Serological pattern of hepatitis B virus among Hbsag negative blood donors in Alexandria, Egypt

This study in Alexandria, Egypt was conducted to investigate the distribution of different hepatitis B virus (HBV) markers in apparently healthy blood donors who were hepatitis B surface antigen (HBsAg) negative, and to determine the major independent risk factors. Evidence of past exposure to HBV was found in 148/508 screened donors (29.1%). The most prevalent marker was anti-NBc in 124/508 donors (24.4%), half of whom (63/124) showed anti-HBc only. Anti-HBs prevalence was 15.9%, combined anti-NBc and antiHBs was 12.0% and anti-HBe was 5.7%. Independent risk factors associated with the presence of at least 1 markerwere: being married (OR 3.82), history of blood transfusion (OR 3.04) and parenteral antibilharzial treatment (OR 2.49). Receiving a full HBV vaccination schedule was reported by 39 donors, but only 1 of them had isolated anti-HBs. The relatively high prevalence of HBV exposure necessitates solid infection control measures and adult vaccination programme awareness.

Immune response to hepatitis B vaccine in haemodialysis patients

Widespread vaccination of haemodialysis patients had occurred during the year 1999 as a result of the promulgation of the Ministry of Health & Population. To our knowledge, this might be the first study in Egypt concerning post-vaccination response in haemodialysis patients and possible risk factors influencing this response. Eighty-three haemodialysis patients vaccinated with 10 microg dose of recombinant hepatitis B Merck Sharp vaccine at 0, 1 and 6 months were enrolled in the study. Blood samples were withdrawn one month after the third dose and sera were tested for anti-HBc to exclude those who had previous HBV exposure and for quantitative determination of antibodies to hepatitis B surface antigen (anti-HBs) using commercial enzyme immunoassay kits. Routine analysis for anti-HIV, anti-HCV and HBsAg every 3 months is done for all haemodialysis patients in the governmental sector. Only 65 patients negative for both anti-HBc and HBsAg were considered eligible for evaluating the immunogenicity of the vaccine. Seroconversion rate (anti-HBs>10 mlU/ml) was detected in 64.6% and adequate response (anti-HBs>100 mlU/ml) was achieved in 38% only. Non-responders were 35.4% reflecting the profound immune suppression in haemodialysis patients. Seroconversion rate was 84.2% in patients below 40 years of age and dropped to 33.3% in those 60 years or above. Seroconversion was significantly higher in females than males (76.5% vs. 51.6%). HCV infection was strikingly high among dialyzed patients (78.5%). Seroconversion rate was 58.8% in HCV-infected and 85.7% in non HCV-infected haemodialysis patients. Neither the duration of haemodialysis nor the frequency of blood transfusions had any significant association with seroconversion rate.

Human chronic fascioliasis: hepatitis B and C among infected cases

Sera from one hundred and fifty three chronic Fasciola cases were screened for the presence of HB markers (HBsAg, anti HBc and anti HBs) and anti HCV using ELISA technique. Quantitative stool examination and estimation of liver enzymes (AST-ALT-bilirubin) levels of the study population were performed. HBsAg was present in 5 (3.3%), anti HBs in 13 (8.5%), HBexposed (HBex) in 44 (28.8%) and anti HCV in 13 (8.5%) of examined sera. HBV and HCV markers were significantly higher among older age groups. Concerning familial aggregation of hepatitis markers, 7 (15.9%) of the 44 HBex cases had two individuals per family who had evidence of exposure to HBV. No significant change in Fasciola GMEC and liver function tests have been noticed.

Hepatitis B and C virus infections among patients with gingivitis and adult periodontitis: seroprevalence and public health importance

The aim of the present case control study was to identify seroprevalence of hepatitis B and C virus (HBV and HCV) infections among one hundred cases with periodontal disease (71% gingivitis and 29% adult periodontitis) and one hundred controls with healthy gingiva matdhed for age and sex. Moreover, it aimed to detect hepatitis markers in saliva samples corresponding to the positive sera. Different risk factors associated with hepatitis infection and detectability rate of hepatitis markers were also studied.

METHODOLOGY

enzyme linked immunosorbent assay (ELISA) technique was used to detect the presence of hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti HBc), e antigen (eAg) and antibody to hepatitis C virus (anti HCV) both in serum and saliva samples. HCV RNA was detected by polymerase chain reaction (PCR) technique. Oral examination was performed for assessment of simplified Oral Hygiene Index (OHI-S), Papillary Bleeding Index (PBI), probing pocket depth and loss of fibre attachment.

RESULTS

cases with periodontal disease showed higher percentages of hepatitis exposure (hepex; anti HCV and/or anti HBc) and significantly higher anti HCV seropositivity than the controls (26% and 13% versus 22% and 8%, respectively). No difference in HBsAg carrier rate nor in anti HBc seropositivity was elicited. Furthermore, cases with periodontal disease showed higher detectability rate of HBsAg, anti HBc, anti HCV or both anti HCV and/or anti HBc in whole unstimulated saliva than the controls (100% vs 66.7%, 50% vs 23.5%, 23.1% vs 0.0% and 42.3% vs 18.2%, respectively). Stepwise logistic regression delineated two significant factors associated with the risk of hepatitis exposure, the first predictor was the rural residence and the second one was the history of blood transfusion (OR=3.10, 2.94, respectively). Periodontal disease, severity of bleeding and bad oral hygiene were associated with the risk of hepatitis infection and with the detectability of hepatitis markers in the whole saliva.

Health status assessment of drug addicts in Alexandria

The case-control study was conducted among addicts in Alexandria to determine the different health problems among them, as well as to study the correlation between addiction and these problems. One hundred drug addicts and eighty apparently healthy controls were included in this study. The whole sample was subjected to the following: filling a predesigned questionnaire sheet, clinical and electrocardiogram (ECG) examination, measurements of Body Mass Index (BMI), complete blood picture and antistreptolysin O titre (ASO), testing for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B core antigen (anti HBc), skin scrapings from superficial fungal lesions in addition to complete urine and stool examination. The results revealed that chest rhonchi, hepatomegaly, central nervous system (CNS) abnormalities, skin lesions lymphadenopathy, underweight and anaemia were significantly higher among addicts than the controls. Hepatitis B virus (HBV) exposure and HBsAg seropositivity were found 48.0% and 21.0%, respectively among addicts compared to 26.3% and 5.0%, respectively among the controls. The intravenous injections and tattooing were the most risky routes for HBV infection among addicts. A positive correlation was revealed between HBV exposure and both the duration and the number of daily injections. Chest X-ray suggestive of pulmonary tuberculosis were found in 7.0% of the addicts. Addiction potentiated the risk of fungal infection among low social class, but it had no effect on the relationship between anaemia and social class nor on that between loss of appetite and underweight.

The effect of praziquantel administration on the course of hepatitis B among cases with concomitant schistosome infection

The present work was designed to study the course of HB virus infection among bilharzial and non-bilharzial patients and to assess the therapeutic effect of praziquantel administration on subsequent course of HB among individuals with concomitant infections. This study included 26 bilharzial cases, 14 cases with HB and 40 cases with both infections (HB and schistosomiasis). Praziquantel was administered to all bilharzial positive cases. Sera were collected from all groups prior to anti-bilharzial chemotherapy, and then later at three and six months post treatment. The results show improvement of both liver function tests and cell mediated immunity as estimated by increased mean value of CD3, CD4, helper/suppressor ratio among individuals who received praziquantel in the two groups with schistosomiasis and concomitant infection. Furthermore the individuals who lost their HB surface antigenaemia were found to have a higher mean pan T cells, CD4 values, normal helper/suppressor ratio and absence of Clc in their sera than those who retained their carrier state. The follow up of HB carriers demonstrated a higher cure rate (clearance of HBsAg) among the group with concomitant infection as compared to the group with virus hepatitis only. HBV type two infection was common among the study population accounting for 25.9% of HBsAg positive cases. 42.9% of them cleared their antigenemia after treatment with praziquantel.