly facilitating translation reinitiation. In addition, the translation of the C0 ORF across the [epsilon] region may also preclude encapsidation, potentially acting as a switch discriminating the pgRNA template between encapsidation and translation. Therefore, the highly conserved [epsilon] region and C0 ORF present an excellent target for molecular based antiviral drugs (antisense oligonucleotides, aptamers, ribozymes) potentially providing new anti HBV drugs.
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Laestadius, Hanna, and Berfin Güven. "Hur patienter med hepatit B och hepatit C upplever bemötandet av omvårdnadspersonal." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-397661.
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Background: In 2019, hepatitis is seen as one of the deadliest virus infections in the world and is seen as a global health problem. Hepatitis is a DNA-virus that can lead to chronic hepatitis and liver cirrhosis. Both hepatitis B and C are blood infections which means that they are transmitted through contact with damaged skin, mucus membrane or the eyes. Aim: The aim of this study was to describe how patients with hepatitis B and C experience the treatment from healthcare professionals. Method: The method used in this study was a review of literature research. The study was conducted through examination of 10 research articles. The chosen articles were found on the databases PubMed and CINAHL. The differences and the similarities were noted to create a larger understanding of the results. Results: The results consist of four categories which shows how patients with hepatitis B and C experience the treatment from healthcare professionals. The four categories are, a lack of information, faulty information, withholding of the diagnosis hepatitis and dismissive treatment. Patients were in need of support in the form of information and understanding. The negative experience received from healthcare professionals could be derived from lack of information. Conclusion: The conclusion of this study is that patients with hepatitis B and C experience negative treatment from healthcare professionals. The negative treatment is often connected to information and lack thereof. This study may have significance for future treatment of patients with hepatitis by highlighting the existing response.Bakgrund: År 2019 anses hepatit vara den näst dödligaste virusinfektionen i världen. Det är ett globalt folkhälsoproblem. Hepatit är ett DNA-virus som kan leda till kronisk hepatit och levercirros. Både hepatit B och C är blodsmittor vilket innebär att de smittar genom att blod kommer i kontakt med skadad hud, slemhinna eller öga. Syfte: Syftet med studien var att beskriva hur patienter med hepatit B och C upplever bemötandet från omvårdnadspersonal. Metod: Studien är en litteraturöversikt med beskrivande design. Studien har genomförts genom granskning av 10 vetenskapliga artiklar. Valda artiklar har hittats genom sökningar på PubMed och CINAHL. Skillnader och likheter har noterats för att skapa större förståelse för resultatet. Resultat: Resultatet består av fyra kategorier som påvisar hur patienter med hepatit B och C upplever bemötandet från omvårdnadspersonal. De fyra kategorierna är otillräcklig- och felaktig information, undanhållande av diagnosen hepatit och avvisande bemötande från omvårdnadspersonalen. Patienterna hade ett stort behov av stöd i form av information och förståelse. Det negativa bemötandet från omvårdnadspersonalen kunde ofta härledas till okunskap. Slutsats: Slutsatsen av denna studie är att patienter med hepatit B och C upplever negativt bemötande från omvårdnadspersonal. Det negativa bemötandet är ofta kopplat till information och brist på sådan. Det finns en kunskapslucka hos omvårdnadspersonal när det gäller hepatit vilket får konsekvenser för patientens behandling och hälsa. Denna studie kan komma att få betydelse för den framtida vården för patienter med hepatit genom att konsekvenser av det befintliga bemötandet belyses.
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Ho, Ka-nung Stephen. "Assay for hepatitis B virus (HBV) DNA in serum: recent advances in methodology and its clinical relevancein renal allograft recipients with HBV infection." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31222602.
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Lo, Kin-hang Ken, and 盧建恆. "Relationship of serological markers, basic core promoter and precore mutations to genotypes of Hepatitis B virus." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43781287.
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