Serological and molecular expression of Hepatitis B infection in patients with chronic Hepatitis C from Tunisia, North Africa

Article (PDF Available)inVirology Journal 7(1):229 · September 2010with16 Reads
DOI: 10.1186/1743-422X-7-229 · Source: PubMed
This study reports the prevalence and the viral aspects of HBV infection in HCV-positive patients from Tunisia, a country with intermediate and low endemicity for hepatitis B and C, respectively. HBV infection was assessed in the serum samples of 361 HCV-positive patients and compared to a group of HCV negative individuals. Serological markers were determined by ELISA tests and HBV DNA by real-time PCR. HBV serological markers were found in 43% and 44% of patients and controls, respectively. However, the serological and molecular expression of HBV infection differed in the two groups: The group of patients included more individuals with ongoing HBV infection, as defined by the presence of detectable HBsAg and or HBV DNA (17% and 12%, respectively). Furthermore, while most of the controls with ongoing HBV infection expressed HBsAg, the majority of HCV and HBV positive patients were HBsAg negative and HBV DNA positive. Genotyping of HCV isolates showed large predominance of subtype 1b as previously reported in Tunisia. Comparison of the replicative status of the two viruses found low HBV viral load in all co-infected patients as compared to patients with single HBV infection. In contrast, high levels of HCV viremia levels were observed in most of cases with no difference between the group of co-infected patients and the group with single HCV infection. This study adds to the knowledge on the prevalence and the virological presentation of HCV/HBV dual infection, providing data from the North African region. It shows that, given the local epidemiology of the two viruses, co-infected patients are likely to have low replication levels of HBV suggesting a suppressive effect of HCV on HBV. In contrast, high replication levels for HCV were fond in most cases which indicate that the presence of circulating HBV-DNA does not necessarily influence HCV replication.


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Available from: Imed Cheikh, Oct 09, 2014
    • "Multiple studies evaluated the rates of HCV co-infection among HBsAg carriers; the rates range from 1.3% to 18%, depending on the geographic centers and selected patients36373839. The prevalence of co-infection in neighboring countries is variable with 5% in Tunisia and less than 0.01% in Morocco while in Lybia the prevalence was 1.3%; however, the latter study was carried on a group of dialysis patients404142 . The low prevalence rate of coinfection in our study could likely be due to the reciprocal inhibition of either virus on the other's replication4344. "
    [Show abstract] [Hide abstract] ABSTRACT: Aim: Infections with Hepatitis B virus (HBV) and Hepatitis C virus (HCV) cause serious morbidity and mortality. This study was designed to determine the prevalence of Hepatitis B and C infections and their co-infections among blood donors in Minia governorate, Egypt. Study Design: A cross-sectional study. Place and Duration of Study: The study was conducted over a period of 6 months starting from May 2011 till December 2011 and it included 5410 samples from blood donors at the Regional Blood Transfusion Center in Minia governorate. Methodology: Both HBsAg and antibodies to HCV were detected by EIA in 5410 blood samples from potentially healthy asymptomatic blood donors. Detection of HBV DNA and HCV RNA was carried out by real-time PCR (RT-PCR). Results: Most individuals were males (4305; 79.6%) and were from rural areas (3695; 68.3%). The sero-prevalence of infections was 0.9% (48 cases) for HBV and 6% (322 cases) for HCV, and 0.1% (7 cases) for co-infection. Out of 7 samples with co-infection, only one (14.3%) was positive for HBV DNA and HCV RNA. The mean age of HCV-antibody positive donors (33.2 ±9.41 years) was significantly higher than that of the HBV-positive donors (27.3± 6.06 years) and co-infection (29.9± 10.21 years) (P<0.05). Prevalence of HBV and HCV was higher in males (1% and 6.6% respectively) while HCV was higher in rural areas (6.8%) unlike HBV which did not show any difference in residential distribution (0.9% for both rural and urban areas). Conclusion: The prevalence of both viruses is low and that of the dual infection is lower than any of the two viruses alone.
    Full-text · Article · Oct 2014
    • "Therefore, further studies are needed to determine the prevalence of HBV among the general population. The small number of subjects included in the studies we referred to might explain this variation; thus, larger more detailed studies are needed to gather reliable data33343536. Genotypes D is the most common genotype among the different settings throughout the previously mentioned Arab states37383940414243444546. "
    [Show abstract] [Hide abstract] ABSTRACT: The epidemiology of viral hepatitis during pregnancy is of paramount importance for health planners and program managers. Data on viral hepatitis during pregnancy are not readily available in many African and Arab countries. Both regions have their own unique geography, and comprise over 59 states with crossover and interaction of different cultures. A systematic electronic search of the published literature was conducted and data on epidemiology and risk factors of maternal hepatitis B virus (HBV) infection and hepatitis C (HCV) infection in Arab and African countries were extracted from relevant studies. The serology of hepatitis viruses varies greatly among these countries, with different viral genotype patterns. Such a variation in prevalence could be explained by the different risk factors involved. Sexual contact, perinatal infection, blood and its derivatives, hemodialysis, intravenous and percutaneous drug use, and occupational, habitual, and social behavior have been identified as risk factors for hepatitis transmission in various settings in these countries. Infection from hepatitis B and C viruses imposes major socioeconomic and even political burdens on such young and dynamic societies. Thus strategies and clear policies of intervention are required to combat the consequences of hepatitis B and C at both the regional and national levels.
    Full-text · Article · Aug 2013
    • "Analysis by gender reveals that, the seroprevalence of hepatitis B among males is significantly higher than that found in females; this data was comparable to other reports [26], and no plausible explanation has been given for the higher rate in males in the general population but probably due to the higher exposure to occupational HBV risk factors in men, or else females clear the HBV more efficiently as compared to males [27]. Our research shows a very low prevalence (two cases among 23 578 personts tested) of hepatitis co-infection comparing with Tunisia (5%) and Egypt (22.5%) [28,29], these results indicate that the HBV positive patients investigated herein do not have an increased risk of exposure to HCV infection. Although this small sample size of reactive cases does not allow data to be compared with other reports, one Italian study found that rates of dual infection increased with age, and was more common in patients over 50 years of age [30]. "
    [Show abstract] [Hide abstract] ABSTRACT: Background Viral hepatitis is a serious public health problem affecting billions of people globally. Limited information is available on this issue in Morocco. This cross-sectional study was undertaken with the aim of determining the seroprevalence and risk factors of hepatitis B virus (HBV) and hepatitis C virus (HCV) among the general population and among blood donors. Methods Blood samples from volunteers, have been screened with ELISA tests for detecting the hepatitis-B surface antigen (HBsAg) and anti-HCV. Within the seroreactive patients for HCV in the general population, RT-PCR was performed by the Cobas Ampliprep/Cobas Amplicor. Results HCV and HBV-seropositivity was documented in 1.58% and 1.81% out of 41269 and 23578 participants respectively from the general population. Two patients were found to be co-infected. HCV-RNA was detected by PCR in 70.9% of the 195 anti-HCV positive subjects. The anti-HCV prevalence was not different among males and females (P = 0.3). It increased with age; the highest prevalence was observed among subjects with >50 years old (3.12%). Various risk factors for acquiring HCV infection were identified; age, dental treatment, use of glass syringes and surgical history. In addition to these factors, gender and sexual risk behaviors were found to be associated with higher prevalence of hepatitis B. The HBV positivity was significantly higher among males than females participants in all age groups (P < 0.01). The peak was noticed among males aged 30–49 years (2.4%). None of the 152 persons younger than 20 years had HBsAg or anti-HCV. The prevalence of anti-HCV and HBsAg among 169605 blood donors was 0.62% and 0.96% respectively. Conclusions Our study provided much important information concerning hepatitis B and C prevalence and risk factors; it confirmed the intermediate endemicity for HCV infection and pointed to a decreasing trend of HBV incidence, which might reclassify Morocco in low HBV endemicity area. This could be attributed primarily to the universal HBV vaccination among infants and healthcare workers over the past 13 years. HCV and HBV infections in the present survey were mainly associated with nosocomial exposures. Prevention and control of HBV infection are needed to reduce HBV transmission between adults.
    Full-text · Article · Jan 2013
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