Differing profiles of people diagnosed with acute and chronic hepatitis B virus infection in British Columbia, Canada

Binka, Mawuena; Butt, Zahid A; Wong, Stanley; Chong, Mei; Buxton, Jane A.; Chapinal, N.; Yu, Amanda; Alvarez, Maria; Darvishian, Maryam; Wong, Jason; McGowan, Gina; Torban, Mikhail; Gilbert, Mark; Tyndall, Mark; Krajden, Mel; Janjua, Naveed Z.

doi:10.3748/wjg.v24.i11.1216

Cited by 21 publications

(23 citation statements)

References 25 publications

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“…The odds of hepatitis C viral infection were 1.5 folds higher among tuberculosis patients with problematic alcohol use. This finding was in line with previous work [ 39 , 40 ]. This is because people with problematic alcohol use can commit unprotected sexual intercourse that exposes them to acquire the virus more easily [ 41 ].…”

Section: Discussionsupporting

confidence: 94%

Impacts of hepatitis B and hepatitis C co-infection with tuberculosis, a prospective cohort study

Feleke

Adane

et al. 2020

Virol J

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Background This study was conducted to estimate the prevalence, determinants of hepatitis B, hepatitis C and the survival of tuberculosis patients until drug-induced hepatitis. Methods Prospective cohort study design was implemented. The data were collected from September 2016 – May 2019. Systematic random sampling was used to select the study participants. Baseline data were collected before the patient starts DOTS, the sign of liver toxicity was assessed every week. Tuberculosis treatment outcomes and WHO clinical stage was recorded at the end of 6th months. Descriptive statistics were used to estimate the prevalence of hepatitis B, hepatitis C viral infections and their effect on tuberculosis treatment outcomes. Binary logistic regression was used to identify the determinants of hepatitis B and C infections. The Kaplan Meier survival curve was used to estimate the survival of tuberculosis patient and Cox regression was used to identify the predictors of drug-induced hepatitis. Results A total of 3537 tuberculosis patients were followed. The prevalence of hepatitis B and C viral infection among tuberculosis patients were 15.1 and 17.3% respectively. Hepatitis B viral infection among tuberculosis patients was associated with alcohol, sex, HIV, chronic illness. Hepatitis C viral infection among tuberculosis patients was associated with alcohol, sex, HIV, chronic illness. The incidence density for liver toxicity among tuberculosis patients was 843/15707 person-months and liver toxicity was determined by HIV, Hepatitis B, Hepatitis C, the severity of tuberculosis and chronic illnesses. Conclusion Decision-makers should consider incorporating screening for hepatitis B and C viral infection during tuberculosis treatment.

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Section: Discussionsupporting

confidence: 94%

Impacts of hepatitis B and hepatitis C co-infection with tuberculosis, a prospective cohort study

Feleke

Adane

et al. 2020

Virol J

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“…In both studies high values were reported for chronic infection however, the difference between our findings and those from the Colombian study may be because our study was a cross-sectional and sample size was 254 participants. Our findings are reflective of what is happening elsewhere in that many individuals have chronic hepatitis B [15]. The greatest (95%) transmission of HBV is during perinatal period, 30% in children below the age of 5 [2].…”

Section: Type Of Hepatitis B Infection (Acute or Chronic)supporting

confidence: 73%

“…In our study 33.3% of those actively infected with HBV were positive for the HepB core IgM, 66.7% had negative HBcAb IgM but positive HBcAb IgG an indication of chronic hepatitis B infection [14]. In a cohort study with over 1.7 million individuals done in British Colombia from 1990-2015 describing the characteristics of people diagnosed with acute and chronic hepatitis B virus (HBV) infection, 4.3% of the individual had acute Hepatitis B infection and 95.7% of the individuals had chronic infection [15]. In both studies high values were reported for chronic infection however, the difference between our findings and those from the Colombian study may be because our study was a cross-sectional and sample size was 254 participants.…”

Section: Type Of Hepatitis B Infection (Acute or Chronic)mentioning

confidence: 99%

Hepatitis B Infection and Immunity among Pregnant Women Attending Antenatal Clinics in Health Centers of Mbarara Municipality, Southwestern Uganda

Kabajulizi¹,

Bazira²,

Atuheire³

et al. 2019

AID

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Introduction: Viral hepatitis B (HBV) in pregnancy is a risk for childhood transmission where the majority become chronically infected. In Uganda, HBV is not tested for during antenatal, therefore the number of infected, infectious, immune and none-immune pregnant women is unknown curtailing efforts to prevent mother to child transmission. Methods: We conducted a descriptive cross-sectional study involving 254 pregnant women from four health centers in Mbarara Municipality. HBV status was assessed using an immunochromatographic (COMBO) kit, the type of infection; based on demonstration of anti hepB core IgM (acute infection) and total core IgG antibodies (chronic infection) and infectiousness; based on the presence of HBeAg and/or a quantitative HBV viral load ≥ 20,000 IU/mL. Immunity was determined using the COMBO kit and HBsAb quantification ELISA. One was deemed immune to HBV if HBsAb titers were ≥10 mIU/mL. Results: The prevalence of HBV infection was 1.2%; 33% and 67% with acute and chronic HBV respectively. 33% were infectious based on a high viral load, none had detectable HBeAg. 14% were immune; amongst whom 72% had natural exposure and 18% after vaccination. There was insufficient immunity in 11% with a majority (75%) having acquired immunity following vaccination. Conclusion: The prevalence of HBV is low and most of those are chronically infected. HBeAg and Hepatitis B viral load should be performed when evaluating infectiousness. Further, there is a high transmission of HBV among adults and a low uptake of the HBV vaccine in Mbarara Municipality.

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“…Assessment of injection drug use (IDU) and problematic alcohol use was based on diagnostic codes ( Supplementary Table 1 ) for medical visits and hospitalizations in respective databases. Ethnicity was classified on the basis of validated name recognition software Onomap, as reported previously [ 20 ]. The algorithm has high sensitivity and specificity for South Asian and East Asian peoples, with the exception of Filipinos.…”

Section: Methodsmentioning

confidence: 99%

Concurrent Hepatitis C and B Virus and Human Immunodeficiency Virus Infections Are Associated With Higher Mortality Risk Illustrating the Impact of Syndemics on Health Outcomes

Butt

Wong

Rossi

et al. 2020

Open Forum Infectious Diseases

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Background Hepatitis C (HCV) and B (HBV) virus and HIV infections are associated with significant mortality globally, and in North America. However, data on impact of concurrent multiple infections on mortality risk is limited. We evaluated the effect of HCV, HBV and HIV infections, coinfections and associated factors on all-cause mortality in British Columbia (BC), Canada. Methods The BC Hepatitis Testers Cohort includes ~ 1.7 million individuals tested for HCV or HIV, or reported as a case of HCV, HIV, or HBV from 1990-2015, linked to administrative databases. We followed people with HCV, HBV or HIV mono-infection, co-infections, and triple infections from their negative status to date of death or December 31, 2016. Extended Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for factors associated with all-cause mortality. Results Of 658,704 individuals tested for HCV, HBV, and HIV, there were 33,804 (5.13%) deaths. In multivariable Cox regression analysis, individuals with HCV/HBV/HIV [HR:8.9, 95% CI:8.2-9.7] infections had the highest risk of mortality followed by HCV/HIV [HR:4.8, 95% CI:4.4-5.1], HBV/HIV [HR:4.1, 95%CI:3.5-4.8] , HCV/HBV [HR:3.9, 95%CI:3.7-4.2], HCV [HR:2.6 95%CI:2.6-2.7], HBV [HR:2.2, 95%CI:2.0-2.3]), HIV [HR:1.6, 95%CI:1.5-1.7]. Additional factors associated with mortality included injection drug use, problematic alcohol use, material deprivation, diabetes, chronic kidney disease, heart failure, and hypertension. Conclusions Concurrent multiple infections are associated with high mortality risk. Substance use, comorbidities and material disadvantage were significantly associated with mortality independent of co-infection. Preventive interventions, including harm reduction combined with co-infection treatments could significantly reduce mortality.

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Differing profiles of people diagnosed with acute and chronic hepatitis B virus infection in British Columbia, Canada

Cited by 21 publications

References 25 publications

Impacts of hepatitis B and hepatitis C co-infection with tuberculosis, a prospective cohort study

Impacts of hepatitis B and hepatitis C co-infection with tuberculosis, a prospective cohort study

Hepatitis B Infection and Immunity among Pregnant Women Attending Antenatal Clinics in Health Centers of Mbarara Municipality, Southwestern Uganda

Concurrent Hepatitis C and B Virus and Human Immunodeficiency Virus Infections Are Associated With Higher Mortality Risk Illustrating the Impact of Syndemics on Health Outcomes

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