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Madihi S, Charoute H, Boukaira S, Bouafi H, Baha W, Zyad A, Benani A. Virological characterization of Hepatitis B virus infection in Morocco: A ten-years study (2014 - 2023). Diagn Microbiol Infect Dis 2024; 110:116502. [PMID: 39191154 DOI: 10.1016/j.diagmicrobio.2024.116502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/16/2024] [Accepted: 08/20/2024] [Indexed: 08/29/2024]
Abstract
In alignment with Morocco's national strategy for eliminating viral hepatitis, we aimed to characterize and update the virological profile of chronic hepatitis B patients. Demographic, serological and molecular parameters of 804 HBsAg-positive patients were retrospectively analyzed. Overall, 58.24 % were HBV-positive (55.37 % males, p = 0.74). The median age was 46 years (37-57). Patients ≤ 24 years comprised 5 % of HBsAg-positive and 4.34 % of HBV-positive cases. The median viral load was 2.62 log10 IU/mL (1.87-3.44). The prevalent genotypes were D (91.04 %), A (7.55 %) and E (1.41 %). Liver enzymes were normal in most of cases. 91.04 % of patients were HBeAg-negative, with 92.23 % having genotype D (p < 0.001). Co-infection rates with other hepatitis viruses were low. Significant associations were found between HBeAg-negative status, genotype D, viral load, and liver enzyme levels (p < 0.001). We highlighted the need for prenatal HBsAg screening for pregnant women and prioritizing the birth-dose vaccine to prevent mother-to-child transmission, especially after the COVID-19 pandemic.
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Affiliation(s)
- Salma Madihi
- Molecular Biology Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco; Team of Experimental Oncology and Natural Substances, Cellular and Molecular Immuno pharmacology, Sultan Moulay Slimane University, Faculty of Sciences and Technologies, Beni Mellal, Morocco.
| | - Hicham Charoute
- Research Unit of Epidemiology, Biostatistics and Bioinformatics, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Samia Boukaira
- Molecular Biology Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco; Molecular Microbiology and Biology Laboratory, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - Hind Bouafi
- Human Genomics and Genetics Laboratory, Pasteur Institute of Morocco, Casablanca, Morocco
| | - Warda Baha
- Molecular Biology Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Abdelmajid Zyad
- Team of Experimental Oncology and Natural Substances, Cellular and Molecular Immuno pharmacology, Sultan Moulay Slimane University, Faculty of Sciences and Technologies, Beni Mellal, Morocco
| | - Abdelouaheb Benani
- Molecular Biology Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
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Ismael NY, Usmael SA, Belay NB, Mekonen HD, Johannessen A, Orlien SM. Chronic hepatitis B virus infection in Eastern Ethiopia: Clinical characteristics and determinants of cirrhosis. World J Hepatol 2024; 16:995-1008. [PMID: 39086536 PMCID: PMC11287608 DOI: 10.4254/wjh.v16.i7.995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/14/2024] [Accepted: 07/05/2024] [Indexed: 07/26/2024] Open
Abstract
BACKGROUND Chronic hepatitis B (CHB) virus infection is a major cause of liver-associated morbidity and mortality, particularly in low-income countries. A better understanding of the epidemiological, clinical, and virological characteristics of CHB will guide appropriate treatment strategies and improve the control and management of CHB in Ethiopia. AIM To investigate the characteristics of CHB in Eastern Ethiopia and assess the efficacy and safety of antiviral treatment. METHODS This cohort study included 193 adults who were human immunodeficiency virus-negative with CHB between June 2016 and December 2019. Baseline assessments included chemistry, serologic, and viral markers. χ 2 tests, Mann-Whitney U tests, and logistic regression analyses were used to identify the determinants of cirrhosis. Tenofovir disoproxil fumarate (TDF) was initiated using treatment criteria from the Ethiopian CHB pilot program. RESULTS A total of 132 patients (68.4%) were men, with a median age of 30 years [interquartile range (IQR): 24-38]. At enrollment, 60 (31.1%) patients had cirrhosis, of whom 35 (58.3%) had decompensated cirrhosis. Khat use, hepatitis B envelope antigen positivity, and a high viral load were independently associated with cirrhosis. Additionally, 66 patients (33.4%) fulfilled the treatment criteria and 59 (30.6%) started TDF. Among 29 patients who completed 24 months of treatment, the median aspartate aminotransferase to platelet ratio index declined from 1.54 (IQR: 0.66-2.91) to 1.10 (IQR: 0.75-2.53) (P = 0.002), and viral suppression was achieved in 80.9% and 100% of patients after 12 months and 24 months of treatment, respectively. Among the treated patients, 12 (20.3%) died within the first 6 months of treatment, of whom 8 had decompensated cirrhosis. CONCLUSION This study highlights the high prevalence of cirrhosis, initial mortality, and the efficacy of TDF treatment. Scaling up measures to prevent and control CHB infections in Ethiopia is crucial.
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Affiliation(s)
- Nejib Y Ismael
- Department of Internal Medicine, Haramaya University, College of Health and Medical Sciences, Harar 252, Ethiopia
| | - Semir A Usmael
- Department of Internal Medicine, Haramaya University, College of Health and Medical Sciences, Harar 252, Ethiopia.
| | - Nega B Belay
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa 1000, Ethiopia
- Regional Centre for Imported and Tropical Diseases, Oslo University Hospital, Oslo 0450, Ullevål, Norway
| | - Hailemichael Desalegn Mekonen
- Internal Medicine, Gastroenterology and Hepatology Unit, Saint Paul's Hospital Millennium Medical College, Addis Ababa 1000, Ethiopia
- Department of Infectious Disease, Vestfold Hospital Trust, Tønsberg 3103, Norway
| | - Asgeir Johannessen
- Regional Centre for Imported and Tropical Diseases, Oslo University Hospital, Oslo 0450, Ullevål, Norway
- Department of Infectious Disease, Vestfold Hospital Trust, Tønsberg 3103, Norway
- Institute of Clinical Medicine, Oslo University, Oslo 0318, Norway
| | - Stian Ms Orlien
- Regional Centre for Imported and Tropical Diseases, Oslo University Hospital, Oslo 0450, Ullevål, Norway
- Department of Infectious Disease, Vestfold Hospital Trust, Tønsberg 3103, Norway
- Department of Pediatrics, Oslo University, Oslo 0450, Ullevål, Norway
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Azebaze Agueguia FS, Talla P, Okomo Assoumou MC, Jacobs GB, Mbakam CH, Guiedem E, Mesembe MT, Lyonga E, Ikomey GM. Involvement of CD95 and ligand in CD4+ T-cell and CD8+ T-cell depletion and hepatic cytolysis in patients with chronic viral hepatitis B. Afr J Lab Med 2021; 10:1224. [PMID: 33824856 PMCID: PMC8008047 DOI: 10.4102/ajlm.v10i1.1224] [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: 03/16/2020] [Accepted: 10/20/2020] [Indexed: 11/03/2022] Open
Abstract
Background Chronic viral hepatitis B (HBV) is characterised by progressive hepatocyte destruction and T-cell depletion. The mechanisms of the CD95-CD95 ligand (CD95L) signalling pathway during this chronic disease and the cirrhotic process remains unclear. Objective We evaluated the involvement of the CD95-CD95L receptor-ligand system in T-cell depletion and hepatic cytolysis in patients with chronic HBV. Methods This was a cross-sectional study conducted from September to December 2018 at the Yaoundé General Hospital, Cameroon. Four mL of whole blood was collected and analysed. The CD95 and CD95L levels, as well as the CD4+ T-cell and CD8+ T-cell counts, were performed by enzyme-linked immunosorbent assay and flow cytometry. Results Of the 130 HBV-positive patients, 36 (27.7%) were cirrhotic and 94 (72.3%) were non-cirrhotic. The cirrhotic patients had significantly elevated CD95 (p < 0.001) and CD95L (p = 0.001) plasma levels, compared with non-cirrhotic patients. The CD4/CD8 ratios were lower in cirrhotic patients, compared to non-cirrhotic patients (p < 0.001). There were statistically significant correlations between CD95 level and CD4+ T-cell counts, between CD95 level and CD8+ T-cell counts, between CD95 level and the CD4/CD8 ratio, between CD95 level and fibrosis score, and between CD95L level and fibrosis score. Conclusion CD95 and CD95L could be involved in T-cell depletion and hepatic cytolysis during the pathogenesis of chronic HBV and could potentially be used as biomarkers for immunological and hepatic monitoring in patients with chronic HBV.
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Affiliation(s)
- Franklin S Azebaze Agueguia
- Center for the Study and Control of Communicable Diseases (CSCCD), Faculty of Medicine and Biological Sciences (FMBS), University of Yaoundé 1 (UY1), Yaoundé, Cameroon
| | - Paul Talla
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences (FMBS), Yaoundé General Hospital, University of Yaoundé 1 (UY1), Yaoundé, Cameroon
| | - Marie C Okomo Assoumou
- Department of Microbiology, Haematology, Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaoundé 1 (UY1), Yaoundé, Cameroon
| | - Graeme B Jacobs
- Division of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Cedric H Mbakam
- Center for the Study and Control of Communicable Diseases (CSCCD), Faculty of Medicine and Biological Sciences (FMBS), University of Yaoundé 1 (UY1), Yaoundé, Cameroon
| | - Elise Guiedem
- Center for the Study and Control of Communicable Diseases (CSCCD), Faculty of Medicine and Biological Sciences (FMBS), University of Yaoundé 1 (UY1), Yaoundé, Cameroon
| | - Martha Tongo Mesembe
- Center for the Study and Control of Communicable Diseases (CSCCD), Faculty of Medicine and Biological Sciences (FMBS), University of Yaoundé 1 (UY1), Yaoundé, Cameroon
| | - Emilia Lyonga
- Center for the Study and Control of Communicable Diseases (CSCCD), Faculty of Medicine and Biological Sciences (FMBS), University of Yaoundé 1 (UY1), Yaoundé, Cameroon
| | - George Mondinde Ikomey
- Center for the Study and Control of Communicable Diseases (CSCCD), Faculty of Medicine and Biological Sciences (FMBS), University of Yaoundé 1 (UY1), Yaoundé, Cameroon
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Comparison of HBV-DNA Levels with Biochemical and Microbiological Parameters for Chronic Hepatitis Evaluation, Bursa, Turkey. JOURNAL OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASES 2021. [DOI: 10.52547/jommid.9.1.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Risk factors of transmission and natural history of chronic hepatitis B infection in Iranian patients. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2019; 12:S149-S155. [PMID: 32099616 PMCID: PMC7011058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
AIM To investigate routes of transmission, demographic characteristics, and frequency of different phases of chronic hepatitis B (CHB) in 2000 Iranian patients. BACKGROUND Knowledge about the most frequent risk factors of CHB and its different phases is very important for optimal prevention and management policy making. METHODS In this cross-sectional study, 2000 HBsAg positive patients who were referred to Taleghani Hospital from 2011 through 2018 were enrolled. ELISA method was employed to detect serological markers of CHB. Taking into account the HBV DNA and ALT levels and HBeAg status, the patients were classified in four groups, according to AASLD 2017 guideline. RESULTS Male and female patients had nearly equal frequencies in our study and 82.5 % of them aged more than 20 years. A great number of our patients (95%) were HBeAg negative and the most frequent risk factors of HBV infection were positive periodontal and family history (40.3% and 24.9%, respectively). The majority of our patients were inactive carriers (63.35%), while s mall number of them were in the immune tolerant group (2.15 %). CONCLUSION Immune tolerance phase group had the minimum number of members in our study and most of them were above 20 years old. This can be due to the mass vaccination of neonates since 1993. Most of CHB patients were in inactive carrier group. Although it is recommended not to treat these patients, performing periodic liver function tests and disease severity assessment is warranted, especially in patients above 40 years old.
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Ashtari S, Sharifian A, Hatami B, Mohebbi SR, Nouri G, Bazdar M, Naderi N. Comparative study on guidelines in determining HBV phases in Iranian patients. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2019; 12:S145-S148. [PMID: 32099615 PMCID: PMC7011065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIM The aim of this study was to compare the different phases of chronic Hepatitis B virus (HBV) infection with different values for normal ALT. BACKGROUND For many years, the upper limit of 40 IU was considered normal for ALT for both sexes, but in recent years this value is challenged and some guidelines have lowered their limit. METHODS In this cross-sectional study, 2000 HBsAg positive patients who were referred to Taleghani Hospital, Tehran, Iran, from 2011 through 2018 were classified in four groups according to American Association of the study of the liver disease (AASLD), European Association of the study of the liver (EASL) /Asian-Pacific Association of the study of the liver (APASL) and American Collage of Gastroenterology (ACG) guidelines. The frequency of each group based on 3 different guidelines was compared. RESULTS In HBeAg positive patients (n=100), the percentage of immune tolerance phase was 43% according to AASLD cutoff for normal ALT (35 IU for men, 25 IU for women), while it was 68% and 28% with regard to EASL/APASL and ACG (30 IU for men, 19 IU for women) cutoffs respectively. In HBeAg negative patients (n=1900), 66.68% were inactive carriers according to AASLD, but the percentage changed to 82.89% and 52.42% considering EASL/APASL and ACG values, respectively. CONCLUSION Using ACG and to a lesser extent AASLD cutoff for ALT, many patients shift from immune tolerance and inactive carrier state into the immune active phase. Thus, more patients are candidates for treatment or intensive workup to determine the extent of liver damage.
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Affiliation(s)
- Sara Ashtari
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Afsaneh Sharifian
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behzad Hatami
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Reza Mohebbi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gholamreza Nouri
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Monireh Bazdar
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nosratollah Naderi
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sharafi H, Karimi-Sari H, Alavian SM. The high-diagnostic characteristics of HBsAg level in differentiation of hepatitis B clinical presentations: Myth or truth? Liver Int 2017; 37:620-621. [PMID: 27696618 DOI: 10.1111/liv.13259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- Heidar Sharafi
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Middle East Liver Diseases (MELD) Center, Tehran, Iran
| | - Hamidreza Karimi-Sari
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Middle East Liver Diseases (MELD) Center, Tehran, Iran.,Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed Moayed Alavian
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Middle East Liver Diseases (MELD) Center, Tehran, Iran
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Ghasemian N, Shahbazi M. Interferon Gamma Gene Polymorphism (+874 T > A) and Chronic Hepatitis B in the Population of Gorgan, North-Eastern Iran. Jundishapur J Microbiol 2016; 9:e33639. [PMID: 27800132 PMCID: PMC5080914 DOI: 10.5812/jjm.33639] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 08/09/2016] [Accepted: 08/13/2016] [Indexed: 01/28/2023] Open
Abstract
Background Based on differences in individual immune responses to the hepatitis B virus (HBV), between 5% and 10% of patients become persistently infected with the virus, which leads to the determination of chronic HBV. Cytokines such as interferon gamma (IFN-γ) are secretory proteins that play important roles in both innate and adaptive immune responses. Functional studies have demonstrated that the IFN + 874A/T gene polymorphism can increase or decrease the overall expression of IFN-gamma (γ) and ultimately determine the outcome of the infection. Objectives This study was performed to investigate the relationship between the IFN-γ + 874 gene polymorphism and susceptibility to chronic HBV infection. Methods Polymorphism detection analysis was performed on 598 subjects from North-Eastern Iran. The IFN-γ gene polymorphism (+ 874A/T) was genotyped through a specific sequence primer polymerase chain reaction (SSP-PCR). Results The frequencies of the AA, AT, and TT genotypes were 31%, 51%, and 18% in the chronic HBV patient group, and 40%, 45%, and 15% in the healthy control group, respectively. However, a lack of association of the + 874 polymorphism in the IFN-γ gene of those with chronic HBV infection was found. Evaluation of HBV association with this polymorphism was significant under the dominant genetic model (P = 0.04). Conclusions Ultimately, no association could be characterized between the polymorphism in IFN-γ + 874A/T and susceptibility to chronic HBV infection in this segment of the Iranian population (P > 0.05).
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Affiliation(s)
- Nadia Ghasemian
- Medical Cellular & Molecular Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran
| | - Majid Shahbazi
- Medical Cellular & Molecular Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran
- Corresponding author: Majid Shahbazi, Medical Cellular & Molecular Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran. Tel/Fax: +98-1732421657, E-mail:
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Gholami Parizad E, Gholami Parizad E, Khosravi A, Amraei M, Valizadeh A, Davoudian A. Comparing HBV Viral Load in Serum, Cerumen, and Saliva and Correlation With HBeAg Serum Status in Patients With Chronic Hepatitis B Infection. HEPATITIS MONTHLY 2016; 16:e30385. [PMID: 27313632 PMCID: PMC4908613 DOI: 10.5812/hepatmon.30385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 02/17/2016] [Accepted: 04/06/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hepatitis B is a disease that is prevalent worldwide and is responsible for 10% of the deaths that occur every year. The virus persists in 5% of infected adults and 90% of infected children and can cause chronic hepatitis. In addition to blood, the virus may also be present in other secretions. Transmission through saliva, sexual fluids, and urine has also been confirmed. OBJECTIVES The main aim of this study was to compare viral DNA copies in the serum, cerumen, and saliva of patients with HBeAg levels in their sera. PATIENTS AND METHODS This was a cross-sectional study and subjects were selected by non-randomized methods. Serum, cerumen, and saliva samples were collected from 50 patients who were diagnosed with chronic hepatitis B about a year prior to the study. Enzyme-linked immunosorbent assay (ELISA) was performed to determine the presence of HBsAg and HBeAg in the gathered specimens. Viral DNA was extracted from specimens by using a Qiagen kit. The number of viral DNA copies was determined using a real-time polymerase chain reaction (PCR) assay. The study was performed in Ilam province in western Iran. RESULTS Twenty-eight percent of the patients were HBeAg positive. The average number of viral copies in serum, cerumen, and saliva was higher in women than in men, and a significant correlation was observed between the gender and average viral copies. However, no significant correlation was observed between viral copies present in the serum and cerumen with the age and gender of patients. In addition, no correlation was observed between serum HBeAg and viral copies present in serum, cerumen, and saliva. The correlation analysis confirmed a direct and definite correlation between viral DNA loads in the patients' serum and cerumen. CONCLUSIONS A significant direct correlation was observed between the viral DNA copies present in patients' cerumen and serum. However, the correlation between saliva viral load with serum and cerumen viral load was very low and inverse. These findings suggest that the presence of the hepatitis B virus (HBV) in non-invasive specimens (such as cerumen and saliva) should also be evaluated when monitoring patients to determine the course of infection and disease.
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Affiliation(s)
- Elaheh Gholami Parizad
- Clinical Microbiology Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Eskandar Gholami Parizad
- Public Health Department, Psychosocial Injuries Prevention Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
- Corresponding Author: Eskandar Gholami Parizad, Public Health Department, Psychosocial Injuries Prevention Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran. Tel: +98-8432240404, Fax: +98-8432240404, E-mail:
| | - Afra Khosravi
- Clinical Microbiology Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Mansour Amraei
- Department of Clinical Physiology, Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Azar Valizadeh
- Clinical Microbiology Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Abdoullah Davoudian
- Department of Clinical Immunology, Ilam University of Medical Sciences, Ilam, IR Iran
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