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HCV-HBV co-infection in Russian Federation

HCV-HBV co-infection in Russian Federation. Karen Kyuregyan. Chumakov Institute of Poliomyelitis and Viral Encephalitis, Moscow. VIII Annual Conference of New Visby Network on Hepatitis C February 13-16, 2011 Vilnius.

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HCV-HBV co-infection in Russian Federation

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  1. HCV-HBV co-infection in Russian Federation Karen Kyuregyan Chumakov Institute of Poliomyelitis and Viral Encephalitis, Moscow VIII Annual Conference of New Visby Network on Hepatitis C February 13-16, 2011 Vilnius

  2. Data on incidence of hepatitis B and C in Russian Federation based on official registration • Results of laboratory study of patients from two regions with different HBV and HCV prevalence: Moscow region and Tyva Republic

  3. Incidence of acute and chronic hepatitis B in Russian Federation (1999-2009)

  4. Incidence of acute and chronic hepatitis C in Russian Federation (1999-2009)

  5. Transmission routes of Hepatitis B and Hepatitis C in Russian Federation (1997 and 2008)

  6. Distribution of chronic hepatitis B and chronic hepatitis C incidence in different age groups in Russian Federation (2008)

  7. Similar trends in incidence for hepatitis B and hepatitis C; • Common routes of transmission for HBV and HCV; • Similar affected age groups; • High prevalence of HBV-HCV co-infection could be expected; • No official registration for mixed infections

  8. Study groups Moscow: • 244 patients with chronic hepatitis C Tyva • 133 patients with chronic hepatitis: • 38 patients with chronic hepatitis C • 95 patients with chronic hepatitis B/D and cirrhosis

  9. Incidence of chronic hepatitis B and chronic hepatitis C in Moscow region and in Tyva Republic (2006-2009)

  10. HBV detection • HBsAg: ELISA (“Diagnostic systems”, Russia) sensitivity - 0.01 ng/ml, K141E, Q129H, M133L, T126N, K 142S, P 142S, T143K, G145R • HBV DNA: Nested PCR, S-gene primers sensitivity – about 100 copies/ml Batches < 15 samples Low copy K+ (150 copies/ml and 1500 copies/ml) 4 K- per batch

  11. Moscow group Tyva group • 244 patients with chronic hepatitis C • 38 patients with chronic hepatitis C

  12. Prevalence of HBV/HCV co-infection in Moscow group CHC, n=244 HBsAg + (HBV DNA -) N= 2 (0.82%) Anti-HBc + Anti-HBs+ HBsAg – N = 42 (17.2%) Anti-HBc + Anti-HBs - HBsAg – N = 96 (39.3%) Anti-HBc - Anti-HBs- HBsAg – N = 104 (42.6%) N = 138 (56.6%) Testing for occult HBV infection No cases of OBI detected

  13. Prevalence of HBV/HCV co-infection in Tyva group CHC, n=38 HBsAg + (HBV DNA -) N= 3 (7.9%) Anti-HBc + Anti-HBs+ HBsAg – N = 13 (34.2%) Anti-HBc + Anti-HBs - HBsAg – N = 13 (34.2%) Anti-HBc - Anti-HBs- HBsAg – N = 9 (23.7%) N = 26 (68.4%) Testing for occult HBV infection 2 cases of OBI

  14. Cases of occult HBV infection in CHC patients (Tyva)

  15. Immune staining with protein A – colloidal gold complex. x 300 000

  16. Prevalence of HCV infection in patients with HBV/HDV HBsAg+/anti-HDV+ N=95 anti-HCV+ (HCV RNA-) N=8 (8.4%) After 1 year follow up 10/95 patients died * - cirrhosis grade by Child-Pugh

  17. Summary Prevalence of HBV/HCV co-infection in studied cohorts: • 2 cases (0.82%) in Moscow region; however, 56.6% patients with HCV have markers of HBV exposure; • 5 cases (13.2%) in hepatitis C patients + 8 cases (8.4%) in hepatitis B/D patients in Tyva Republic; • Difference in HBV/HCV co-infection prevalence in 2 regions may be due to acquisition of HBV in different age.

  18. Conclusion • In such hyperendemic regions as Tyva Republic HBV testing should be recommended for all HCV positive patients

  19. M.I.Mikhailov O.V.Isaeva L.Yu.Ilchenko N.I.Gromova I.A.Morozov T.V.Kozhanova I.V.Gordeychuk N.D.Oorzhak

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