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The article is devoted to the problem of viral hepatitis B and C in children with malignant hematologic disorders. Given the peculiarities of antiviral therapy of a patient with a combination of these diseases.

The global burden of viral hepatitis B is substantial, and monitoring infections across the care cascade is important for elimination efforts. There is little information on care disparities by immigration status, and we aimed to quantify disease burden among immigrant subgroups.In this population-based, retrospective cohort study, we used linked laboratory and health administrative records to describe the HBV care cascade in five distinct stages: (1) lifetime prevalence; (2) diagnosis; (3) engagement with care; (4) treatment initiation; and (5) treatment continuation. Infections were identified based on at least one reactive antigen or nucleic acid test, and lifetime prevalence was estimated as the sum of diagnosed and estimated undiagnosed cases. Care cascades were compared between long-term residents and immigrant groups, including subgroups born in hepatitis B endemic countries. Stratified analyses and multivariable Poisson regression were used to identify drivers for cascade progression. Between January 1997 and December 2014, 2,014,470 persons were included, 50,475 with infections, of whom 30,118 were engaged with care, 11,450 initiated treatment, and 6554 continued treatment1 year. Lifetime prevalence was estimated as 163,309 (1.34%) overall, 115,722 (3.42%) among all immigrants, and 50,876 (9.37%) among those from highly endemic countries. Compared to long-term residents, immigrants were more likely to be diagnosed (adjusted rate ratio [aRR], 4.55; 95% CI, 4.46, 4.63), engaged with care (aRR, 1.07; 95% CI, 1.04, 1.09), and initiate treatment (aRR, 1.09; 95% CI, 1.03, 1.16).In conclusion, immigrants fared well compared to long-term residents along the care cascade, having higher rates of diagnosis and slightly better measures in subsequent cascade stages, although intensified screening efforts and better strategies to facilitate linkage to care are still needed.

The liver is the main target organ for hepatitis viruses and the vital organ for alcohol metabolism. These two factors of viral hepatitis and alcohol abuse in combination can exert dual harmful actions, leading to enhanced damage to the liver. Epidemiological studies have revealed a higher prevalence of hepatitis C virus (HCV) infection among alcoholics than the general population. The interaction of alcohol with viral hepatitis [e.g., hepatitis B virus (HBV), HCV] and the underlying mechanisms are not fully understood. The effects of alcohol on viral hepatitis include promoted viral replication, weakened immune response, and increased oxidative stress. Clinically, alcohol abuse is correlated with an increased risk of developing end-stage liver cirrhosis and hepatocellular carcinoma in patients with chronic hepatitis B and C, suggesting that the combination of alcohol and HBV/HCV lead to more severe liver damage. The influence of mild to moderate alcohol drinking on the HBV-induced liver fibrosis, cirrhosis, and hepatocellular carcinoma among patients infected with HBV remains unclear. Unlike HBV infected patients, no safe level of alcohol intake has been established for patients with HCV. Even light to moderate alcohol use can exert a synergistic effect with viral hepatitis, leading to the rapid progression of liver disease. Furthermore, interferon-based therapy is less effective in alcohol drinkers than in control patients, even after abstinence from alcohol for a period of time. Therefore, abstaining from alcohol is highly recommended to protect the liver, especially in individuals with HBV/HCV infection, to improve the clinical efficacy of antiviral treatment and prevent the rapid progression of chronic viral hepatitis.

Los tumores hepáticos constituyen un importante problema de salud a nivel mundial que en multitud de ocasiones va asociado a patologías previas y factores de riesgo como las hepatitis víricas B y C, el consumo excesivo de alcohol y el aumento de casos de esteatohepatitis no alcohólica, cada vez más relevante en los países industrializados.En hepatocarcinomas no susceptibles de resección quirúrgica, la braquiterapia se está mostrando muy eficaz frente a la quimioterapia sistémica y transarterial, por lo que se desarrollan nuevos tratamientos locorregionales mínimamente invasivos y con menor toxicidad.La radioembolización hepática es una forma de braquiterapia consistente en la administración por vía arterial de microesferas marcadas con radionucleidos emisores beta negativos que en el tejido hepático tienen una escasa penetración, lo que permite la administración de dosis elevadas que provoquen daño celular en el tejido tumoral, de manera que se evita la irradiación de tejido sano contiguo.Entre las microesferas más utilizadas se encuentran las de resina y/o vidrio marcadas con 90Y, aunque actualmente se está incrementando el uso de las de 166Ho sobre matriz biodegradable de ácido poli-L-láctico, los motivos principales residen en las características de este radionucleido, como son la emisión beta de menor energía, el periodo de semidesintegración más corto y presentar, además, emisión de fotones gamma, lo que permite su seguimiento gammagráfico. Asimismo, es un elemento paramagnético, por lo que se puede detectar mediante resonancia magnética, lo que facilita la simulación previa al tratamiento y el seguimiento posterior de este.

The aim of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) that applied herbal medicine to treat viral hepatitis B and C in order to determine the therapeutic efficacy of herbal medicine.EMBASE, Pubmed, NDSL, KMBASE, KISS, KISTI, Koreamed, Koreantk, and Oasis databases were searched to identify RCTs. The selected studies were assessed by the Cochrane group's risk of bias tool.A total of 15 RCTs were selected, and the hepatitis B virus (HBV) DNA reduction was significantly higher in patients treated with herbal medicine combined with Western medicine than in patients treated with herbal medicine. Herbal medicine combined with Western medicine was also superior to Western medicine alone in achieving hepatitis B e-antigen (HBeAg) and alanine aminotransferase [ALT] reduction. Only herbal medicine alone was not superior to Western medicine treatments in achieving HBV DNA, HBeAg, and ALT reduction.

Long-term antiviral treatment of chronic hepatitis B patients has been proven to be beneficial in reducing liver-related complications. However, lengthy periods of daily administration of medication have some inevitable drawbacks, including decreased medication adherence, increased cost of treatment, and possible long-term side effects. Currently, discontinuation of antiviral agent has become the strategy of interest to many hepatologists, as it might alleviate the aforementioned drawbacks and increase the probability of achieving functional cure. This review focuses on the current evidence of the outcomes following stopping antiviral treatment and the factors associated with subsequent hepatitis B virus relapse, hepatitis B surface antigen clearance, and unmet needs.

Objective – before and after the treatment to determine the functional state of the liver, serum levels of enzymes and biochemical indices in syphilis patients with viral hepatites B and C. The results of the study are based on the data from a comprehensive examination of 35 patients with syphilis alone and 127 patients with syphilis co-infected with viral hepatites B and C before and after treatment. Test methods: hepatology, rheogeopathography, enzyme content and biochemical parameters determined in the serum. According to the results of radionuclide hepatology it has been established that disorders of the functional capacity of the liver already occur in the early stages of the disease. The most significant disorders have been in the patients with the prescription of infection for more than 12 months and in the patients co-infected with viral hepatites B and C. A disorder of pigment metabolism and increased activity of trans­aminases have been revealed in early latent syphilis. In co-infection with viral hepatites B and C an increase in total bilirubin, Lactate dehydrogenase, Alanine transaminase, Aspartate aminotransferase and albumin has been revealed. Dysproteinemia has been revealed in patients with early latent syphilis co-infected with hepatitis C. Patients with early latent syphilis treated with immunomodulators tend to normalize these indices. In patients with syphilis a disorder of the functional state of the liver have been revealed already at an early stage of the disease. The most pronounced disorder of biochemical parameters and activity of liver enzymes are observed in syphilis patients with viral hepatites B and C, as well as in patients with early latent syphilis only with the prescription of the infection for more than 12 months; in such a case it is advisable to use drugs affecting the immune system.

Objective: to determine the frequency, spectrum and severity of liver affection in anti-centromere antibodies (ACA) positive patients with primary Sjogren's syndrome (pSS).Patients and methods. 119 ACA-positive patients with pSS were included in the study, 37 (31%) of them had signs of liver damage, 3 of these patients were excluded from the study (2 had cholelithiasis, 1 had viral hepatitis B). Signs of autoimmune liver damage were found in 34 (28.6%) patients, most of them were seropositive for antimitochondrial antibodies (AMA). The diagnosis of primary biliary cholangitis (PBC) and autoimmune hepatitis (AIH) was established according to the recommendations of the American Association for the Study of Liver Diseases, the Russian Gastroenterological Association and the Russian Society for the Study of the Liver. In 5 (14.7%) patients the cause of cholestasis remained unspecified.Results and discussion. AMA were found in 73.5% of patients, elevated serum IgM levels – in 57.6%. Clinically liver damage in most cases was characterized by an asymptomatic, slowly progressive course without a dramatic increase of symptoms over time. Liver cirrhosis was found in 14.7% of patients. According to clinical, laboratory and morphological manifestations, PBC was diagnosed in 21 patients, 4 of them also had a cross syndrome with AIH. AMA-negative PBC was found in 3 patients and isolated AIH – in 1. In most cases, histological stage I of PBC was detected. During follow-up, median of 7 years (range from 2 to 15 years), in 7 patients with stage I PBC and in 7 AMA-positive patients without functional liver disorders no clinical, laboratory or instrumental progression of liver damage was noted. In this regard, it was suggested that these patients have epitheliitis of the biliary ducts as manifestation of glandular affection in pSS, and not true PBC.Conclusion. Autoimmune liver lesions are detected in 28.6% of ACA-positive patients with pSS, most (41.2%) of them develop epitheliitis of the biliary ducts as pSS manifestation or a combination of pSS with PBC (with the same frequency), less often PBC / AIH cross syndrome is diagnosed. PBC / pSS-related epitheliitis of the biliary ducts in ACA-positive patients is characterized by a slowly progressive asymptomatic course in most cases and rarely leads to the development of liver cirrhosis.

The World Journal of Hepatology (WJH) was launched in October 2009. It mainly publishes articles reporting research findings in the field of hepatology, covering a wide range of topics, including viral hepatitis B and C, non-alcoholic fatty liver disease, alcoholic liver disease, autoimmune and chronic cholestatic liver disease, drug-induced liver injury, cirrhosis, liver failure, hepatocellular carcinoma, coronavirus disease 2019-related liver conditions, etc. As of December 31, 2020, the WJH has published 1349 articles, among which, the total cites is 18995 and the average cites per article is 14. In celebrating the New Year, we are pleased to share with you special a New Year's greeting from the WJH Editors-in-Chief, along with a detailed overview of the journal's submission, peer review and publishing metrics from 2020. In all, we are appreciative for the substantive support and submissions from authors worldwide, and the dedicated efforts and expertise provided by our invited reviewers and editorial board members.

Introduction: The HbsAg prevalence in Burkina Faso was 9.1%. We aimed at describing the therapeutic features and the clinical outcome for the patients taking antiretroviral treatment. Materials and Methods: We implemented a cross-sectional study from January 1st, 2004 to December 31st, 2015. Patients aged more than 15 years with positive hepatitis B surface antigen for over six months and positive hepatitis B e-antigen were included. Results: We analyzed the data of 148 participants for a sex ratio of 3; sixty-three patients including 49 men (77.8%) were on treatment. and 81.5% had inflammatory activity greater than one. Under tenofovir, the normalization of ALT was observed in 42 (84%) patients while HBV-DNA became undetectable in 24/33 patients. HBeAg negativation was observed in 16/25 (64%) patients after seven years of treatment. With lamivudine, 2/9 patients had a complete virologic response and six had a normalization of their ALT. Two and 9 patients lost HBeAg after 7 and 9 years of treatment, respectively. Overall 63% and 27% of the patients were in the high or low-adherence group, respectively. In the low-adherence group, all patients had normal or abnormal ALT, but detectable HBV DNA. Ten patients taking lamivudine developed resistance including primary resistance in three patients. No resistance has been observed with tenofovir. Conclusion: The management of the viral hepatitis B includes often a long follow up period without any medication. When antiviral is indicated, the adherence to the treatment is crucial to a long-term control of the virus. In our setting, the low purchase power of the patients may jeopardize their therapeutic future and there is a need to support this group of patients with free-of-charge medicines as it is provided for the HIV infected people.

Despite its high burden of disease, viral hepatitis B has been long neglected and still receives little public attention and political support as compared to other infectious diseases (e.g HIV, tuberculosis, malaria). Prevention of hepatitis B virus (HBV) mother-to-child transmission (MTCT), a key component to achieve HBV elimination, relies on antiviral therapy of highly viremic HBV-infected pregnant women and HBV vaccination at birth of their babies1 . In its elimination plan, the World Health Organisation (WHO) called for a major increase in coverage of vaccination (90%), diagnosis (90%) and treatment (80%) by 2030.

The purpose of the study is to analyze the dynamics of the chronic hepatitis B morbidity under the condition of mass vaccination in the Republic of Moldova during 2000–2019. Materials and methods . Statistical data provided by the National Agency of Public Health of the Republic of Moldova on acute and chronic hepatitis B for 2000–2019 were analyzed. The analysis was performed by using epidemiological, descriptive-evaluative, analytical and statistical research methods. Results and discussion . Еpidemiological study over a 20-year period (2000–2019) revealed that the introduction of immunization against viral hepatitis B has made a great contribution to the reduction of acute viral hepatitis B . At this stage, the incidence of HBV in the Republic of Moldova has significantly decreased from 76.,6 in 1989 to 0,17 per 100 thousands population in 2019. The incidence of chronic viral hepatitis B, is increasing from 23,32 in 2000 to 59,24 per 100 thou -sands population in 2019. A pronounced tendency of incidence decreasing in acute viral hepatitis B is recorded in both children and adults. The incidence of chronic viral hepatitis B in children shows a pronounced decreasing as well, compared to adults, who had an increasing incidence of from 26,85 in 2000 to 72,87 per 100 thousands population in 2019. The data obtained as a result of interviewing patients, revealed that patients with chronic viral hepatitis B constitute 50,22±1,91%, P < 0,001. The average age of patients with chronic viral hepatitis B was 54,05±10,53 years (X2=8,45, P=0,036). The female constitute 51,25±2,67%, P < 0,001, and the male – 48,75±2,74%, P < 0,001. Patients with high risk of infection were those exposed to intramuscular injections [OR=1,07; 95%, Cl: 0,79–1,45, P=0,62], sharing sharp objects [OR=1,06; 95%, Cl: 0,86–1,31, P=0,53], sharing scissors [OR=1,04; 95%, Cl: 0,85–1,28, P=0,66] and blood transfusion [OR=1,01; 95%, Cl: 0,78–1,32, P=0,89].

In 2019, a Lancet Gastroenterology & Hepatology Commission on accelerating the elimination of viral hepatitis reported on the status of 11 viral hepatitis policy indicators in 66 countries and territories with the heaviest burden by global region. Policies were reported as being either in place, in development, or not in place. This study uses the Commission findings to estimate hepatitis B virus (HBV) and hepatitis C virus (HCV) policy scores and rankings for these 66 countries and territories. We applied a multiple correspondence analysis technique to reduce data on policy indicators into a weighted summary for the HBV and HCV policies. We calculated HBV and HCV policy scores for each country. Countries and territories that received higher scores had more policies in place and in development than did countries with lower scores. The highest scoring country for HBV was Australia, whereas Somalia had the lowest score. For the HCV policy score, Australia and New Zealand had perfect scores, whereas Somalia, Sudan, and Yemen had the lowest scores, all having no policy indicators in place.

The article describes a clinical case of Kaposi sarcoma in a patient with concurrent tuberculosis, HIV infection with severely compromised T-cell immunity, viral hepatitis B and C, and substances and alcohol abuse. Also, the patient had low adherence to treatment with anti-tuberculosis and antiretroviral drugs.

Fibrosis and cirrhosis are traditionally diagnosed by making a biopsy. However, in recent decades, scientists around the world have shown that the accepted “gold standard of diagnosis” – morphological assessment of biopsy – has a number of limitations. The search for non-invasive techniques to diagnose fibrosis has led to the development of many scales using laboratory indices. Non-invasive diagnostic techniques are safer for the patient than liver biopsy. In addition, they can be repeated in a dynamic to assess the condition of the liver over time. Most currently available non-invasive diagnostic techniques are considerably cheaper than the accepted “gold standard”. Their practical use is increasing every year, and in a number of countries the frequency of liver biopsies in viral hepatitis B and C is steadily decreasing due to the development of serum and imaging diagnostic systems. Recent studies show that the assessment of the degree of fibrosis by non-invasive methods is as accurate as a morphological study. In recent years, a number of serum markers have been considered as non-invasive diagnostics of the stages of liver fibrosis, among which the largest number of studies are devoted to hyaluronic acid, type IV collagen, and their combination with various common laboratory tests. The latest non-invasive techniques will make a significant paradigm shift in the evaluation of liver fibrosis in the near future. In this review we have analyzed widely used as well as experimental laboratory techniques used in the diagnosis of liver fibrosis.

Background: HBV infection is a serious ailment which damages the liver yet not well known and hence not given adequate attention. Many are infected but are not aware because they do not manifest any sign and symptom. Aim: The purpose of this study was therefore to evaluate the prevalence of HBsAg among asymptomatic hospital attendees. Study Design: A cross sectional study. Place and Duration of Study: St Mary’s Catholic Hospital, Ibadan, Nigeria, between November 2017 and August 2018. Methodology: 1328 consecutive patients who attended the hospital were enrolled into this study after obtaining their consent. Their blood samples were aseptically collected and assayed for HBsAg using conventional method. Results: A total of 1,328 participants were enrolled, out of which 421 (31.7%) were male and 907 (68.3%) were female with a gender ratio of 1:2.2 - male to female. 5.9% (25/421) of the males tested positive to HBsAg while 5.4% (49/907) of the females tested positive to HBsAg (p=0.692). Of the overall 1328 individuals screened, 5.6% tested positive to HBsAg. The age group with the highest prevalence of HBsAg were those between 51 and 60 years with 13.1% followed by 41 - 50 years (7.2%) while > 70 years had the lowest prevalence. Conclusion: This study showed that HBsAg infection is high among asymptomatic hospital attendees in Ibadan, Nigeria. More public sensitization and awareness programmes are strongly advocated for.

The intensity and duration of preservation of the immune response to viral hepatitis B after vaccination among the medical staff of the polyclinic was studied. Some features of postvaccinal immunity in medical staff were revealed. In 39.2 % of the surveyed, postvaccinal antibodies were not detected or their level was lower than protective, which is the basis for a course of vaccinations against the HV virus in this group of persons in the absence of contraindications for vaccination. The intensity of post-vaccination immunity to the HV virus among different groups of medical personnel of the polyclinic depends on the type of professional activity.

Egypt had led a unique successful campaign in treating and surveillance of the most prevalent viral infections. However, social awareness evaluation is an unmet need for viral eradication strategic plans. Assess the level of knowledge and awareness of the community about HCV and HBV infections. This community-based cross-sectional survey, was conducted between November 2018 and March 2019 in Menofia Governorate, Egypt. A well-structured pretested questionnaire testing knowledge and awareness regarding HBV and HCV infections and their modes of transmission in 14000 medical and non-medical, urban and rural participants. Knowledge about HBV found to be good regarding transmission (81.9% correct answers), while in cure 51.7% of participants gave false answers. For HCV infection, good knowledge (79.3% of correct answers) was documented, while the curable nature of disease was denied in 40.9%. Blood and blood products (53.2%), sexual contact (27.8%), mother to child during delivery (7.3%) and others were reported as the commonest modes of transmission of HCV respectively. Television and newspapers were the main sources of knowledge (33 and 22% respectively). On asking participants about precautions against HCV infections, 30.2% stated that they are being educated on this issue, 22.3% had heard something like that and 47.5% of participants did not know anything about that. Multivariate logistic regression revealed that for both HBV and HCV knowledge and awareness were affected by age, residence and level of education. Despite the good results, levels of social awareness should be more elevated for proper viral eradication programs.

An overview of the incidence of health care-associated infection (HAIs) is presented. It is shown that most often medical workers are infected with infections transmitted through the blood and other biomaterials of patients, such as viral hepatitis B (HBV) and C (HCV), HIV infection. The significant frequency of occupational injuries among medical workers is emphasized. It is established that at the present stage, relatively new infections require some attention, which can lead to infection of medical workers in the course of their professional activities. These infections include atypical pneumonia (TOPC or SARS-severe acute respiratory syndrome), middle Eastern respiratory syndrome coronavirus (BRVS-Cov), African hemorrhagic fevers (Marburg, Ebola, Lassa), Crimea-Congo hemorrhagic fever (CCGL), and others. All these infections are quite severe, with a large number of deaths. Special attention is paid to the polyethyleneological nature of HAIs, which determines the need for a multi-modal approach to organizing preventive measures to protect medical workers from infection.

The involvement of general practitioners in the early detection of viral hepatitis B and C must be paramount. The objectives of this work were to assess GPs’ knowledge, attitude and practice with regard to screening for viral hepatitis B and C. We carried out a cross-sectional analytical study among GPs recruited by simple random sampling from the list of GPs in the city of Brazzaville. The judgement criteria were knowledge and practice of screening for viral hepatitis B and C, assessed according to a Likert scale divided into 3 categories: very good, good and bad. One hundred and twenty-one general practitioners were included, including 48 women and 73 men, with a sex ratio of 1.52; the average age was 33 years; 52.89% of them worked in the private sector with an average period of activity of 4 years. The majority of the doctors had a good knowledge (69.42%) and a bad practice (56.20%) of screening for viral hepatitis B and C. The duration of activity was the factor linked to knowledge of viral hepatitis B and C (p = 0.006) while age was the factor linked to the practice of screening for viral hepatitis B and C (p = 0.0366). In conclusion, in Brazzaville, general practitioners’ knowledge of screening for viral hepatitis B and C is good in general, but the practices are poor and require targeted in-service training.

Aim. To conduct the analysis and estimation of acute viral hepatitis B pharmacotherapy through identification of drug-related problems; to form a list of recommendations with elements of pharmaceutical care concerning some aspects of acute viral hepatitis B pharmacotherapy. Materials and Methods. The objects of research: 27 medical records of patients with acute viral hepatitis B who were hospitalized to one of Lviv City Hospitals in the first quarter of 2016; medical and technological documents on acute viral hepatitis B management; results of clinical research and clinical case reports; The Pharmaceutical Care Network Europe classification (version 5.01) for drug-related problems. Methods: systemic approach, clinical-pharmaceutical, clinical-pharmacological, statistical, and analytical. Results and Discussion. All patients with acute hepatitis B received only pathogenetic and/or symptomatic pharmacotherapy which corresponds to modern scientific approaches of rational pharmacotherapy of acute hepatitis B. The total number of identified drug-related problems was 192 (a mean of 7,1±1,4 drug-related problems per patient), out of them: 30,1% - potential drug-drug interactions; 27,5% - insufficient dosage of drugs; 14,6% - co-administration of medications with the same active ingredients (duplicate prescriptions); 11,5% - excessive duration of pharmacotherapy; 6,3% - incorrect drugs; 4,7% - incorrect route of drug administration; 1,6% - contraindicated use of drugs; 1,6% - excessive dosage of drugs; 1,6% - technical drug-related problems; and 0,5% - insufficient duration of pharmacotherapy. Conclusions. According to the results of this study, the list of clinical pharmacist's recommendations (messages of pharmaceutical care) have been formed which can be used for improving the quality and safety of pharmacotherapy. Key words: clinical pharmacist, acute viral hepatitis B, drug-related problems, rational pharmacotherapy

The article examines the new coronavirus (COVID-19) infection in comparison with other socially significant infections (HIV and viral hepatitis B and C), which are widespread among patients with substance addiction The general factors that increase the risk of their spread and complicate the introduction of effective preventive measures include: 1) lack of vaccines as specific preventive agents (except HBV vaccine);2) the presence of asymptomatic carriage stages, when an infected person can be a source of the infection transmission in the absence of clinical manifestations;3) behavioral factors contributing to epidemic spreading;4) stigmatization and discrimination of infection carriers in the society;5) the pandemic spread of infections, which has a significant impact on the health care system with serious social and economic consequences for the society and the state In the conclusion, the need is substantiated to improve and introduce modern measures for the prevention of all socially significant infections into the process of providing integrated specialized addiction care Рассматривается новая коронавирусная инфекция COVID-19 в сравнении с другими социально значимыми инфекциями: ВИЧ-инфекцией и вирусными гепатитами В и С, имеющими широкое распространение среди пациентов с зависимостями от психоактивных веществ (ПАВ) Названы общие факторы, повышающие риск их распространения, и осложняющие внедрение эффективных профилактических мероприятий: 1) отсутствие средств специфической профилактики - вакцин (за исключением ВГВ);2) наличие стадий бессимптомного носительства, когда инфицированный может быть источником распространения инфекции при отсутствии клинических проявлений;3) поведенческие факторы, способствующие эпидемическому распространению;4) стигматизация и дискриминация в обществе носителей инфекций;5) пандемический характер распространения инфекций, оказывающий значительное влияние на систему здравоохранения и имеющий серьезные социальные и экономические последствия для общества и государства В заключении обосновывается необходимость совершенствования и внедрения в процесс оказания комплексной специализированной наркологической помощи современных мер профилактики всех социально значимых инфекций

Background The rate of viral infections in donated bloods is one of the main indicators of blood safety which has to be monitored precisely. This paper provides a thorough study of blood safety indicators in the last 15 years in Iran. Methods The data of the transfusion organization in Iran from years 2003 to 2017 were used. The study focuses on the analysis of the frequency of viral hepatitis B and C (HBV and HCV) as well as human immunodeficiency virus (HIV) in blood donations. Results Of 27,442,124 donated bloods, the relative frequencies were 4, 302, and 81 for HIV, HBV and HCV, respectively. This study also shows that the corresponding frequencies were significantly lower in recent years (2.5, 53, and 26 per 100,000 samples in 2017). Conclusion The presented study indicates an overall low infection rate and provides evidence for the effectiveness of modern safety measures in improving the level of blood safety in Iran.

Aim. To determine the diagnostic possibilities of using liver shear wave elastography in pregnant women with hepatitis B and C viral infection. Methods. The study included 87 women with hepatitis B and C viral infections admitted to the Center of Clinical Medicine №1 and Educational and Therapeutic Clinic of Azerbaijan Medical University (basis of the department of obstetrics and gynecology 2 of Azerbaijan Medical University) in 2016 to 2017 aged 18-45 (average age 31.4±7.1 years), and 50 uninfected women with physiological pregnancy matched by the age (average age 30.6±6.8 years). Infected women were divided into two groups: 70 pregnant women (group 1) and 17 women (group 2), who were non-pregnant at the time of the study (average age 29.8±7.2 and 30.9±6.7 years, respectively). Women with physiological course of pregnancy were included into group 3 (average age 30.6±6.8 years). Groups of pregnant patients were matched by age, gestation age and parity (p ˃0.05). All patients underwent clinical and biochemical analyses and shear wave elastography of the liver. The obtained data were processed using the methods of variation statistics with calculation of mean and standard error (M±m), Mann-Whitney U-test, Spearman's rank correlation coefficient. Results. In 52.9±6% of the examined pregnant women with viral hepatitis, hepatitis B was identified, in 47.1±6% - hepatitis C. According to the results of shear wave elastography, the average density of the liver in these patients was 7.2±1.0 kPa. An increase in liver density in pregnant women with viral hepatitis was not accompanied by changes in the size of the liver (only 1 patient had hepatomegaly). In 71.4±5.4% of the patients, F1 degree was revealed, in 20.0±4.8% - F2, in 5.7±2.8% - F3, in 2.9±2.0% - F4. İn comparison with infected patients without pregnancy, pregnant women with viral hepatitis B and C had more severe degree of fibrosis [F1 was significantly less frequent (p ˂0.05), and F2 was significantly more frequent (p ˂0.05)], and also had F4 degree, which was not observed in non-pregnant. In infected pregnant women, there was a positive correlation between liver echogenicity and density of its tissues (p=0.495; p

The article considers modern approaches to the elimination of viral hepatitis B and C in the world, taking into account the guidelines developed by the World Health Organization. The current state and problematic aspects of the diagnosis and treatment of viral hepatitis with modern antiviral drugs as well as vaccine prophylaxis of viral hepatitis B in the world and the Republic of Belarus are presented.

The Republic of Korea has a high prevalence of hepatitis B virus (HBV) infection, and the policies concerning costly antiviral medication have been revised recently. However, in the past 10 years, no related research on costs has been conducted. The objective of this study was to estimate the economic burden of viral hepatitis B and determine the trend of changes in its costs between 2002 and 2015. Claims data from the National Health Insurance Service were used. To identify viral hepatitis B cases, the ICD-10th code B16, B17.0, B18.0 and B18.1 were used based on a primary diagnosis. This study was conducted from a societal perspective regarding both direct and indirect costs. Annual costs were adjusted for inflation by calculations based on the 2015 costs. The number of patients with viral hepatitis B increased from 213 758 in 2002 to 342 672 in 2015. The total socio-economic costs increased from 127.1 million USD in 2002 to 459.1 million USD in 2015, mainly due to the increase in pharmaceutical costs, which accounted for the largest proportion of total costs since 2009-220.5 million USD in 2015, which was ~15 times higher than that in 2002. The healthcare costs for viral hepatitis B accounted for 0.13% of the national health expenditure in 2002, increasing to 0.31% in 2015. The economic burden of viral hepatitis B has increased in the Republic of Korea. It is therefore essential to reduce the healthcare costs of HBV infection by establishing an effective management policy.

Onychomadesis is a nail plate abnormality with temporary cessation in the growth of the nail plate due to disturbances in the nail matrix. Any local or systemic condition affecting the nail matrix directly or indirectly can lead to onychomadesis. The causes can vary from idiopathic infections to systemic causes. Although onychomadesis is not a finding unique to any disease, it indicates the presence of a preceding trigger, which affects the nail matrix. Here, we report one such case of onychomadesis following acute hepatitis B infection.

Viral hepatitis B course in HIV patients in Zambia is still bad studied. At present, the study of the influence of immunosuppression on the clinical and laboratory features of viral hepatitis B acquires a special relevance. The aim of research is to investigate clinical and laboratory features of viral hepatitis B course among HIV-patients in Zambia. Epidemiological, descriptive, serological (HBV, HIV markers), biochemical (cytolysis and cholestasis syndromes’ indicators), statistic method for determining the reliability using average errors (m), t-criterion of the probability difference of the Student) methods are used. The results show HBV/HIV-positive Zambian patients reliably differ from HBV-monoinfected ones. As well, HBV/HIV-positive patients have significantly higher indexes of asteno-vegetatic, dyspeptic syndromes, hepato- and splenomegaly, cytolysis indexes (alanine aminotransferase, lactate dehydrogenase), which are associated with increase of HIV-infection’s stage. Hepatocellular deficiency’s indicators don’t differ reliably in comparison groups. Therefore, HBV/HIV-infected patients have more severe clinical and laboratory course than HBV-monoinfected ones.

Introduction. Infection caused by virus hepatitis B is a serious medical and social problem worldwide because of high morbidity, mortality and high costs of treatment. After introduction of mass vaccination for HBV in Russia the main issue related to HBV is high incidence and prevalence of chronic forms. Methods. Forms No. 2 and No. 6 of the state statistical reporting in 1986-2016 were analyzed. A population-based cross-sectional study of Arkhangelsk population aged 18-39 years was carried out to assess the prevalence of HBV markers (HBs Ag, anti-HBc) and antibodies to HBs Ag as well as factors associated with HBV infection. Results. During the study period, the pattern of incidence of acute- and chronic HBV infection in the Arkhangelsk region is similar to the pattern of incidence in Russia, but the magnitude of regional indicators of the incidence of acute HBV was lower while the incidence of chronic HBV infection was higher than nationwide. According to laboratory data, among 1243 participants the prevalence of serological markers (HBs Ag and/or anti-HBc) in the sample was 11.8% among men and 10.2% among women. Altogether, 1.1% of the men and 1.3% of the women had positive results for HBs Ag. In total, 46.4% of the men and 38.9% of the women had all three tests negative. 46.9% of the participants were positive only for antibodies to HBs Ag. Discussion. In the Arkhangelsk region the vaccination has had the greatest influence on intensity of epidemic process of acute HBV infection. The incidence of chronic HBV infection decreased in the region in 3 times after initiation of large-scale vaccination. Conclusion. The percentage of vaccinated persons in Arkhangelsk region is high. Still there are sources of infection in the population.

Objectives Chronic infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) have a major impact on mortality worldwide. Although effective treatments are available for both HBV and HCV infection

A new approach in understanding the mechanisms of immune response in viral hepatitis is the discovery of a unique type of immune cells – plasmocytoid dendritic cells (pDCs). Plasmocytoid dendritic cells (pDCs) are cells of lymphoid origin and morphologically resemble plasma cells. Functionally, they are professional IFN-a-producing cells that play an important role in antiviral immune response. Data on the mechanisms of PDCs participation in hepatitis B virus infection are few and contradictory. In chronic HBV infection, the role of pDCs remains mysterious and poorly understood with conflicting circulating blood pDCs results that show differently that they are not affected or reduced. However, functional disorders of pDCs were observed in patients with chronic HBV infection. The establishment of these mechanisms, as well as the search for the cause of hepatitis B virus latency and the formation of chronic infection remains one of the important and promising areas of scientific activities today.

Clinical following-up of children born to a-HCV/HBSAg-positive women referred to a risk group for vertical transmission of hepatitis C/B viruses is one of the most important areas of medical care for this group of patients. The data of the analysis of the organization, quality and effectiveness of dispensary observation of children from the «risk groups» for the vertical transmission of HCV/HBV infection are presented. The unsatisfactory quality and effectiveness of the dispensary observation of this category of patients has been established. Inadequate medical activity and awareness of doctors on the prevention of parenteral viral hepatitis have been identified. There is substantiated the necessity of implementing a multi-level system for the prophylaxis of viral hepatitis C/B in a system encompassing both a child and a mother based on continuity at each of its stages, which will allow reduce the number of infected children of younger age groups.

Current study was aimed at investigating prevalence of overt and occult hepatitis B infection in HIV-positive individuals as well as molecular-epidemiological characteristics of the circulating hepatitis B virus (HBV) strains in the Far Eastern Federal District (FEFD). A total number of 297 blood serum/plasma samples obtained from HIV-positive patients residing in the FEFD were enrolled in the study. The first control group included 351 blood serum/plasma samples of general population without indication on HIV and HBV-infection that underwent laboratory check up at the Centers for AIDS Prevention and Control. After evaluating the group of HIV-positive patients 20 HIV-HBV positive samples were selected for further detailed analysis. The second control group included 43 patients with chronic hepatitis B. All groups were age and gender-matched. The research included serological and molecular-genetic (real-time PCR, positive for HBV DNA samples underwent clonal sequencing of PCR-amplified HBV P/S gene) assessment of the biological material followed by a phylogenetic analysis of the HBV sequences. Our research revealed that HIV-positive patients are exposed to a higher risk of HBV infection compared to general population enrolled in the study, which is evident from the prevalence of anti-HBcAg antibodies in the groups examined. HIV-positive vs. first control group was positive for anti-HBcAg antibodies at higher rate (35.02%, CI 95: 29.59–40.45% versus 22.22%, CI 95: 17.87–26.57%, p = 0.0003). Abundance of ongoing HBV-infection markers was also higher in HIV-positive individuals compared to general population (6.73%, CI 95: 3.88–9.58% versus 0.85%, CI 95: 0–1.81%, p = 0.0001, respectively). Should be noted, that HBsAg-negative HBV infection in HIV-positive patient cohort comprised 1.01% (CI 95: 0–2.15%) whereas in general population this index was as low as 0.28% (CI 95: 0–0.84%). Virus hepatitis С and D were revealed at higher rate in HIV-positive individuals compared to patients with HIV-negative chronic HBV infection (p = 5.84 × 10 –7 and p = 0.000001 respectively). HCV and HDV prevalence rates comprised 50.0% (CI 95: 27.46–77.46%) and 40.0% (CI 95: 17.97–62.03%) in HIV-positive patients. Similar indices in control group were 4.65% (CI 95: 0–10.94%) and 4.65% (CI 95: 0–10.94%), respectively. The phylogenetic analysis of the six isolated HBV sequences showed that the five samples belonged to genotype D, with dominant subtype D2 (verified in 4 cases). Further, HBV genotype С was detected only in one case. The obtained data indicate a necessity for further in-depth diagnostic examination of viral hepatitis in HIV-positive patients to lower a risk of developing life-threatening complications as well as preventing hepatitis spread in human population.

We conducted a comparative analysis of the parenteral viral hepatitis B and C (HBV and HCV) prevalence and their molecular genetic characteristics among prisoners of persons diagnosed with HIV infection (41 samples), HIV-positive free citizens (187 samples) and «conditionally healthy population» with the lack of information about the presence of a diagnosis of chronic viral hepatitis of any etiology and HIV infection (231 samples). Immunological and molecular biological research methods were used. Obtained data analysis showed that the prevalence of infection markers with viruses of parenteral hepatitis was significantly higher in the groups of HIV-positive individuals (imprisoned and freemen). The HBsAg-negative form of the disease was determined among the HIV-positive free population and in the «conditionally healthy population». Over the past 10 years (2009–2018), the proportion of HIV-positive prisoners in custody of people with HCV monoinfection doubled, HBV was increased in 8.7 times. Significant decrease in the combined infection of HBV and HCV of this contingent was found. Given this decrease in the penitentiary system in HIV-positive individuals, the overall burden of HBV infection (both in mono form and coinfection with HCV) significantly (5.3 times) decreased , which can be attributed to successful widespread vaccination against hepatitis B in Russia. The most common HCV genotypes among HIV-positive individuals were 1b and 3a, genotypic structure of HBV prevailed genotype D.

Chronic HBV infection (CHB) can lead to acute-on-chronic liver failure (HBV-ACLF) characterized by high mortality. This study aimed to reveal ACLF-related proteomic alterations, from which protein based diagnostic and prognostic scores for HBV-ACLF were developed. Methods: Ten healthy controls, 16 CHB, and 19 HBV-ACLF according to COSSH (Chinese group on the study of severe hepatitis B) criteria were enrolled to obtain the comprehensive proteomic portrait related to HBV-ACLF initiation and progression. Potential markers of HBV-ACLF were further selected based on organ specificity and functionality. An additional cohort included 77 healthy controls, 92 CHB and 71 HBV-ACLF was used to validate the proteomic signatures via targeted proteomic assays. Results: Significant losses of plasma proteins related to multiple functional clusters, including fatty acid metabolism/transport, immuno-response, complement and coagulation systems, were observed in ACLF patients. In the validation study, 28 proteins were confirmed able to separate ACLF, CHB patients. A diagnostic classifier P4 (APOC3, HRG, TF, KLKB1) was built to differentiate ACLF from CHB with high accuracy (auROC = 0.956). A prognostic model P8 (GC, HRG, HPR, SERPINA6, age, NEU, INR and total protein) was built to distinguish survivors from non-survivors in 28 and 90-days follow-up (auROC = 0.882, 0.871), and to stratify ACLF patients into risk subgroups showing significant difference in 28 and 90-days mortality (HR=7.77, 7.45, both P

The article presents the results of a retrospective analysis of viral hepatitis B incidence in the Russian Federation from 2013 to 2017, taking into account the use of vaccines included into the National Immunisation Schedule and the Immunisation Programme in Case of Epidemic Outbreaks. The analysis of the data revealed a trend towards a reduction in the incidence of acute and chronic forms of hepatitis B in the territory of the Russian Federation during the past five years. The reduction of viral hepatitis B incidence was achieved thanks to a higher vaccination coverage of both children and adults. The article presents an overview of monovalent and combination recombinant hepatitis B vaccines licensed in the Russian Federation. It describes the WHO position on preventive vaccination against viral hepatitis B, and pays special attention to vaccination of people at risk. The article considers promising areas for improving immunobiological products for hepatitis B prevention, including new technologies used in vaccine production, development and introduction of new adjuvants or adjuvants systems, and development of therapeutic vaccines.

Viral hepatitis B (HBV) and C (HCV) can significantly influence maternal and child health. Although HIV infection, malaria, and syphilis in pregnant women are likely to be systematically screened for and managed according to national guidelines in the Democratic Republic of Congo, there is no plan for HBV and HCV. Furthermore, there is no documentation regarding pregnant women's knowledge about HBV and HCV. This situation has motivated the researchers to undertake the current study, which was designed to estimate the seroprevalence of HBV and HCV. We have also assessed knowledge of the HBV infection among pregnant women who consulted for antenatal care for the first time at Vanga Evangelical Hospital in Vanga. A cross-sectional study was conducted with 457 pregnant women who attended antenatal care. Sociodemographic, obstetric, and previous medico-surgical data, as well as information related to women's HBV knowledge, were collected using a questionnaire. Rapid tests were used to detect HBV surface antigen and HCV antibodies. Most pregnant women were aged 20-24 years. Only 6.8% of respondents had knowledge of HBV, and the main source of this knowledge was health facilities (4.6%). Only 0.7% reported having been tested, whereas 98.5% said that they had not been offered a test. Overall, 18 (3.9%) participants were HBV positive and 22 (4.8%) were positive for HCV. There is limited knowledge about HBV and HCV among pregnant women in rural Vanga. All pregnant women should be screened during antenatal care, and a well-implemented program of management is needed.

Patient living with chronic viral hepatitis in India faces the high cost of treatment and impoverishment. The present study is aimed to assess the cost of treatment and economic consequences among chronically infected viral hepatitis patients at a tertiary care hospital in Delhi. The descriptive cross-sectional study was undertaken during October 2016–January 2017. Three hundred and eighty-nine participants were interviewed through a schedule for variables and assessing both direct and indirect costs. Costs of hospital expenditure were extracted from records available with patients or databases of the hospital. The average outpatient expenditure and the inpatient costs were calculated. Direct nonmedical costs were also included. The analysis revealed the total cost of treatment ranged from Rs. 16,600/-to Rs. 1,709,000/-with a median of Rs. 193,500 per year. The cost of treatment increased with the severity of the disease. The cost of treatment led to impoverishment in 52.8% of families and imposed a substantial economic burden and consequences on the patients.

Introduction:viral hepatitis B remains a major public health problem around the world, especially in underdeveloped and developing countries. Cameroon shows a grate variability in prevalence of this infection in the country and even within different populations groups. The aim of this study was to determine the prevalence and factors associated with viral hepatitis B infection in the rural area of Dschang. Methods:we conducted a cross-sectional community-based study, involving 551 participants of both genders recruited by a voluntary sampling technique. The biological diagnosis of HBsAg was done by the Immunochromatographic method (PKL®kit of PARAMEDICAL srl laboratories). Positive cases were confirmed by ELISA method (reagent Kit from DIALAB Laboratories). Results:results show a Viral Hepatitis B prevalence of 5.08% (95% CI: 3.2-6.9). University students were the most infected (11/88) with a positivity rate of 12.50% (95%CI: 5.6-19.4). Only 29/551 participants (5.26%) had received at least one dose of vaccine against the disease and were less infected (3.44%) than the others (5.17%). Age (p=0.000), level of education (p=0.013), occupation (p=0.002), belief in the traditional healing of hepatitis B (p=0.000) and knowledge about the disease and its contamination roads (p=0.049) were associated with viral hepatitis B. Conclusion:there is a need of intensifying awareness, education, routine screening and vaccination of the population, especially in schools and university milieu to better counteract the infection with hepatitis B virus in our local Communities.

The novel coronavirus disease 2019 (COVID-19) clinically manifests as respiratory and gastrointestinal presentations, most commonly vomiting, diarrhea, and abdominal pain. Although the impaired liver function is prevalent in COVID-19, it is poorly understood. We report the first case of hepatitis B virus (HBV) reactivation caused by COVID-19 in a young adult with altered mental status and severe transaminitis. The patient was asymptomatic, hypothermic, his skin was jaundiced with the icteric sclera, with very high levels of aspartate aminotransferase (AST; 4,933 U/L), alanine aminotransferase (ALT; 4,758 U/L), and total bilirubin (183.9 mmol/L) levels. It is warranted that patients with abnormal liver functions tend to have an increased risk of COVID-19. Thus, increased attention should be paid to the care of patients with abnormal liver functions, and testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA is warranted in the COVID era.