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Background: Hepatitis C Virus is endemic to many areas of Thailand, whose population structure is tending towards older age groups as birth rate and mortality decrease. With around 790,000 cases in 2019, prevalence is still relatively high, but the World Health Organisation has called for elimination of HCV by 2030., Methods: An age structured compartmental transmission model was used to explore the effectiveness of screening strategies with respect to WHO elimination goals, as well as the effect of changing population structure on the success or failure of such strategies., Results: Population structure did not appear to affect the timeline of elimination targets and screening individuals over the age of 30 at a high (50% per year) coverage could bring forward achievement of the incidence elimination target by four years compared to baseline (approximately 6% per year). Achievement of mortality elimination targets was not reached until after the end of the simulation (2040), and intensive screening strategies did not appear to lead to incidence elimination by 2030., Conclusion: The model suggested that with age-targeted screening programmes incidence elimination could be brought forward by several years. However, WHO elimination goals may not be met by 2030., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Astley et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The World Health Organization aims to eliminate HCV infection worldwide by 2030. A targeted HCV screening policy is currently unavailable in Thailand, but a decrease in HCV infection has been observed in the country. However, a previous study showed that there was a higher HCV seroprevalence in adults aged between 30–64 years in the Phetchabun province (15.5%), as compared to the Khon Kaen province (3.6%). It was hypothesized that young adults had a lower rate of HCV seropositivity; this was determined by the age distribution of anti-HCV in Phetchabun and with the identification of high seroprevalence birth cohorts. In order to compare the provincial findings to the national level, anti-HCV birth cohorts were further analyzed in Khon Kaen (averaged-HCV prevalence) as well as the Thai data set that was derived from the previous literature. Thai individuals aged between 18–30 years residing in Phetchabun (n = 1453) were recruited, tested for the presence of anti-HCV antibodies and viral RNA and completed questionnaires that were designed to identify HCV exposure risks. Data was collected and compiled from previously published articles (n = 1667, age 30–64 years). The HCV seropositivity in Phetchabun by age group (18–64, at 5-year intervals) and the birth year were tabulated parallel to the Khon Kaen data set (n = 2233) in conjunction with data from the national survey 2014 (n = 5964) representing the Thai population. Factors such as age, male gender, agricultural work, blood transfusion, intravenous drug use and having a tattoo were associated with anti-HCV positivity in Phetchabun. HCV seroprevalence was less than 4.0% (ranging from 0.0–3.5%) from the age of 18–34 years. A dramatic increase of 15.1% was found in adults aged greater than or equal to 35 years, whereas, the age group in Khon Kaen and the national population with increasing prevalence of HCV were older (≥40). The HCV seropositivity cohort accumulated for those born between 1951–1982 accounted for 71.4–100.0% of all seropositive individuals. Subsequently, new cases occurred sporadically. This finding provides evidence that there is a disproportionately high HCV seroprevalence among people born before 1983 (or aged ≥35). This cohort should be targeted for priority screening as part of the national HCV screening policy. Incorporating this birth cohort with other risk factors could improve HCV diagnostic rates, resulting in overall improvements in parallel to those given by novel antiviral treatment. [ABSTRACT FROM AUTHOR]

Improved awareness of the hepatitis C virus (HCV) transmission has contributed to the overall decline in the HCV infection rate in some developing countries including Thailand. Chronic HCV infection in some rural Thai communities, however, presents a challenge in the efforts to treat and manage HCV-related diseases. Published and unpublished studies have suggested an unusually high incidence of HCV infection in a Thai province of Phetchabun compared to elsewhere in Thailand. To determine the magnitude of HCV infection and identify potential factors contributing to the higher rate of HCV infection in this province, we performed a population-based study in Phetchabun (n = 1667) and the neighboring Khon Kaen province (n = 1410) where HCV prevalence is much lower. Individuals between 30 and 64 years old completed detailed questionnaires designed to identify HCV risk factors and provided blood samples for anti-HCV antibody screening. The anti-HCV seropositive rates were 15.5% (259/1667) in Phetchabun and 3.6% (51/1410) in Khon Kaen. Positive samples were subsequently genotyped for HCV core gene sequence and assessed for the hepatitis B virus surface antigen (HBsAg) and human immunodeficiency virus antigen/antibody (HIV Ag/Ab). More individuals in Phetchabun possessed the combined presence of HBsAg (5.0%) and HIV Ag/Ab (0.4%) than those in Khon Kaen (3.9% HBsAg and 0.0% HIV Ag/Ab). While male gender, intravenous drug use (IVDU) and tattoos were significant HCV risk factors in both provinces (p <0.05), education less than high school and agriculture-related occupation were additionally associated with HCV in Phetchabun. HCV genotypes 6, 3, and 1 were identified in similar frequency in both provinces. We estimated that prevalence of HCV seropositivity and viremic carriers were higher in Phetchabun (143 and 111 per 1000) than in Khon Kaen (34 and 22 per 1000). Finally, we derived a simple risk factor-based scoring system as a useful preclinical tool to screen individuals at risk of chronic HCV infection prior to intervention. Knowledge gained from this study will assist in HCV screening and promote access to anti-viral treatment in high-risk groups. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) infection is an important worldwide public health problem, and most of the global HCV burden is in low- to middle-income countries. This study aimed to estimate the future burden of chronic hepatitis C (CHC) and the impact of public health policies using novel antiviral agents in Thailand. A mathematical model of CHC transmission dynamics was constructed to examine the disease burden over the next 20 years using different treatment strategies. We compared and evaluated the current treatment (PEGylated interferon and ribavirin) with new treatments using novel direct-acting antiviral agents among various treatment policies. Thailand’s CHC prevalence was estimated to decrease 1.09%–0.19% in 2015–2035. Expanding treatment coverage (i.e., a five-fold increment in treatment accessibility) was estimated to decrease cumulative deaths (33,007 deaths avoided, 25.5% reduction) from CHC-related decompensated cirrhosis and hepatocellular carcinoma (HCC). The yearly incidence of HCC-associated HCV was estimated to decrease from 2,305 to 1,877 cases yearly with expanding treatment coverage. A generalized treatment scenario (i.e., an equal proportional distribution of available treatment to individuals at all disease stages according to the number of cases at each stage) was predicted to further reduce death from HCC (9,170 deaths avoided, 11.3% reduction) and the annual incidence of HCC (i.e., a further decrease from 1,877 to 1,168 cases yearly, 37.7% reduction), but cumulative deaths were predicted to increase (by 3,626 deaths, 3.7% increase). Based on the extensive coverage scenario and the generalized treatment scenario, we estimated near-zero death from decompensated cirrhosis in 2031. In conclusion, CHC-related morbidity and mortality in Thailand are estimated to decrease dramatically over the next 20 years. Treatment coverage and allocation strategies are important factors that affect the future burden of CHC in resource-limited countries like Thailand. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) infection affects ≥ 180 million individuals worldwide especially those living in developing countries. Recent advances in direct-acting therapeutics promise effective treatments for chronic HCV carriers, but only if the affected individuals are identified. Good treatment coverage therefore requires accurate epidemiological data on HCV infection. In 2014, we determined the current prevalence of HCV in Thailand to assess whether over the past decade the significant number of chronic carriers had changed. In total, 5964 serum samples from Thai residents between 6 months and 71 years of age were obtained from 7 provinces representing all 4 geographical regions of Thailand and screened for the anti-HCV antibody. Positive samples were further analyzed using RT-PCR, sequencing, and phylogenetic analysis to identify the prevailing HCV genotypes. We found that 56 (0.94%) samples tested positive for anti-HCV antibody (mean age = 36.6±17.6 years), while HCV RNA of the core and NS5B subgenomic regions was detected in 23 (41%) and 19 (34%) of the samples, respectively. The seropositive rates appeared to increase with age and peaked in individuals 41–50 years old. These results suggested that approximately 759,000 individuals are currently anti-HCV-positive and that 357,000 individuals have viremic HCV infection. These numbers represent a significant decline in the prevalence of HCV infection. Interestingly, the frequency of genotype 6 variants increased from 8.9% to 34.8%, while the prevalence of genotype 1b declined from 27% to 13%. These most recent comprehensive estimates of HCV burden in Thailand are valuable towards evidence-based treatment coverage for specific population groups, appropriate allocation of resources, and improvement in the national public health policy. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis C virus (HCV) infection is an infection that may lead to cirrhosis and hepatocellular carcinoma. Most patients with HCV infection are asymptomatic. The previous study conducted in age group of 30-64 years and in two provinces. Additionally, most surveillance studies conducted in a point period; not longitudinally. This study aimed to evaluate HCV infection rate in all age groups in the northeastern, Thailand in a longitudinal fashion., Methods: This was a surveillance study conducted in 20 provinces of northeastern, Thailand. The study period was between July 2010 and November 2019. During the surveillance, demographic data of participants were collected. HCV screening test was performed in each participant by using a rapid point-of-care assay. Rates of HCV infection in each province and in overall were calculated., Results: During the surveillance period, there were 31,855 subjects who participated the project. Of those, 1,285 subjects (4.037%) were tested positive for HCV infection (Tab. I). The HCV infection rate was highest in 2011 (8.98%): ranges 1.28 to 9.59%. The age group of over 50 years had 690 subjects with HCV infection (5.45%) out of 12,660 subjected tested in this age group. There was significant different among age groups (p < 0.001) and difference of age over 30 years and sex (p 0.043)., Conclusions: This longitudinal surveillance showed that HCV infection rates in northeastern, Thailand were varied across the provinces with the highest rate of 9.59%. The HCV infection should be aware in male with age over 30 years., Competing Interests: Conflict of interest statement The authors declare no conflict of interest., (©2022 Pacini Editore SRL, Pisa, Italy.)

Background: Viral hepatitis is highly prevalent among people with HIV (PWH) and can lead to chronic liver complications. Thailand started universal hepatitis B vaccination at birth in 1992 and achieved over 95% coverage in 1999. We explored the prevalence of hepatitis B and C viral infections and the associated factors among PWH from same-day antiretroviral therapy (SDART) service at the Thai Red Cross Anonymous Clinic, Bangkok, Thailand., Methods: We collected baseline characteristics from PWH enrolled in the SDART service between July 2017 and November 2019. Multivariable logistic regression was performed to determine factors associated with positive hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV)., Results: A total of 4011 newly diagnosed PWH who had HBsAg or anti-HCV results at baseline: 2941 men who have sex with men (MSM; 73.3%), 851 heterosexuals (21.2%), 215 transgender women (TGW; 5.4%), and 4 transgender men (0.1%). Median age was 27 years. Overall seroprevalence of HBsAg and anti-HCV were 6.0 and 4.1%, respectively. Subgroup prevalence were 6.2 and 4.7% among MSM, 4.6 and 2.4% among heterosexuals, and 9.3 and 3.7% among TGW, respectively. Factors associated with HBsAg positivity were being MSM, TGW, born before 1992, CD4 count < 200 cells/mm 3 , and alanine aminotransferase ≥ 62.5 U/L. Factors associated with anti-HCV positivity were being MSM, age > 30 years, alanine aminotransferase ≥ 62.5 U/L, creatinine clearance < 60 ml/min, and syphilis infection., Conclusions: Around 5-10% of newly diagnosed PWH in Bangkok had hepatitis B viral infection after 25 years of universal vaccination. Anti-HCV positivity was found in 4-5% of PWH who were MSM and TGW. As World Health Organization and Thailand national guidelines already support routine screening of hepatitis B and C viral infections in PWH and populations at increased risk of HIV including MSM and TGW, healthcare providers should reinforce this strategy and provide linkage to appropriate prevention and treatment interventions. Catch-up hepatitis B vaccination should be made available under national health coverage., (© 2022. The Author(s).)

Background: People who inject drugs (PWID) are the most exposed to hepatitis C virus (HCV). In Thailand, drug use is highly criminalized, and harm reduction services are scarce. This study estimates risky injection practices and assesses the proportion of HCV awareness and screening in the PWID population in Northern Thailand., Methods: We used respondent-driven sampling (RDS) to recruit PWID in Chiang Mai Province. Social and behavioural data were collected through face-to-face interviews at an addiction treatment facility. Weighted population estimates were calculated to limit biases related to the non-random sampling method. Univariate and multivariate analyses were performed to study factors associated with HCV awareness and screening., Results: One hundred seventy-one PWID were recruited between April 2016 and January 2017. Median age was 33 (Interquartile range: 26-40) years, 12.2% were women, and 49.4% belonged to a minority ethnic group. Among participants, 76.8% injected heroin, 20.7% methadone, and 20.7% methamphetamine. We estimate that 22.1% [95% CI: 15.7-28.6] of the population had shared needles in the last 6 months and that 32.0% [95% CI: 23.6-40.4] had shared injection material. Only 26.6% [95% CI: 17.6-35.6] had heard of HCV. Factors independently associated with knowledge of HCV included belonging to a harm reduction organization (adjusted odds ratio (aOR) = 5.5 [95% CI: 2.0-15.3]) and voluntary participation in a drug rehabilitation programme (aOR = 4.3 [95% CI: 1.3-13.9]), while Lahu ethnicity was negatively associated (aOR = 0.3 [95% CI: 0.1-0.9]). We estimate that 5% of the PWID population were screened for HCV; the only factor independently associated with being screened was membership of a harm reduction organization (aOR = 5.7 [95% CI: 1.6-19.9])., Conclusion: Our study reveals that the PWID population is poorly informed and rarely screened for HCV, despite widespread risky injection practices. A public health approach aimed at reducing the incidence of HCV should target the PWID population and combine harm reduction measures with information and destigmatization campaigns. Civil society organizations working with PWID are a major asset for the success of such an approach, based on their current positive interventions promoting awareness of and screening for HCV.

BACKGROUND To prevent the transmission of HIV and hepatitis B and C viruses, early detection is necessary; however, in the early stage, most infected people are symptomless. Screening for these infections should be targeted to certain clinical settings to increase the early detection rate. MATERIAL AND METHODS This retrospective study was conducted by analyzing data from patients' medical records to determine how the screening tests for these viral infections were utilized and what the clinical outcomes from the test utilization were. RESULTS From 11 676 collected records, the screening tests for HIV, HBV, and HCV infections were utilized in 871, 556, and 236 cases, respectively. The tests for HIV and HCV were utilized the most in people with chronic non-infectious diseases, while the test for HBV infection was utilized the most in pregnant women. The positive results of these tests were highly found in the group of patients with acute non-infectious diseases. HIV infection was newly detected in 1.38% of patients, and HBV and HCV infections were newly detected in 5.58% and 2.12%, respectively. CONCLUSIONS Screening for HIV and HBV infections was performed according to the guidelines of the national HIV and HBV programs. The Outpatient Department (OPD) and medical ward may be the most appropriate clinical settings for HIV screening because most patients are there and blood tests are often ordered there, too. The national programs helped slow the rates of HIV and HBV infections in this community.

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major causes of transfusion-transmitted infection (TTI). In Thailand, the prevalence of HBV infection in new blood donors has decreased gradually from 7.1% in 1988 to 2.6% in 2009. This drastic decline in HBV prevalence is mostly the result of an effective expanded program on immunization (EPI) against HBV; the current coverage rate with HBV vaccine in newborns is more than 98% nation-wide. The prevalence of HCV infection, has decreased at a slower rate due to lack of HCV vaccination. The use of healthy volunteer blood donors and nucleic acid amplification technology (NAT) has also contributed to the steady decrease in rates of HBV and HCV infections. We summarize the current status of the EPI program for preventing HBV and the current strategy of HBV and HCV screening in new blood donors.

An attempt is made in this review to update the reader on recent developments and progress in the study of cholangiocarcinoma: a major primary carcinoma of the liver with a very poor prognosis. Knowledge of the cell biology and physiological functions of the cholangiocyte has recently so progressed that our understanding of cholangiocarcinogenetic mechanism is expected to follow. The first part of the review deals with semantic problems, temporal changes in the incidence of cholangiocarcinoma and geographic differences in epidemiology, etiologic factors (particularly opistorchiasis in Thailand and hepatolithiasis in the Far East), and discusses a recently disclosed role of hepatitis C virus infection (30% of cholangiocarcinoma patients have antibodies against hepatitis C virus in Japan).

The gene encoding nucleocapsid (core) protein of hepatitis C virus (HCV) was isolated from a Thai blood donor infected with HCV genotype 1b. The nucleotide sequence of this clone showed a high degree of homology to that of 4 HCV strains isolated from other Thai blood donors as well as that of the HCV prototypes of genotypes 1a, 1b, 2a and 3a. The entire region of the core gene was cloned into an expression plasmid pGEX-3X to be expressed as a fusion protein with glutathione-S-transferase (GST). E. coli transformants containing this plasmid did not express the fusion protein. However, GST-HCV core fusion protein could be produced when the core gene was truncated at the 3' end resulting in a gene encoding only the first 123 amino acid residues of the core protein. This fusion protein was insoluble in standard buffers, but could be solubilized by sarkosyl and thus subsequently purified using glutathione-Sepharose 4B. The purified fusion protein was immunogenic and could react with antibodies from blood donors infected with all genotypes of HCV found in Thailand. In addition, two murine hybridoma clones secreting monoclonal antibodies specific to the recombinant HCV core protein were produced. The purified HCV core protein and the monoclonal antibodies to the recombinant protein will be useful for developing assay systems for detecting anti-HCV antibodies and HCV antigen, respectively.