Epidemiology of Pathogenic Retroviruses and Domestic Cat Hepadnavirus in Community and Client-Owned Cats in Hong Kong

Understanding the local epidemiology of feline leukaemia virus (FeLV) and feline immunodeficiency virus (FIV) in Hong Kong will inform retrovirus prevention strategies. Domestic cat hepadnavirus (DCH), a novel hepatitis-B-like virus, is commonly detected among client-owned cats in Hong Kong, but community cats have not been studied. The aims of this study were to investigate the frequency and potential risk factors for (i) FeLV and FIV among community and client-owned cats and (ii) perform molecular detection of DCH among community cats in Hong Kong. Blood samples from 713 cats were obtained from client-owned (n = 415, residual diagnostic) and community cats (n = 298, at trap-neuter-return). Point-of-care (POC) testing for FeLV antigen and feline immunodeficiency virus (FIV) anti-p15 and p24 antibodies was performed. FeLV-positive samples were progressed to p27 sandwich enzyme-linked immunosorbent assay. Whole blood DNA was tested with qPCRs for FeLV U3 and gag, and nested PCRs where additional information was required. DCH qPCR was performed on a subset of community cats (n = 193). A single, regressive, FeLV infection was detected in a client-owned cat (1/415 FeLV U3 qPCR positive, 0.2%, 95% CI 0.0-1.3%). Five/415 client-owned cats tested presumably false FeLV-antigen positive (qPCR negative). No markers of FeLV infection were detected in community cats (0/298; 0%). FIV seroprevalence was much higher in community cats (46/298, 15.4%) than in client-owned cats (13/415, 3.1%) (p < 0.001). Mixed breed was a risk factor for FIV infection in client-owned cats. Neither sex nor age were associated with FIV infection. DCH DNA was detected in 34/193 (17.6%) community cats (median viral load 6.32 × 103 copies/reaction). FeLV infection is rare in Hong Kong, negatively impacting the positive predictive value of diagnostic tests. FeLV-antigen testing remains the screening test of choice, but confirmation of a positive result using FeLV qPCR is essential. FIV infection is common in community cats and the absence of a sex predisposition, seen previously in cats managed similarly, raises questions about virus-transmission dynamics in these groups. DCH infection is very common in Hong Kong, both in client-owned and community cats, highlighting the importance of understanding the pathogenic potential of this virus for cats.

Knowledge, awareness, and vaccination compliance of hepatitis B among medical students in Riyadh's governmental universities

Background:

Hepatitis B is a blood-borne infectious liver disease caused by the Hepatitis B Virus (HBV) and it is best prevented by immunization. Due to occupational exposure, medical students have an increased risk of contracting HBV. Therefore, it is essential for all medical students to have good knowledge about HBV and to complete their HBV vaccinations.

Aims:

The aim of this study was to assess and compare HBV knowledge, awareness, and vaccination compliance among pre-clinical medical students in four universities.

Settings and Design:

A cross-sectional study was conducted in September 2018 at the College of Medicine of four governmental universities: King Saud Bin Abdulaziz University for Health Sciences, King Saud University, Princess Noura university, and Imam Mohammed bin Saud Islamic University, in Riyadh, Saudi Arabia.

Methods and Materials:

Two-hundred-sixty-three pre-clinical medical students completed a questionnaire with sections about demographics, HBV awareness, knowledge, and vaccination compliance.

Statistical analysis used:

The data was transferred to Excel and SPSS version 22 was used for statistical analysis. A significance level of P < 0.05 was considered statistically significant.

Results:

The overall knowledge about HBV and vaccination compliance were poor. KSU students had the highest vaccination compliance (n = 52, 54.2%) and KSAU-HS the lowest (n = 19, 23,8%). The most-cited reasons for noncompliance were “forgetting about the vaccine” and “busy schedule“.

Conclusion:

Overall, most of the participants had poor HBV knowledge and vaccine compliance. Therefore, we recommend the implementation of pre-clinical vaccine checking and the addition of an infectious disease awareness and prevention program.

Analysis and Classification of Hepatitis Infections Using Raman Spectroscopy and Multiscale Convolutional Neural Networks

Hepatitis infections represent a major health concern worldwide. Numerous computer-aided approaches have been devised for the early detection of hepatitis. In this study, we propose a method for the analysis and classification of cases of hepatitis-B virus ( HBV), hepatitis-C virus (HCV), and healthy subjects using Raman spectroscopy and a multiscale convolutional neural network (MSCNN). In particular, serum samples of HBV-infected patients (435 cases), HCV-infected patients (374 cases), and healthy persons (499 cases) are analyzed via Raman spectroscopy. The differences between Raman peaks in the measured serum spectra indicate specific biomolecular differences among the three classes. The dimensionality of the spectral data is reduced through principal component analysis. Subsequently, features are extracted, and then feature normalization is applied. Next, the extracted features are used to train different classifiers, namely MSCNN, a single-scale convolutional neural network, and other traditional classifiers. Among these classifiers, the MSCNN model achieved the best outcomes with a precision of 98.89%, sensitivity of 97.44%, specificity of 94.54%, and accuracy of 94.92%. Overall, the results demonstrate that Raman spectral analysis and MSCNN can be effectively utilized for rapid screening of hepatitis B and C cases.

Cardiac arrest in a case of systemic lupus erythematosus and hepatitis-B coinfection: Can Strongyloides stercoralis be the culprit?

Strongyloides stercoralis is one of the most important helminths causing neglected tropical diseases. Its ability to cause autoinfection can lead to chronic infections and hyper infection, especially in autoimmune cases and prove to be highly fatal. We report a case of systemic lupus erythematosus (SLE) having hepatitis-B coinfection, who presented with rash all over the body, recurrent nausea, vomiting, cough, loose stool, and joint pain for 1 month and was later on found to be infected with S. stercoralis. He suffered a massive cardiac arrest during his hospital stay, which was efficiently managed. S. stercoralis infection in cases of SLE and other immunocompromised conditions must be treated at the earliest, to prevent fatal cardiac arrests and other complications.

Bone Health and Impact of Tenofovir Treatment in Men with Hepatitis-B Related Chronic Liver Disease

BACKGROUND

Chronic Liver Disease (CLD) has been shown to have an adverse impact on bone health. Hepatitis-B related CLD and its treatment with tenofovir may have additional effects on skeleton.

OBJECTIVE

To study the impact of HBV related CLD and its treatment with Tenofovir on bone health in Indian subjects.

METHODS

This cross sectional study included men (18-60 years) and comprised of three groups: Group-1 was treatment naïve HBV related CLD (n = 79), Group-2 those with HBV related CLD on tenofovir for at least 1 year (n = 136), Group-3 age, sex and Body Mass Index (BMI) matched healthy controls (n = 58). Bone biochemistry and Bone Mineral Density (BMD) at spine, Femoral Neck (FN) and forearm were studied. Independent t-test or ANOVA was used to compare the means of continuous variables and chi-square test for categorical variables. Multiple logistic regression was used to assess the factors causing Low Bone Mass (LBM) at FN.

RESULTS

A significantly greater proportion (P < 0.05) of patients (40%) with CLD (group 1 and group 2) had vitamin D deficiency (<20 ng/ml) in comparison with control group (22%). The mean serum C-Terminal telopeptide was significantly higher (P < 0.05) and the mean BMD was significantly lower (P < 0.05) in subjects with HBV related CLD than controls. The prevalence of LBM was higher in group 1 at the spine (31%) and forearm (18.4%) when compared to controls (8.1% and 7.8% respectively) (P < 0.05). The proportion of patients with LBM at FN was highest in group 2 (12.3%) compared to those in group 1 (8%) and group 3 (4%) (P < 0.05). Advanced age, low BMI, and high viral load (>10,000 IU/ml) emerged as significant risk factors for LBM at FN.

CONCLUSION

The impact of hepatitis-B related CLD as well as its treatment on bone health is significant. Bone health need to be periodically evaluated in these subjects especially in older men who are lean and have a higher viral load.

Hurdles to the Development of Effective HBV Immunotherapies and HCV Vaccines

Chronic infections with HBV and HCV continue to be major public health problems, with hundreds of millions of people infected worldwide; this is despite the availability of both an effective prophylactic HBV vaccine for more than 3 decades and potent direct antivirals for HBV and, more recently, HCV infection. Consequently, development of HBV immunotherapies and prophylactic HCV vaccines remains extremely urgent, but limited funding and significant gaps in our understanding of the correlates of immune protection pose serious hurdles for the development of novel immune-based interventions. Here we discuss immunological questions related to HBV and HCV, some shared and some pertinent to only 1 of the viruses, that should be addressed for the rational design of HBV immunotherapies and HCV vaccines.

Comparison of the accelerated and standard vaccination schedules against hepatitis B in healthcare workers

BACKGROUND

For healthcare workers, sometimes the conventional hepatitis-B virus (HBV) vaccination schedule might not provide seroconversion rapidly enough. The aim of this study was to compare the efficacy of conventional HBV vaccination with an accelerated schedule (days 0-1-21).

MATERIALS AND METHODS

In this randomized clinical trial, 161 healthcare workers were divided into two vaccination groups; group A underwent the conventional schedule (0-1-6 months) and group B received the accelerated program (0-10-21 days) of hepatitis B virus vaccine. The anti-HBs antibody was determined 30 days after completion of the third vaccine injection in both groups by enzyme immunoassay (EIA) (Abbot, Aux SYMsys). By using the Fisher's exact and Wilcoxon tests, the results were analyzed. The protective level of anti-HBS was defined as titer ≥10 MIU/ml.

RESULTS

The seroprotection rate, 30 days after vaccination, were similar in both groups A and B; 96.3% of the participants in group A and 92.6% in group B had anti-HBS antibody ≥10 MIU/ml.

CONCLUSION

Our data indicated that compared to the classic HBS vaccination program an accelerated schedule could also be effective and achieve seroprotection more rapidly.