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Orabueze IN, Ike AC, Aniche OM, Nwafia IN, Ebede SO. Hepatitis B virus infection among illegal drug users in Enugu State, Nigeria: prevalence, immune status, and related risk factors. BMC Public Health 2024; 24:1203. [PMID: 38724938 PMCID: PMC11080182 DOI: 10.1186/s12889-024-18675-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION Hepatitis B virus infection poses a global health challenge, particularly in low- and middle-income African countries. Illicit drug use exacerbates the problem, with drug users having a higher HBV infection risk and maintaining a quiet transmission pool. This study aimed to determine HBV infection prevalence, immune status, and risk factors among illegal drug users in Enugu State, Nigeria. MATERIALS AND METHODS A cross-sectional study was conducted in Enugu State, using privileged access interviewer methods to enroll drug users. Pre-tested structured questionnaires were administered after informed consent was obtained. Blood samples were tested for HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb using immunochromatographic rapid test kits. Statistical analysis was performed using SPSS version 25. RESULTS One hundred drug users were recruited into the study. Overall, 7% of the drug users had HBV infection. 61% were found to be susceptible to HBV infection, 15% showed serological evidence of immunity from HBV vaccination and 1% developed natural immunity from HBV exposure. Significant risk factors for HBV infection were age less than 20 years, young age (≤ 20 years) at drug initiation, being single, injecting drugs more than or equal to 20 times per month and injecting with used syringes. CONCLUSION This study shows high intermediate endemicity of HBV infection among drug users, low vaccination uptake, and high susceptibility to HBV infection. This calls for the urgent inclusion of drug users in national HBV vaccination campaigns and the adoption of the World Health Organization's recommendations on the prevention of viral hepatitis among people who inject drugs.
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Affiliation(s)
- Ibuchukwu N Orabueze
- Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
- Department of Medical Microbiology, Faculty of Basic Clinical Sciences, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Enugu, Enugu State, Nigeria
| | - Anthony C Ike
- Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Oluchi M Aniche
- Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
- Department of Community Medicine, Faculty of Basic Clinical Sciences, University of Nigeria Enugu Campus, Enugu, Enugu State, Nigeria
| | - Ifeyinwa N Nwafia
- Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria.
- Department of Medical Microbiology, Faculty of Basic Clinical Sciences, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Enugu, Enugu State, Nigeria.
| | - Samuel O Ebede
- Department of Medical Microbiology, Faculty of Basic Clinical Sciences, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Enugu, Enugu State, Nigeria
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Semá Baltazar C, Ribeiro Banze A, Seleme J, Boothe M. People Who Inject Drugs in Mozambique: We need to normalize HIV treatment and care services in specialized community centers for people who inject drugs! Harm Reduct J 2024; 21:6. [PMID: 38184600 PMCID: PMC10771667 DOI: 10.1186/s12954-023-00910-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 11/28/2023] [Indexed: 01/08/2024] Open
Abstract
Globally, People Who Inject Drugs (PWID) have limited healthcare, treatment, and prevention services, and they frequently experience stigma and negative attitudes toward healthcare providers when accessing services. Mozambique, with a general population HIV prevalence of 12.5%, has one of the highest rates in the world, and the PWID population has the highest HIV prevalence among key populations, estimated at nearly 50%. Less than half of HIV positives who inject drugs are linked to HIV treatment and are retained in care. One of the main reasons is that HIV treatment is mainly provided in a public health facility and PWID delayed accessing healthcare since they anticipated mistreatment from multiple levels of healthcare providers. To improve the health outcomes in this group, we need to treat them where they feel comfortable and respected. In this commentary, we outline the importance of innovative approaches to enhance the management of HIV-positive PWID. As a country gets close to controlling the HIV epidemic, refocusing and targeting responses to the highest-risk groups becomes even more essential for shaping more effective HIV interventions and achieving epidemic control.
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Affiliation(s)
| | | | - Jessica Seleme
- Mozambique National Program for STI, HIV and AIDS Control, Ministry Oh Health, Maputo, Mozambique
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Lunel Fabiani F, El Bara A, Hamed CT, LE Guillou Guillemette H. [Delta hepatitis in Africa: epidemiological and clinical particularities]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2023; 3:mtsi.v3i4.2023.430. [PMID: 38390020 PMCID: PMC10879896 DOI: 10.48327/mtsi.v3i4.2023.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/04/2023] [Indexed: 02/24/2024]
Abstract
In 2022, the World Health Organization (WHO) estimated that hepatitis B virus (HBV) infections caused 1.5 million deaths, mostly attributable to complications from chronic infections, cirrhosis and hepatocellular carcinoma (HCC). Despite the availability of a vaccine, 296 million people were chronically infected in 2019. Asia and Africa are the continents most affected by this infection, with around 100 million people infected in Africa as a whole.Hepatitis Delta or D virus (HDV), which is a "satellite" virus of HBV, is often misunderstood and its diagnosis remains neglected. However, it is associated with acute fulminant forms and chronic forms of hepatitis leading to a more rapid evolution towards cirrhosis and HCC than during HBV mono-infection. Research on these two viruses HBV and HDV has progressed a lot in recent years, and new treatments are currently in development.In people living with the human immunodeficiency virus (PlHIV), liver disease is a major cause of morbidity and mortality. Due to common modes of transmission, dual or triple HIV/HBV or HIV/HBV/HDV infections are relatively common, particularly in HBV endemic regions such as Africa. However, while today most co-infected patients benefit from effective treatment against both HIV and HBV, the latter is not active against HDV. In Africa, hepatitis B and D have already been the subject of several studies. However, the frequency and clinical consequences of these co-infections have been little studied in the general population and in PlHIV.This review seeks to update the epidemiological and clinical data and the therapeutic perspectives of HDV co-infections or triple infections (HIV-HBV-HDV) in Africa.
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Affiliation(s)
- Françoise Lunel Fabiani
- Service de virologie, Centre hospitalier universitaire d'Angers, Angers, France
- Université d'Angers, Laboratoire HIFIH (Hémodynamique, interaction fibrose et invasivité tumorales hépatiques), EA 3859, Angers, France
| | - Ahmed El Bara
- Université d'Angers, Laboratoire HIFIH (Hémodynamique, interaction fibrose et invasivité tumorales hépatiques), EA 3859, Angers, France
| | - Cheikh Tijani Hamed
- INRSP (Institut national de recherche en santé publique), Nouakchott, Mauritanie
| | - Hélène LE Guillou Guillemette
- Service de virologie, Centre hospitalier universitaire d'Angers, Angers, France
- Université d'Angers, Laboratoire HIFIH (Hémodynamique, interaction fibrose et invasivité tumorales hépatiques), EA 3859, Angers, France
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Mayanja Y, Rida W, Kimani J, Ssetala A, Mpendo J, Nanvubya A, Mutua G, Anzala O, Price MA. Hepatitis B status and associated factors among participants screened for simulated HIV vaccine efficacy trials in Kenya and Uganda. PLoS One 2023; 18:e0288604. [PMID: 37459311 PMCID: PMC10351693 DOI: 10.1371/journal.pone.0288604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 07/02/2023] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION Hepatitis B (HBV) prevalence remains high in Sub Saharan Africa and among some key populations such as those with continued exposure through sexual contact. We assessed the HBV status among potential participants who were screened for simulated HIV vaccine efficacy trials in Kenya and Uganda. METHODS We conducted a cross sectional analysis of data collected from individuals who were screened in Kenya (Nairobi) and Uganda (Entebbe and Kampala). The studies followed hypothetical procedures of an HIV vaccine efficacy trial and aimed to enroll HIV negative key and vulnerable populations at elevated risk of HIV acquisition. HBV status was the main outcome categorized using Hepatitis B surface antigen (HBsAg) and total Hepatitis B core antibody (HBcAb). Baseline characteristics potentially associated with never being infected were analyzed using logistic regression. RESULTS We screened 1,366 participants with mean age (SD) 28.7 (7.3) years. Overall, 46.6% were from Entebbe, 50.7% had secondary or higher level of education, 76.4% had informal high-risk jobs and 56.3% were male. Kampala had only female participants contributing 60.6% of females screened. Of the screened participants, 94.7% and 3.4% were negative and positive for HBsAg respectively. The prevalence on HBV infection was 3.9% among males and 2.8% among females while prevalence by site was: Entebbe (4.9%); Kampala (4.1%) and Nairobi (0.3%). The highest HBV prevalence was found among participants aged 25-29-years (5.2%), those with primary level education (4.5%), and those in informal low risk jobs (6.5%). Considering 1265 participants with complete data on HBsAg and HBcAb-Total, HBV status was never infected (67.9%), past infection (28.5%), chronic infection (3.2%) and acute infection (0.5%). Of 859 who were never infected, 685 (79.7%) were tested for anti-HBs titers of whom 60 (8.8%) had titers >10IU/L (immune due to vaccination). The odds of never being HBV infected were lower among older individuals 25-29 years (AOR 0.51; 95%CI 0.36-0.71) and ≥30 years (AOR 0.35; 95% CI 0.25-0.49). The odds were higher among participants with informal high-risk jobs from Kampala (AOR 2.21; 95% CI 1.41-3.47) and Nairobi (AOR 2.61; 95% CI 1.72-4.00) compared to those from Entebbe. CONCLUSION HBV prevalence and immunity due to vaccination were low among HIV negative individuals who are eligible for HIV vaccine trials and prevalence varies by age, education level and main occupation. Younger individuals and those recruited from existing cohorts/ clinics have a higher likelihood of having no prior HBV infection. HIV prevention intervention trials are a platform to identify individuals that need HBV vaccination.
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Affiliation(s)
- Yunia Mayanja
- Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Wasima Rida
- Biostatistics Consultant, Arlington, Virginia, United States of America
| | - Joshua Kimani
- SWOP-PHDA, University of Nairobi/University of Manitoba, Nairobi, Kenya
| | - Ali Ssetala
- Uganda Virus Research Institute/ International AIDS Vaccine Initiative (UVRI-IAVI) HIV Vaccine Programme, Entebbe, Uganda
| | - Juliet Mpendo
- Uganda Virus Research Institute/ International AIDS Vaccine Initiative (UVRI-IAVI) HIV Vaccine Programme, Entebbe, Uganda
| | - Annet Nanvubya
- Uganda Virus Research Institute/ International AIDS Vaccine Initiative (UVRI-IAVI) HIV Vaccine Programme, Entebbe, Uganda
| | | | - Omu Anzala
- KAVI- Institute for Clinical Research, Nairobi, Kenya
| | - Matt A. Price
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States of America
- IAVI, New York, New York, United States of America
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Feasibility and acceptability of integrating hepatitis B care into routine HIV services: a qualitative study among health care providers and patients in West Nile region, Uganda. BMC Health Serv Res 2023; 23:59. [PMID: 36670448 PMCID: PMC9854069 DOI: 10.1186/s12913-022-08924-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 12/05/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Despite facing a dual burden of HBV and HIV, Africa lacks experience in offering integrated care for HIV and HBV. To contextualize individual and group-level feasibility and acceptability of an integrated HIV/HBV care model, we explored perspectives of health care providers and care recipients on feasibility and acceptability of integration. METHODS In two regional hospitals of West Nile region, we performed a demonstration project to assess feasibility and acceptability of merging the care of HBV-monoinfected patients with existing HIV care system. Using interviews with health care providers as key informants, and 6 focus groups discussions with 3 groups of patients, we explored feasibility [(i)whether integration is perceived to fit within the existing healthcare infrastructure, (ii) perceived ease of implementation of HIV/HBV integrated care, and (iii) perceived sustainability of integration] and acceptability [whether the HIV/HBV care model is perceived as (i) suitable, (ii) satisfying and attractive (iii) there is perceived demand, need and intention to recommend its use]. We audio-recorded the interviews and data was analysed using framework analysis. RESULTS The following themes emerged from the data (i) integrating HBV into HIV care is perceived to be feasible, fit and beneficial, after making requisite adjustments (ii) integration is acceptable due to the need for both free treatment and anticipated collaboration between HIV and HBV clients in terms of peer-support (iii) there are concerns about the likely rise in stigma and the lack of community awareness about integrated care. CONCLUSION The integrated HIV/HBV care model is feasible and acceptable among both providers and recipients. Necessary adjustments to the existing care system, including training, for community sensitization on the reasons and significance of integration are required.
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Giang HT, Duc NQ, Khue PM, Quillet C, Oanh KTH, Thanh NTT, Vallo R, Feelemyer J, Vinh VH, Rapoud D, Michel L, Laureillard D, Moles JP, Jarlais DD, Nagot N, Huong DT. Gender Differences in HIV, HCV risk and Prevention Needs Among People who Inject drug in Vietnam. AIDS Behav 2022; 27:1989-1997. [PMID: 36441408 PMCID: PMC10149475 DOI: 10.1007/s10461-022-03932-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 11/30/2022]
Abstract
We examined gender differences among people who inject drug (PWID) in Hai Phong, Vietnam in term of blood-borne infections, risk behaviors, and access to care. Using respondent-driven-sampling surveys, we recruited 3146 PWID from 2016 to 2018. Inclusion criteria included a positive urine test for heroin and recent injection marks. There were 155 female PWID (4,9%), including 82 at RDS-2016, 32 at RDS-2017 and 38 at RDS-2018. The age mean was 36.3 ± 7.2 years. The majority of female PWID had less than high school education (90.9%) and were unemployed (51.3%). There was no difference in the proportion of HIV and HCV positive by gender. However, women had several significant differences in risk behaviors than men in multivariable logistic regression. Being a woman was independently associated with being unemployed, being a sex worker, having unstable housing, having uses drugs for less than 5 years, more use of methamphetamine, having a partner who ever injected drugs, and less access to methadone treatment. Interventions targeting female PWID are needed, possibly through community organizations and peer educators.
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Affiliation(s)
- Hoang Thi Giang
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, 72A, Nguyen Binh Khiem, Ngo Quyen district, Haiphong city, Vietnam.
| | - Nguyen Quang Duc
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, 72A, Nguyen Binh Khiem, Ngo Quyen district, Haiphong city, Vietnam
| | - Pham Minh Khue
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, 72A, Nguyen Binh Khiem, Ngo Quyen district, Haiphong city, Vietnam
| | - Catherine Quillet
- Pathogenesis and control of chronic & emerging infections, Etablissement Français du Sang, University of Montpellier, INSERM, University of Antilles, Montpellier, France
| | | | | | - Roselyne Vallo
- Pathogenesis and control of chronic & emerging infections, Etablissement Français du Sang, University of Montpellier, INSERM, University of Antilles, Montpellier, France
| | | | - Vu Hai Vinh
- Dept of Infectious and Tropical Diseases, Viet Tiep Hospital, Hai Phong, Vietnam
| | - Delphine Rapoud
- Pathogenesis and control of chronic & emerging infections, Etablissement Français du Sang, University of Montpellier, INSERM, University of Antilles, Montpellier, France
| | - Laurent Michel
- Pierre Nicole Center, CESP/Inserm 1018, French Red Cross, Paris, France
| | - Didier Laureillard
- Pathogenesis and control of chronic & emerging infections, Etablissement Français du Sang, University of Montpellier, INSERM, University of Antilles, Montpellier, France
- Infectious Diseases Department, Caremeau University Hospital, Nîmes, France
| | - Jean Pierre Moles
- Pathogenesis and control of chronic & emerging infections, Etablissement Français du Sang, University of Montpellier, INSERM, University of Antilles, Montpellier, France
| | | | - Nicolas Nagot
- Pathogenesis and control of chronic & emerging infections, Etablissement Français du Sang, University of Montpellier, INSERM, University of Antilles, Montpellier, France
| | - Duong Thi Huong
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, 72A, Nguyen Binh Khiem, Ngo Quyen district, Haiphong city, Vietnam
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Pachuau LN, Tannous C, Dhami MV, Agho KE. HIV among people who inject drugs in India: a systematic review. BMC Public Health 2022; 22:1529. [PMID: 35948967 PMCID: PMC9367073 DOI: 10.1186/s12889-022-13922-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 07/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background Little is known about the epidemiology of HIV infection among HIV positive people who inject drugs (PWID) in India. Injecting drug use has emerged as an important route of HIV transmission in India. The objective of this study was to conduct a systematic review on the risk behaviours associated with HIV infection among HIV positive PWID and assess the data reported. Methods A systematic search of six electronic databases, Scopus, PubMed, PsycINFO, CINAHL, Embase and Ovid Medline was conducted. These databases were searched for published studies on injecting risk behaviours, sexual risk behaviours and socio-demographic factors associated with HIV infection among HIV positive PWID in India. Results A total of 15 studies were included in the review of which 3 studies evaluated HIV/HCV coinfection among HIV positive PWID. Older age, low educational level and employment status were significantly associated with HIV infection. Sharing of syringe and needle, frequency of injection, early initiation of injecting practice, inconsistent condom use and having multiple sexual partners were all commonly associated with HIV infection among HIV positive PWID. Conclusion Our study identified significant injecting and sexual risk behaviours among HIV positive PWID in India. There is an increasing HIV transmission among PWID in different states, more so in the northeastern states and in metropolitan cities in India. More studies need to be conducted in other regions of the country to understand the true burden of the disease. The lack of sufficient data among HIV positive female PWID does not preclude the possibility of a hidden epidemic among female PWID. The need of the hour is for the prevention of further transmission by this high-risk group through the provision of comprehensive programs, surveillance and robust continuation of harm reduction services. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13922-2.
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Affiliation(s)
- Lucy Ngaihbanglovi Pachuau
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, NSW, DC1797, Penrith, Australia.
| | - Caterina Tannous
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, NSW, DC1797, Penrith, Australia
| | - Mansi Vijaybhai Dhami
- Translational Health Research Institute (THRI), Western Sydney University, Campbelltown Campus, Penrith, NSW, 2571, Australia.,Belmont Hospital, 16 Croudace Bay Road, Belmont, NSW, 2280, Australia
| | - Kingsley Emwinyore Agho
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, NSW, DC1797, Penrith, Australia.,Translational Health Research Institute (THRI), Western Sydney University, Campbelltown Campus, Penrith, NSW, 2571, Australia.,African Vision Research Institute (AVRI), University of KwaZulu-Natal, Westville Campus, Durban, 3629, South Africa
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Co-infection of Hepatitis B and Hepatitis C among HIV-infected patients: A cross-sectional study from tertiary care hospital of eastern Nepal. PLoS One 2022; 17:e0264791. [PMID: 35239716 PMCID: PMC8893711 DOI: 10.1371/journal.pone.0264791] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/16/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction This study was conducted with an objective to analyze prevalence and risk factors associated with co-infection of hepatitis B virus (HBV) and hepatitis C virus (HCV) in HIV-positive patients with reference to their CD4+ T cell status. Materials and methods HIV-positive patients visiting the HIV clinic for CD4+ T cells testing at B.P. Koirala Institute of Health Sciences were tested for Hepatitis B and Hepatitis C. Data regarding age, gender, mode of HIV transmission, duration of HIV diagnosis, antiretroviral therapy status, antiretroviral therapy duration, hepatitis B or C status, and CD4+ T cells count were collected via face-to-face interview, and hospital records. The data were entered in Microsoft Excel 2019 v16.0 (Microsoft, WA, USA) and statistical analysis was performed by using statistical package for social sciences, IBM SPSS® v21 (IBM, Armonk, New York). Results Out of 474 HIV-positive patients, HIV-HBV, HIV-HCV, and HIV-HBV-HCV co-infections were seen in 2.95% (14/474), 18.14% (86/474), and 2.53% (12/474) respectively. The primary route of infection was intra-venous drug use (IVDU) in those co-infected with HBV only (8, 57.14%), HCV only (46, 53.49%), and both HBV and HCV (8, 66.67%). HIV patients infected via IVDU were 2.40 times more likely to have HIV-HCV co-infection as compared to those infected via sexual route (AOR 2.40, 95% CI: 1.49,3.86). Similarly, HIV patients with CD4+ T cells count less than 350 cells/mm3 were more likely to have HIV-HBV-HCV co-infection as compared to those with CD4 count equal to and more than 350 cells/mm3 (AOR 13.84, 95% CI: 2.90,66.10). Conclusion HIV-positive patients are at high risk of hepatitis B and/or hepatitis C co-infection. Intravenous drug use, and lower CD4+T cells count are the most important risk predictors of co-infection. All HIV-positive patients should be carefully screened with hepatitis B and hepatitis C tests during their follow-up.
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Zhang X, Guan L, Tian H, Zeng Z, Chen J, Huang D, Sun J, Guo J, Cui H, Li Y. Risk Factors and Prevention of Viral Hepatitis-Related Hepatocellular Carcinoma. Front Oncol 2021; 11:686962. [PMID: 34568017 PMCID: PMC8458967 DOI: 10.3389/fonc.2021.686962] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 08/20/2021] [Indexed: 12/11/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is a common cancer in the world, and its incidence is increasing yearly. Hepatitis B virus (HBV) infection and hepatitis C virus (HCV) infection are important causes of HCC. Liver cirrhosis, age, sex, smoking and drinking, and metabolic risk factors will increase the risk of cancer in HBV/HCV patients. And viral load, APRI, FIB-4, and liver stiffness can all predict the risk of HCC in patients with viral infection. In addition, effective prevention strategies are essential in reducing the risk of HCC. The prevention of HCC involves mainly tertiary prevention strategies, while the primary prevention is based on standardized vaccine injections to prevent the occurrence of HBV/HCV. Eliminating the route of transmission and vaccination will lead to a decrease in the incidence of HCC. Secondary prevention involves effective antiviral treatment of HBV/HCV to prevent the disease from progressing to HCC, and tertiary prevention is actively treating HCC to prevent its recurrence.
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Affiliation(s)
- Xinhe Zhang
- Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Lin Guan
- Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Haoyu Tian
- The 3rd Clinical Department of China Medical University, Shenyang, China
| | - Zilu Zeng
- Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jiayu Chen
- Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Die Huang
- Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ji Sun
- Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jiaqi Guo
- Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Huipeng Cui
- Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yiling Li
- Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China
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Kilonzo SB, Gunda DW, Majinge DC, Jaka H, Manyiri PM, Kalokola F, Mtui G, Shao ER, Bakshi FA, Stephano A. Seroprevalence of hepatitis B virus infection, anti-HCV antibodies and HIV and knowledge among people who use drugs attending methadone therapy clinic in Tanzania; a cross-sectional study. BMC Infect Dis 2021; 21:699. [PMID: 34289801 PMCID: PMC8296674 DOI: 10.1186/s12879-021-06393-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 07/07/2021] [Indexed: 12/24/2022] Open
Abstract
Background Methadone therapy clinics have been recently introduced in Tanzania, aiming at reducing risk behaviors and infection rates of viral hepatitis and HIV among people who use drugs. The objective of this study was to estimate the prevalence, associated factors and knowledge level of these conditions among people who use drugs attending a methadone clinic in Tanzania. Methods We enrolled 253 People who using drugs receiving Methadone therapy. Clinical data was retrospectively collected from the medical records and face-to face interviews were conducted to determine the behavioral risk factors and respondents’ knowledge on viral hepatitis and HIV. Results An overall seroprevalence of viral hepatitis (either hepatitis B surface antigen or anti-hepatitis C virus) was 6.3%, while that of hepatitis B virus mono infection was 3.5% and anti-hepatitis C antibodies was 3.5%. Seroprevalence of HIV was 12.6%. Viral hepatitis was strongly predicted by advanced age (> 35 years) (p = 0.02) and staying at Kirumba area (p = 0.004), and HIV infection was predicted by increased age (> 37 years) (p = 0.04) and female sex (p < 0.001). Regarding the knowledge of viral hepatitis, majority of the respondents were unaware of the transmission methods and availability of hepatitis B virus vaccines and only 17% were classified as well informed (provided ≥4 correct answers out of 7 questions). Good knowledge was highly predicted by higher education level of the individual (p = 0.001). Conclusions Despite the efforts to curb viral hepatitis and HIV infections through Methadone clinics, infection rates among people who use drugs are still high and the general knowledge on preventive measures is inadequate.
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Affiliation(s)
- Semvua B Kilonzo
- Department of Medicine, Catholic University of Health and Allied Sciences, P.O Box 1464, Mwanza, Tanzania. .,Department of Medicine, Bugando Medical Center, P.O Box 1370, Mwanza, Tanzania.
| | - Daniel W Gunda
- Department of Medicine, Catholic University of Health and Allied Sciences, P.O Box 1464, Mwanza, Tanzania.,Department of Medicine, Bugando Medical Center, P.O Box 1370, Mwanza, Tanzania
| | - David C Majinge
- Department of Medicine, Catholic University of Health and Allied Sciences, P.O Box 1464, Mwanza, Tanzania.,Department of Medicine, Bugando Medical Center, P.O Box 1370, Mwanza, Tanzania
| | - Hyasinta Jaka
- Department of Medicine, Catholic University of Health and Allied Sciences, P.O Box 1464, Mwanza, Tanzania.,Department of Medicine, Bugando Medical Center, P.O Box 1370, Mwanza, Tanzania
| | - Paulina M Manyiri
- Department of Medicine, Catholic University of Health and Allied Sciences, P.O Box 1464, Mwanza, Tanzania.,Department of Medicine, Bugando Medical Center, P.O Box 1370, Mwanza, Tanzania
| | - Fredrick Kalokola
- Department of Medicine, Catholic University of Health and Allied Sciences, P.O Box 1464, Mwanza, Tanzania.,Department of Medicine, Bugando Medical Center, P.O Box 1370, Mwanza, Tanzania
| | - Grahame Mtui
- Department of Medicine, Sekou Toure Regional Referral Hospital, P.O Box 132, Mwanza, Tanzania
| | - Elichilia R Shao
- Department of Medicine Kilimanjaro Christian University College, P.O Box 2240, Moshi, Tanzania
| | - Fatma A Bakshi
- Department of Medicine, Aga Khan Hospital, P.O Box 2289, Dar es Salaam, Tanzania
| | - Alex Stephano
- Department of Medicine, Catholic University of Health and Allied Sciences, P.O Box 1464, Mwanza, Tanzania
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Semá Baltazar C, Boothe M, Chitsondzo Langa D, Sathane I, Horth R, Young P, Schaad N, Raymond HF. Recognizing the hidden: strengthening the HIV surveillance system among key and priority populations in Mozambique. BMC Public Health 2021; 21:91. [PMID: 33413261 PMCID: PMC7789885 DOI: 10.1186/s12889-020-10110-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 12/21/2020] [Indexed: 11/29/2022] Open
Abstract
High quality, representative data from HIV surveillance systems that have country ownership and commitment are critical for guiding national HIV responses, especially among key and priority populations given their disproportionate role in the transmission of the virus. Between 2011 to 2013, the Mozambique Ministry of Health has conducted five Biobehavioral Surveillance Surveys among key populations (female sex workers, men who has sex with men and people who inject drugs) and priority populations (long distance truck drives and miners) as part of the national HIV surveillance system. We describe the experience of strengthening the HIV surveillance system among those populations through the implementation of these surveys in Mozambique. We document the lessons learned through the impact on coordination and collaboration; workforce development and institutional capacity building; data use and dissemination; advocacy and policy impact; financial sustainability and community impact. Key lessons learned include the importance of multisectoral collaboration, vital role of data to support key populations visibility and advocacy efforts, and institutional capacity building of government agencies and key populations organizations. Given that traditional surveillance methodologies from routine data often do not capture these hidden populations, it will be important to ensure that Biobehavioral Surveillance Surveys are an integral part of ongoing HIV surveillance activities in Mozambique.
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Affiliation(s)
- Cynthia Semá Baltazar
- Instituto Nacional de Saúde (INS), Maputo, Mozambique.
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Makini Boothe
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Isabel Sathane
- HIV and STI Program, Public Health Directorate, Ministry of Health, Maputo, Mozambique
| | - Roberta Horth
- Centers for Disease Control and Prevention, Atlanta, USA
| | - Peter Young
- Centers for Disease Control and Prevention, Maputo, Mozambique
| | - Nick Schaad
- Centers for Disease Control and Prevention, Atlanta, USA
| | - Henry F Raymond
- University of California, San Francisco (UCSF), San Francisco, USA
- School of Public Health, Rutgers University, Piscataway, NJ, USA
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