48 research outputs found
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Hepatitis B virus-associated hepatocellular carcinoma in South Africa in the era of HIV
No full textCITATION: Maponga, T. G., et al. 2020. Hepatitis B virus-associated hepatocellular carcinoma in South Africa in the era of HIV. BMC Gastroenterology, 20:226, doi:10.1186/s12876-020-01372-2.The original publication is available at https://bmcgastroenterol.biomedcentral.comBackground: Patients co-infected with hepatitis B virus (HBV) and the human immunodeficiency virus (HIV) are at
risk of developing hepatocellular carcinoma (HCC). In sub-Saharan Africa, the overlap between high HIV and HBV
prevalence may increase the incidence of HCC. This study investigated the impact of HBV/HIV co-infection on age
at presentation and survival of HCC.
Methods: Ethical approval was obtained to recruit, following informed written consent, patients diagnosed with
HCC at oncology units at four South African hospitals. Between December 2012 and August 2015, patients newly
diagnosed with HCC were recruited and provided demographic and clinical data and blood specimens. Patients
were tested for HBV, hepatitis C virus (HCV) and HIV. Survival data was available for a subset of patients.
Results: Of 107 HCC cases, 83 (78%) were male. Median age was 46 years (range 18 to 90 years), 68/106 (64%) were
HBsAg-positive, and 22/100 (22%) were HIV infected. Among HBV surface antigen (HBsAg)-positive HCC cases, 18/66
(27%) were HIV-infected compared to 3/34 (9%) among those that were HBsAg-negative (p = 0.04). A greater
proportion of HBV/HIV co-infected cases were female than HBV mono-infected (6/18, 33% vs 6/47, 13%; p = 0.005).
In addition, HBV/HIV co-infected females presented at a younger mean age (36.8 years) than HBV mono-infected
women (50.5 years) (p = 0.09). Median survival was 82 days among the HIV-infected HCC patients compared to 181
days among those without HIV (p = 0.15).
Conclusions: HCC is an important complication in the HIV/HBV infected patient. HIV-positive patients presented
with HCC at a younger age than HIV-negative patients, this effect appears to be greater in women. These data
provide more evidence supporting the call to address. HCC as a cause of morbidity and mortality in the HBV/HIV
co-infected patient population. (281 words).https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-020-01372-2Publisher's versio
Rapid epidemic expansion of the SARS-CoV-2 Omicron variant in southern Africa
No full textAutor - Múltiplas Autorias- Raquel Viana, Sikhulile Moyo, Daniel G. Amoako, Houriiyah Tegally, Cathrine Scheepers,
Christian L. Althaus, Ugochukwu J. Anyaneji, Phillip A. Bester, Maciej F. Boni,
Mohammed Chand, Wonderful T. Choga, Rachel Colquhoun, Michaela Davids,
Koen Deforche, Deelan Doolabh, Louis du Plessis, Susan Engelbrecht, Josie Everatt,
Jennifer Giandhari, Marta Giovanetti, Diana Hardie, Verity Hill, Nei-Yuan Hsiao,
Arash Iranzadeh, Arshad Ismail, Charity Joseph, Rageema Joseph, Legodile Koopile,
Sergei L. Kosakovsky Pond, Moritz U. G. Kraemer, Lesego Kuate-Lere,
Oluwakemi Laguda-Akingba, Onalethatha Lesetedi-Mafoko, Richard J. Lessells,
Shahin Lockman, Alexander G. Lucaci, Arisha Maharaj, Boitshoko Mahlangu,
Tongai Maponga, Kamela Mahlakwane, Zinhle Makatini, Gert Marais, Dorcas Maruapula,
Kereng Masupu, Mogomotsi Matshaba, Simnikiwe Mayaphi, Nokuzola Mbhele,
Mpaphi B. Mbulawa, Adriano Mendes, Koleka Mlisana, Anele Mnguni, Thabo Mohale,
Monika Moir, Kgomotso Moruisi, Mosepele Mosepele, Gerald Motsatsi,
Modisa S. Motswaledi, Thongbotho Mphoyakgosi, Nokukhanya Msomi, Peter N. Mwangi,
Yeshnee Naidoo, Noxolo Ntuli, Martin Nyaga, Lucier Olubayo, Sureshnee Pillay,
Botshelo Radibe, Yajna Ramphal, Upasana Ramphal, James E. San, Lesley Scott,
Roger Shapiro, Lavanya Singh, Pamela Smith-Lawrence, Wendy Stevens, Amy Strydom,
Kathleen Subramoney, Naume Tebeila, Derek Tshiabuila, Joseph Tsui, Stephanie van Wyk,
Steven Weaver, Constantinos K. Wibmer, Eduan Wilkinson, Nicole Wolter,
Alexander E. Zarebski, Boitumelo Zuze, Dominique Goedhals, Wolfgang Preiser,
Florette Treurnicht, Marietje Venter, Carolyn Williamson, Oliver G. Pybus, Jinal Bhiman,
Allison Glass, Darren P. Martin, Andrew Rambaut, Simani Gaseitsiwe, Anne von Gottberg & Tulio de Oliveira. Afiliaçao - Múltiplas autorias. Autor Fiocruz - Marta Giovanetti. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brasil / Universidade Federal de Minas Gerais. Laboratório de Genética Celular e Molecular. Belo Horizonte, MG, Brasil.The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in
southern Africa has been characterised by three distinct waves. The first was
associated with a mix of SARS-CoV-2 lineages, whilst the second and third waves were
driven by the Beta and Delta variants, respectively1–3. In November 2021, genomic
surveillance teams in South Africa and Botswana detected a new SARS-CoV-2 variant
associated with a rapid resurgence of infections in Gauteng Province, South Africa.
Within three days of the first genome being uploaded, it was designated a variant of
concern (Omicron) by the World Health Organization and, within three weeks, had
been identified in 87 countries. The Omicron variant is exceptional for carrying over
30 mutations in the spike glycoprotein, predicted to influence antibody
neutralization and spike function4. Here, we describe the genomic profile and early
transmission dynamics of Omicron, highlighting the rapid spread in regions with high
levels of population immunity
Prevalence and risks of hepatitis E virus infection in blood donors from the Western Cape, South Africa
No full textParticipant information sheet for HBV research
No full textWe have generated a participant information sheet to provide details of a research study in a way that is widely accessible.This brief resource supports a full-length description of the study available as supporting text, but recognises that extensive written information is not always appropriate or accessible. A short version with supporting graphics aims to make the information easier to assimilate, and thus to reduce inequities in access to research participation.</div
Hepatitis B Virus Research in South Africa
No full textDespite being vaccine-preventable, hepatitis B virus (HBV) infection remains the seventh leading cause of mortality in the world. In South Africa (SA), over 1.9 million people are chronically infected with HBV, and 70% of all Black chronic carriers are infected with HBV subgenotype A1. The virus remains a significant burden on public health in SA despite the introduction of an infant immunization program implemented in 1995 and the availability of effective treatment for chronic HBV infection. In addition, the high prevalence of HIV infection amplifies HBV replication, predisposes patients to chronicity, and complicates management of the infection. HBV research has made significant progress leading to better understanding of HBV epidemiology and management challenges in the SA context. This has led to recent revision of the national HBV infection management guidelines. Research on developing new vaccines and therapies is underway and progress has been made with designing potentially curative gene therapies against HBV. This review summarizes research carried out in SA on HBV molecular biology, epidemiology, treatment, and vaccination strategies
Highlights from the 3rd international HIV/viral hepatitis Co-infection meeting - HIV/viral hepatitis: improving diagnosis, antiviral therapy and access
No full textThe International AIDS Society convened the 3rd International HIV/Viral Hepatitis Co-Infection Meeting on 17 July 2016 as part of the pre-conference program preceding the 21st International AIDS Conference held in Durban, South Africa. The meeting brought together a diversity of scientific, technical and community interests to discuss opportunities and challenges for increased prevention, diagnosis and treatment of viral hepatitis in people living with HIV, particularly in low- and middle-income settings. The objectives of the meeting were: i. To review the latest therapeutic developments in viral hepatitis; ii. To identify challenges such as high cost of medications for hepatitis C virus (HCV) and risk of developing viral resistance, and successes, such as the provision of HCV treatment in community-based settings, movements to reduce drug costs and increasing access, in relation to scaling up diagnosis, screening, antiviral treatment and prevention of viral hepatitis; iii. To advance the agenda for elimination of viral hepatitis as a public health problem. Discussions centred around the six key interventions outlined by the World Health Organization Global Health Sector Strategy on Viral Hepatitis 2016–2021: hepatitis B virus (HBV) vaccination (including birth dose); safe injection practices plus safe blood; harm reduction among people who inject drugs; safer sex practices; hepatitis B treatment; and hepatitis C cure. This article summarizes the main issues and findings discussed during the pre-conference meeting. One of the recommendations from the meeting delegates is universal implementation of birth dose vaccination for HBV without further delay to prevent mother-to-child transmission of infection. There is also the need to implement screening and treatment of hepatitis among pregnant women. A call was made for concerted efforts to be put together by all stakeholders towards addressing some of the structural barriers, including criminalization of drug use, discrimination and stigma that people living with viral hepatitis face. Finally, the need for greater advocacy was highlighted to enable access to therapy of viral hepatitis at lower cost than currently prevails. Implementation of these resolutions will help in achieving the target of eliminating viral hepatitis as a public health threat
Prevalence of chronic HBV infection in pregnant woman attending antenatal care in a tertiary hospital in Mwanza, Tanzania : a cross-sectional study
No full textCITATION: Geffert, K., et al. 2020. Prevalence of chronic HBV infection in pregnant woman attending antenatal care in a tertiary hospital in Mwanza, Tanzania : a cross-sectional study. BMC Infectious Diseases, 20:395, doi:10.1186/s12879-020-05096-2.The original publication is available at https://bmcinfectdis.biomedcentral.comBackground: Tanzania has a high prevalence (7.17%) of chronic hepatitis B infection. Mother to Child transmission
is very common, resulting in high rate of chronic infections. Currently, there is no screening program for HBV in
pregnant women. This study investigated the prevalence and risk factors for chronic HBV infection in pregnant
women in a tertiary hospital in Mwanza, Tanzania.
Methods: Seven hundred and forty-three women attending antenatal care and/or delivering at the Bugando
Medical Centre were enrolled. All answered a questionnaire on sociodemographic and other risk factors and were
tested for HBsAg using a rapid test. In HBsAg positive mothers, maternal blood and umbilical cord blood samples
collected after delivery were analyzed for serological (HBsAg, HBeAg and anti-HBe) and virologic (HBV-DNA viral
load and genotype) markers. All their babies were vaccinated within 24 h of delivery. The children were followed up
at 3 years of age. Data was analyzed using the Mann-Whitney U-test, independent sample T-test and logistic
regression.
Results: Of the 743 participants, 22 (3%) were positive for HBsAg, and 2 (9%) had detectable HBe-antigen. Low
condom use was the only statistically significant risk factor for chronic HBV infection (OR = 3.514, 95%CI = 1.4–8.0).
Of 14 maternal blood samples genotyped, 10 (71%) were genotype A and 4 (29%) were genotype D. HBV-DNA was
detected in 21/22 samples, with a median of 241 IU/ml (range: 27.4–25.9 × 107 IU/ml). Five (33%) of 15 available
cord blood samples were positive for HBsAg and 10 (67%) were negative. At follow-up, one child showed chronic
HBV infection characteristics, one had anti-HBs level of 7 mIU/ml and 5/7(71%) had protective anti-HBs levels (> 10
mIU/ml).
Conclusion: This cohort of pregnant women showed a lower-intermediate prevalence of HBV of 3%. In the 3 years
follow-up only 1 out of 7 children showed evidence of chronic HBV infection. The child’s mother with high viral
load (25.9 × 107 IU/ml), was positive for HBeAg with a high degree of sequence similarity suggesting vertical
transmission. These results highlight a need for improved diagnosis and treatment of HBV infection in pregnant
women in Tanzania, in order to prevent vertical transmission.https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05096-2Publisher's versio
Additional file 1: of HBV and HIV viral load but not microbial translocation or immune activation are associated with liver fibrosis among patients in South Africa
No full textTable S1. Serum LPB concentration according to patient group (Îźg/ml). Table S2. Proportions of fibrosis scores according to the HBV genotype. Table S3. Multiple correlation analysis of all patients ungrouped. Statistically significant correlations appear in red font. Figure S1. Gating strategy for Immune Activation panel. Plot A shows the singlet population gating while Plot B represents the SSC against FSC plot indicating the position of the singlet cells of the lymphocyte population. Plot C shows the lymphocyte population as shown by less complexity (SS) and intense staining for CD45-KO in a plot of side scatter against CD45-KO. Plot D shows the CD3+ population (Gate G) as gated from Gate F shown in Plot C. Using colour precedence and back gating, Plot D also shows the non-lymphocyte population (red colour) that is included within gate F based on use of complexity (SS INT) and staining for CD45. Picture E shows the CD4+ in the blue colour (gate H) and the CD8+ lymphocytes in the magenta colour (gate I). Plot F shows the CD8+ population staining for CD38-PE and HLA-DR-APC gated from gate I. The gate placement was based on defined fluorescence minus one (FMO) settings. Figure S2. Scatter plot of % CD8/CD38+/HLA-DR+ in the co-infected group. The plot only includes HBV/HIV co-infected patients. All patients with undetectable HIV viral load are assigned values of zero and appear on the y-axis as dots corresponding with the percentage expression CD8/CD38+/HLA-DR. Frequency of HBV genotypes according to HBV and HIV infection status. Among the 13 co-infected patients whose HBV was successfully sequenced, 8 (62%) were infected with HBV genotype A, 3 (23%) with D and 2 had HBV genotype E (15%). The distribution of genotypes among the HBV mono-infected patients was- 16/29 (55%) A, 11/29 (38%) D and 2/29 (7%) E. The red columns represent HBV genotype A, green is for genotype D and the blue corresponds to genotype E. Genotyping was frequently more successful in the HBV mono-infected group compared to the co-infected group. (DOCX 475Â kb
Hepatitis B virus resistance to nucleos(t)ide analogue therapy: WHO consultation on questions, challenges, and a roadmap for the field
No full textIn this Review, we summarise outputs from a multidisciplinary consultation convened by WHO between July 11 and 13, 2023, to discuss hepatitis B virus (HBV) drug resistance (HBVDR). Treatment of chronic HBV infection with highly effective nucleos(t)ide analogue agents, tenofovir and entecavir, is a crucial intervention that supports the global goal of elimination of HBV infection as a public health threat. The risk of HBVDR as a threat to treatment outcomes is currently considered low from a public health perspective; however, drug resistance can influence individual outcomes, particularly among those who are treatment-experienced. We highlight the need to develop appropriate prevention, monitoring, and surveillance approaches for HBVDR, to support investment in the global scale-up of HBV diagnosis and treatment. Recommendations for the HBVDR field will ultimately be incorporated into a WHO integrated Global Action Plan for drug-resistant HIV, viral hepatitis, and priority sexually transmitted infections
Evidence of tenofovir resistance in chronic hepatitis B virus (HBV) infection: an observational case series of South African adults
No full textINTRODUCTION:Tenofovir disoproxil fumarate (TDF) is widely recommended for treatment of chronic hepatitis B virus (HBV) infection because it is safe, affordable and has a high genetic barrier to resistance. TDF resistance associated mutations (RAMs) have been reported, but data are limited, particularly for Africa. We set out to identify potential RAMs in individuals with detectable HBV viraemia on TDF treatment. METHODS:We recruited adults with chronic HBV infection from Cape Town, South Africa, identifying individuals with a TDF resistance phenotype, defined as persistent HBV vireamia despite >12 months of TDF treatment. We sequenced HBV DNA using MiSeq Illumina with whole genome target enrichment, and sought potential TDF RAMs, based on a pre-defined list of polymorphisms. RESULTS:Among 66 individuals with chronic HBV (genotypes A and D), three met our clinical definition for TDF resistance, of whom two were coinfected with HIV. In one participant, the consensus HBV sequence contained nine polymorphisms that have been described in association with TDF resistance. Significant treatment non-adherence in this individual was unlikely, as HIV RNA was suppressed. TDF RAMs were also present in HBV sequences from the other two participants, but other factors including treatment non-adherence may also have had a role in failure of HBV DNA suppression in these cases. DISCUSSION:Our findings add to the evidence that RAMs in HBV reverse transcriptase may underpin a TDF resistant phenotype. This is the first time these RAMs have been reported from Africa in association with clinical evidence of TDF resistance
