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Diseases (Basel, Switzerland) May 2023Autoimmune hepatitis (AIH) is an inflammatory liver disease wherein the body's immune system instigates an attack on the liver, causing inflammation and hepatic... (Review)
Review
Autoimmune hepatitis (AIH) is an inflammatory liver disease wherein the body's immune system instigates an attack on the liver, causing inflammation and hepatic impairment. This disease usually manifests in genetically predisposed individuals and is triggered by stimuli or environments such as viral infections, environmental toxins, and drugs. The causal role of COVID-19 vaccination in AIH remains uncertain. This review of 39 cases of vaccine-related AIH indicates that female patients above the age of 50 years or those with potential AIH risk factors may be susceptible to vaccine-related AIH, and the clinical features of vaccine-associated AIH are similar to those of idiopathic AIH. These features commonly manifest in patients after the first dose of vaccination, with symptom onset typically delayed by 10-14 days. The incidence of underlying liver disease in patients with potential health conditions associated to liver disease is similar to that of patients without preexisting illnesses. Steroid administration is effective in treating vaccine-related AIH-susceptible patients, with most patients experiencing improvement in their clinical symptoms. However, care should be taken to prevent bacterial infections during drug administration. Furthermore, the possible pathogenic mechanisms of vaccine-associated AIH are discussed to offer potential ideas for vaccine development and enhancement. Although the incidence of vaccine-related AIH is rare, individuals should not be deterred from receiving the COVID-19 vaccine, as the benefits of vaccination significantly outweigh the risks.
PubMed: 37366868
DOI: 10.3390/diseases11020080 -
Frontiers in Pharmacology 2023TNFα inhibitors are regularly used to treat autoimmune diseases. Tuberculosis (TB) and viral hepatitis B are considered potential infectious complications, and...
TNFα inhibitors are regularly used to treat autoimmune diseases. Tuberculosis (TB) and viral hepatitis B are considered potential infectious complications, and screening and surveillance are therefore recommended. Current guidelines do not take into account regional differences in endemicity of these infections. A systematic literature review of TB and viral hepatitis in patients receiving TNFα-inhibitors was performed, searching in PubMed, Embase, MEDLINE and Web of Science databases. Studies were selected against predefined eligibility criteria and assessed using the Newcastle-Ottawa scale. The number of TB and viral hepatitis cases/1,000 TNFα-inhibitor patients were evaluated, and regional variation compared. 105 observational studies involving over 140,000 patients were included. Overall, 1% of patients developed TB or viral hepatitis B. TB cases/1,000 TNFα-inhibitor patients were 4-fold higher in Asia, Africa, and South America than in Europe, North America, and Australasia where only 0%-0.4% of patients developed TB. Hepatitis B cases/1,000 patients were over 15-fold higher in countries with high prevalence (China, Taiwan, South Korea, Thailand) compared with low prevalence ( < 0.00001) where only 0.4% of patients developed hepatitis B. Only three of 143 patients developed viral hepatitis C, and there was insufficient data to allow regional sub-analysis. TB and viral hepatitis B infections in patients treated with TNFα inhibitors are largely confined to countries with high prevalence of these infections. As only 1/2,500 patients in low prevalence countries treated with TNFα inhibitors develop TB or viral hepatitis B, we suggest an individualized, risk-based approach, rather than universal screening for all patients.
PubMed: 36744250
DOI: 10.3389/fphar.2023.1046306 -
Canadian Liver Journal 2021Since December 2019, there are 30 million confirmed cases of a novel coronavirus disease (COVID-19) secondary to severe acute respiratory syndrome coronavirus 2. As of... (Review)
Review
BACKGROUND
Since December 2019, there are 30 million confirmed cases of a novel coronavirus disease (COVID-19) secondary to severe acute respiratory syndrome coronavirus 2. As of 2020, hepatitis B virus (HBV) affects more than 200 million people worldwide. Both are caused by viral agents. The short-term mortality rate from COVID-19 is much higher than that of HBV.
OBJECTIVE
We sought to understand the impact of HBV coinfection on hospitalized patients with COVID-19.
SEARCH METHODS
Searches of the literature were conducted in the PubMed, Cochrane Library, and Embase electronic databases.
SELECTION CRITERIA
We included cohort studies and randomized studies with information on rates of mortality and intensive care unit (ICU) admission from individuals coinfected by HBV and COVID-19.
DATA COLLECTION AND ANALYSIS
Data from six cohort studies with 2,015 patients were collected between January and April 2020, and the results were analyzed by meta-analysis.
MAIN RESULTS
HBV coinfection did not lead to increased mortality or ICU admission rates among individuals hospitalized for COVID-19 (risk ratio 0.79, 95% CI 0.333-1.83, = 2,015; adjusted OR = 0.79, 95% CI 0.31-1.98). During their hospital stay, coinfected patients did not appear to have an increased hospital length of stay or risk of hepatitis B reactivation.
CONCLUSIONS
This systematic review and meta-analysis provides support that HBV is not a significant risk factor for serious adverse outcomes among patients hospitalized for COVID-19 infection.
PubMed: 35991468
DOI: 10.3138/canlivj-2020-0029 -
Animals : An Open Access Journal From... Sep 2022Viral hepatitis has recently assumed relevance for equine veterinary medicine since a variety of new viruses have been discovered. Equine Hepacivirus (EqHV) is an RNA... (Review)
Review
Viral hepatitis has recently assumed relevance for equine veterinary medicine since a variety of new viruses have been discovered. Equine Hepacivirus (EqHV) is an RNA virus belonging to the family that can cause subclinical hepatitis in horses, occasionally evolving into a chronic disease. EqHV, to date, is considered the closest known relative of human HCV. EqHV has been reported worldwide therefore assessing its features is relevant, considering both the wide use of blood products and transfusions in veterinary therapies and its similitude to HCV. The present review resumes the actual knowledge on EqHV epidemiology, risk factors and immunology, together with potential diagnostics and good practices for prevention. Moreover, adhering to PRISMA guidelines for systematic reviews a meta-analysis of serological and biomolecular prevalence and an updated phylogenetic description is presented as a benchmark for further studies.
PubMed: 36230228
DOI: 10.3390/ani12192486 -
Virology Journal Dec 2021Vaccination against HCV is an effective measure in reduction of virus-related public health burden and mortality. However, no prophylactic vaccine is available as of...
BACKGROUND
Vaccination against HCV is an effective measure in reduction of virus-related public health burden and mortality. However, no prophylactic vaccine is available as of yet. DNA-based immunization is a promising modality to generate cellular and humoral immune responses. The objective of this study is to provide a systematic review of HCV DNA vaccines and investigate and discuss the strategies employed to optimize their efficacies.
METHODS
MEDLINE (PubMed), Web of Science, Scopus, ScienceDirect, and databases in persian language including the Regional Information Centre for Science & Technology (RICeST), the Scientific Information Database and the Iranian Research Institute for Information Science and Technology (IranDoc) were examined to identify studies pertaining to HCV nucleic acid vaccine development from 2000 to 2020.
RESULTS
Twenty-seven articles were included. Studies related to HCV RNA vaccines were yet to be published. A variety of strategies were identified with the potential to optimize HCV DNA vaccines such as incorporating multiple viral proteins and molecular tags such as HBsAg and Immunoglobulin Fc, multi-epitope expression, co-expression plasmid utilization, recombinant subunit immunogens, heterologous prime-boosting, incorporating NS3 mutants in DNA vaccines, utilization of adjuvants, employment of less explored methods such as Gene Electro Transfer, construction of multi- CTL epitopes, utilizing co/post translational modifications and polycistronic genes, among others. The effectiveness of the aforementioned strategies in boosting immune response and improving vaccine potency was assessed.
CONCLUSIONS
The recent progress on HCV vaccine development was examined in this systematic review to identify candidates with most promising prophylactic and therapeutic potential.
Topics: Animals; Hepacivirus; Hepatitis C; Humans; Iran; Mice; Mice, Inbred BALB C; Vaccines, DNA; Viral Hepatitis Vaccines
PubMed: 34903252
DOI: 10.1186/s12985-021-01716-8 -
BMJ Open Feb 2022Novel mechanisms of service delivery are needed to expand access to pre-exposure prophylaxis (PrEP) for HIV prevention. Providing PrEP directly through pharmacies could...
INTRODUCTION
Novel mechanisms of service delivery are needed to expand access to pre-exposure prophylaxis (PrEP) for HIV prevention. Providing PrEP directly through pharmacies could offer an additional option for reaching potential users.
METHODS
We conducted a systematic review of studies examining effectiveness, values and preferences of end users and health workers, and cost of PrEP initiation and continuation through pharmacies (pharmacy access). We searched PubMed, CINAHL, LILACS and EMBASE through 2 December 2020. We also searched clinical trial registries and recent HIV conference abstracts. Standardised methods were used to search, screen and extract data from included studies.
RESULTS
No studies met the inclusion criteria for the effectiveness review, for either PrEP initiation or continuation. However, six 'case studies' presenting non-comparative data from PrEP pharmacy programmes demonstrated feasibility of this model in the USA. Eleven studies reported values and preferences of end users and health workers. In the USA, Kenya and South Africa, potential PrEP clients generally supported pharmacy access, although some preferred clinics. One study of PrEP pharmacy clients found all would 'definitely recommend' the programme. Six studies found pharmacists were generally supportive of offering PrEP; one study including doctors found more limited favour, while one study of diverse Kenyan stakeholders found broad support. Three studies reported cost data indicating client willingness to pay in the USA and Kenya and initial sustainability of a clinic financial model in the USA.
CONCLUSION
Provision of PrEP through pharmacies has been demonstrated to be feasible in the USA and acceptable to potential end users and stakeholders in multiple settings. Limited evidence on effectiveness and requirements for laboratory testing and assurance of high-quality services may limit enthusiasm for this approach. Further research is needed to determine if pharmacy access is a safe and effective way to help achieve global HIV prevention goals.
PROSPERO REGISTRATION NUMBER
CRD42021231650.
Topics: Acquired Immunodeficiency Syndrome; Anti-HIV Agents; HIV Infections; Humans; Kenya; Pharmacies; Pre-Exposure Prophylaxis
PubMed: 35190430
DOI: 10.1136/bmjopen-2021-054121 -
BMC Infectious Diseases Aug 2021Despite being considered as a low prevalence country for hepatitis B (HBV), some populations in Germany are at higher risk of infection. In the context of the World...
BACKGROUND
Despite being considered as a low prevalence country for hepatitis B (HBV), some populations in Germany are at higher risk of infection. In the context of the World Health Organization's (WHO) viral hepatitis elimination goals, a valid epidemiological data base is needed to plan and monitor the national response. Prevention strategies include general and targeted HBV vaccination programmes.
OBJECTIVE
The aim of this work was to estimate the HBV vaccination coverage (VC) in the general population (GP) and different population groups in Germany from available evidence and to identify current evidence gaps for future research.
METHODS
We conducted a systematic review on HBV VC in the general population and populations at high risk of HBV exposure or severe infection in Germany. We included eligible publications (01/01/2017 to 06/06/2020) from databases Embase, Pubmed and Livivo, from a previous scoping review (including data published 01/01/2005-17/03/2017), from the national surveillance system and screened the reference lists of all publications at full text level. Risk of bias was assessed using the Hoy et al. tool.
RESULTS
We included 68 publications of 67 studies and assigned them to one or more suitable population groups. Twenty-one studies contained data among children/adolescents and three among adults from the GP (VC 65.8-90.5% and 22.9-52.1%, respectively), one among travelers (VC 89.0%), 13 among immunocompromised populations (VC 7.8-89.0%), 16 among populations with occupational risk and 16 with non-occupational risk of HBV exposure (VC 63.6-96.5% and 4.4-84.5%, respectively).
CONCLUSION
Comprehensive evidence at low risk of bias was identified for children/adolescents. However, 25 years after including HBV in the national immunisation schedule, VC in Germany is still below the 95%-goal defined by WHO. For people at occupational risk of HBV exposure, VC was mostly reported to be over the WHO goal of 80%, but quality of evidence was heterogenous and should be improved. For people at non-occupational risk of HBV exposure, evidence was sparse and of low quality. The low VC highlights the need for future research to plan vaccination programmes targeting these populations.
Topics: Adolescent; Adult; Child; Hepatitis B; Hepatitis B Antibodies; Hepatitis B Vaccines; Humans; Prevalence; Vaccination; Vaccination Coverage
PubMed: 34391406
DOI: 10.1186/s12879-021-06400-4 -
Journal of Experimental Pharmacology 2021Traditional medicine is still playing an important role in meeting the basic health care requirement of the peoples in different parts of Ethiopia. There is no published... (Review)
Review
BACKGROUND
Traditional medicine is still playing an important role in meeting the basic health care requirement of the peoples in different parts of Ethiopia. There is no published review that clearly indicates documented medicinal plants available in different parts of the country used for treating viral and fungal infections. Currently, viral epidemics with high mortality and morbidity like SARS COV-2 are emerging. Screening of promising drug from plant source is vital to control such viral and fungal infections. In addition, indicating the most commonly used parts of the plant and their route of administration will help for further drug formulation studies. This review aimed to present an indication of the ethnomedicinal plants used for the treatment of fungal and viral infections.
METHODS
The databases (Google Scholar, pub med, hinari, and research gate) were searched for published articles on the ethnobotany of medicinal plants used to treat viral and fungal infection in Ethiopia without restriction in the methodology and year of publication. Viral infections, fungal infections, anti-fungal and anti-viral activity, ethnobotany, Ethiopia, and medicinal plants were the key search terms. Studies that did not have complete ethnobotanical data and did not address viral and fungal infection as a disease treated traditionally by the practitioners were excluded.
RESULTS
A total of 249 articles were produced by database search. After amendment for exclusion criteria and duplicates, 15 articles were found appropriate for the review. The majority of the studies were qualitative and others were mixed type in nature. All of the medicinal plants traditionally used to treat viral and fungal infections in Ethiopia were not scientifically confirmed. Out of the 95 identified plants, 40.8% were herbs and from the plant parts used and 43.9% and 21.1% were leaves and roots, respectively. The majority, (48.8%), of the plant remedies were given orally. Rabies and Tinea capitis constitute the highest percentage of viral and fungal infections treated by traditional medicinal plants followed by hepatitis and Tinea corporis, respectively.
CONCLUSION
Various plants have been used to treat viral and fungal infections. Information obtained from this review serves as a guide to discover novel antiviral and antifungal agents from plants. Therefore, it is advisable for field researchers to properly identify, document, conserve and conduct efficacy and safety studies on such medicinal plants in animal models.
PubMed: 34429665
DOI: 10.2147/JEP.S316007 -
International Journal of Surgery... Nov 2023Hepatocellular carcinoma (HCC) is the third-most lethal malignant tumor worldwide. The rapid development of immunotherapy utilizing immune checkpoint inhibitors for... (Meta-Analysis)
Meta-Analysis
Clinico-characteristics of patients which correlated with preferable treatment outcomes in immunotherapy for advanced hepatocellular carcinoma: a systematic review and meta-analysis.
BACKGROUND AND AIMS
Hepatocellular carcinoma (HCC) is the third-most lethal malignant tumor worldwide. The rapid development of immunotherapy utilizing immune checkpoint inhibitors for advanced HCC patients has been witnessed in recent years, along with numerous randomized clinical trials demonstrating the survival benefits for these individuals. This systematic review and meta-analysis aimed to identify specific clinico-pathological characteristics of advanced HCC patients that may lead to preferable responses to immunotherapy in terms of overall survival (OS), progression-free survival (PFS), and objective response rate (ORR).
METHODS
The included clinical trials were retrieved from PubMed, Embase, the Cochrane library, and the Web of Science databases published in English between 1 January 2002 and 20 October 2022. A systematic review and meta-analysis for first-line and second-line phase II/III studies were conducted on immunotherapy for patients with advanced HCC by using OS as the primary outcome measure, and PFS and ORR as the secondary outcome measures to obtain clinico-pathological characteristics of patients which might be preferable responses to programmed death-1 (PD-1) and programmed cell death-Ligand 1 (PD-L1) inhibitors. Toxicity and specific treatment-related adverse events (TRAEs) were also determined.
RESULTS
After screening 1392 relevant studies, 12 studies were included in this systematic review and meta-analysis to include 5948 patients. Based on the analysis of interaction, the difference in OS after first-line immunotherapy between the subgroups of viral hepatitis [hazard ratio (HR)=0.73 vs 0.87, P for interaction=0.02] and macrovascular invasion and/or extrahepatic spread (HR=0.73 vs 0.89, P for interaction=0.02) were significant. The difference in PFS between the subgroups of viral hepatitis was highly significant (pooled HR=0.55 vs 0.81, P for interaction=0.007). After second-line immunotherapy, the difference in ORR between the subgroups of Barcelona Clinic Liver Cancer was significant (pooled ES=0.12 vs 0.23, P for interaction=0.04). Compared with PD-L1 inhibitors, PD-1 inhibitors may have a higher probability to cause TRAEs. Diarrhea, increased aspartate aminotransferase, and hypertension were the top three TRAEs.
CONCLUSIONS
This systematic review and meta-analysis represents the first pilot study aimed at identifying crucial clinico-pathological characteristics of patients with advanced HCC that may predict favorable treatment outcomes in terms of OS, PFS, and ORR to immunotherapy. Findings suggest that patients with viral hepatitis positivity (especially hepatitis B virus) and macrovascular invasion and/or extrahepatic spread may benefit more in OS when treated with PD-1/PD-L1 immune checkpoint inhibitors.
Topics: Humans; Carcinoma, Hepatocellular; B7-H1 Antigen; Immune Checkpoint Inhibitors; Pilot Projects; Programmed Cell Death 1 Receptor; Liver Neoplasms; Treatment Outcome; Immunotherapy; Hepatitis, Viral, Human; Lung Neoplasms
PubMed: 37598406
DOI: 10.1097/JS9.0000000000000652 -
Prevalence of hepatitis B, C, and D virus infection in Haiti: A systematic review and meta-analysis.Frontiers in Public Health 2022Viral hepatitis causes an important global health burden. In 2016, the World Health Assembly adopted an objective to globally eliminate this as a public health threat by... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Viral hepatitis causes an important global health burden. In 2016, the World Health Assembly adopted an objective to globally eliminate this as a public health threat by 2030. However, significant gaps exist between countries in their progress. Haiti is the last country that has introduced infant hepatitis B vaccines into the routine immunization program in the Region of the Americas, and its schedule still does not incorporate birth dose vaccines. As the first step to raise awareness of viral hepatitis in this country, we conducted a systematic review and meta-analysis to estimate the prevalence of hepatitis B (HBV), C (HCV), and D (HDV) viruses in Haiti.
METHODS
We searched PubMed, EMBASE, Web of Science and Scopus for studies reporting the prevalence of HBV, HCV and HDV among Haitian, with no language restriction, published until November 30th, 2021. Prevalence was pooled a random-effects meta-analysis using a generalized linear mixed model with the logit link.
RESULTS
Of 453 articles retrieved, 25 studies were included: 16 reported the prevalence of hepatitis B surface antigen (HBsAg), three for anti-HCV antibody, and six for both HBsAg and anti-HCV. No study was found for HDV prevalence. The pooled prevalence of HBsAg was 0.7% [95% confidence interval (CI): 0.3-1.4, = 77.7%] among children, 3.5% (95% CI: 2.8-4.4, = 93.2%) in the general adult population and 7.4% (95% CI: 4.0-13.3, = 83.9%) in high-risk adult population. The pooled prevalence of anti-HCV antibody was 0.9% (95% CI: 0.6-1.4, = 93.5%) among the general population and 1.4% (95% CI: 0.4-4.2, = 0.0%) in high-risk adult population. No study reported the prevalence of anti-HCV antibody exclusively in children.
INTERPRETATION
The prevalence of blood-borne hepatitis, particularly that of HBV, is substantial in Haiti. The introduction of birth dose hepatitis B vaccines and improving access to testing and treatment services should be urgently considered to meet the elimination goal.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022298081, identifier: PROSPERO (CRD42022298081).
Topics: Adult; Child; Humans; Infant; Haiti; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis B Vaccines; Hepatitis, Viral, Human; Prevalence; Virus Diseases; Hepatitis C; Hepatitis D; Hepatitis Antigens
PubMed: 36711383
DOI: 10.3389/fpubh.2022.1099571