A case series of #COVID19 patients with chronic #hepatitis B virus infection (J Med Virol., abstract)

[Source: Journal of Medical Virology, full page: (LINK). Abstract, edited.]

A case series of COVID‐19 patients with chronic hepatitis B virus infection

Yang Li,  Chunyang Li,  Jian Wang,  Chuanwu Zhu,  Li Zhu,  Fang Ji,  Longgen Liu, Tianmin Xu,  Biao Zhang,  Leyang Xue,  Xiaomin Yan,  Rui Huang,  Chao Wu,  Xuebing Yan

First published: 19 June 2020 | DOI:  https://doi.org/10.1002/jmv.26201

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/jmv.26201



Previous studies reported that coronavirus disease 2019 (COVID‐19) was likely to result in liver injury. However, few studies reported the impacts of COVID‐19 on liver function in patients with chronic liver diseases. We aimed to describe a case series of COVID‐19 patients with chronic hepatitis B virus (HBV) infection. Confirmed hospitalized COVID‐19 patients from hospitals in 10 cities of Jiangsu province, China were retrospectively included between January 18, 2020, and February 26, 2020. Demographic information, epidemiologic data, clinical features and treatment data were extracted from medical records. Seven COVID‐19 patients with chronic HBV infection were included. Six (85.7%) patients were male. The patients aged from 33 years to 49 years. Two patients had HBV‐related cirrhosis. One patients (14.3%) were positive for serum hepatitis B virus e antigen. On admission, 1 (14.3%) patients had mildly elevated ALT level (>40 U/L) and 1 (14.3%) had elevated AST level (>40 U/L). The serum albumin level and platelet counts were decreased in 2 patients with HBV‐related liver cirrhosis. Three (42.9%) patients had elevated ALT level and 2 (28.6%) patients had elevated AST level in hospitalization. However, the peak ALT and AST level during hospitalization was 51 U/L and 44 U/L, respectively. As of February 29, 2020, all patients were discharged. No patient was admitted to the intensive care units or developed liver failure during hospitalization. The abnormalities of liver function are not uncommon on COVID‐19 patients with chronic HBV infection in our case series. However, no patient developed severe liver‐related complications during hospitalization.

This article is protected by copyright. All rights reserved.

Keywords: SARS-CoV-2; COVID-19; Hepatitis B.


#TB, #HIV, and viral #hepatitis #diagnostics in eastern #Europe and central #Asia: high time for integrated and people-centred services (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

Tuberculosis, HIV, and viral hepatitis diagnostics in eastern Europe and central Asia: high time for integrated and people-centred services

Masoud Dara, MD  †, Soudeh Ehsani, MD, Antons Mozalevskis, MD, Elena Vovc, MD, Daniel Simões, MPH, Ana Avellon Calvo, PhD, Jordi Casabona i Barbarà, PhD, Otar Chokoshvili, MPH, Irina Felker, PhD, Sven Hoffner, PhD, Gulmira Kalmambetova, PhD, Ecatarina Noroc, MD, Natalia Shubladze, PhD, Alena Skrahina, MD, Rasim Tahirli, MD, Prof Tengiz Tsertsvadze, PhD,

Published: November 15, 2019 / DOI: https://doi.org/10.1016/S1473-3099(19)30524-9



Globally, high rates (and in the WHO European region an increasing prevalence) of co-infection with tuberculosis and HIV and HIV and hepatitis C virus exist. In eastern European and central Asian countries, the tuberculosis, HIV, and viral hepatitis programmes, including diagnostic services, are separate vertical structures. In this Personal View, we consider underlying reasons for the poor integration for these diseases, particularly in the WHO European region, and how to address this with an initial focus on diagnostic services. In part, this low integration has reflected different diagnostic development histories, global funding sources, and sample types used for diagnosis (eg, typically sputum for tuberculosis and blood for HIV and hepatitis C). Cooperation between services improved as patients with tuberculosis needed routine testing for HIV and vice versa, but financial, infection control, and logistical barriers remain. Multidisease diagnostic platforms exist, but to be used optimally, appropriate staff training and sensible understanding of different laboratory and infection control risks needs rapid implementation. Technically these ideas are all feasible. Poor coordination between these vertical systems remains unhelpful. There is a need to increase political and operational integration of diagnostic and treatment services and bring them closer to patients.

Keywords: Public Health; European Region; TB; HIV/AIDS; Viral hepatitis.


Detection of #Hepatitis B Virus-Like Nucleotide #Sequences in #Liver Samples from Murine #Rodents and Asian House #Shrews (Vector Borne Zoo Dis., abstract)

[Source: Vector Borne and Zoonotic Diseases, full page: (LINK). Abstract, edited.]

Detection of Hepatitis B Virus-Like Nucleotide Sequences in Liver Samples from Murine Rodents and Asian House Shrews

Wen-Qiao He, Xue-Jiao Chen, Yu-Qi Wen, Yong-Zhi Li, Huan He, and Qing Chen

Published Online: 19 Jun 2019 / DOI: https://doi.org/10.1089/vbz.2018.2424



In recent years, hepatitis B virus (HBV) has been detected in some species of animals. In this study, we found HBV-like nucleotide sequences in murine rodents and Asian house shrews (Suncus murinus) collected in China. A total of 801 animals were trapped. We found that 0.48% (3/624) of the murine rodents and 1.69% (3/177) of Asian house shrews were positive for HBV-like DNA. Detection of HBV-like DNA in brown rats (Rattus norvegicus), rice-field rat (Rattus losea), and Asian house shrews indicated that these species of animals might be hosts for HBV. However, none of the HBV-like DNA-positive animals was additionally positive for anti-HBV antibodies or hepatitis B surface antigen. A 585 bp nucleic acid sequence, mapping to a hepadnavirus, was extracted from rice-field rat, and bores strong resemblance to human HBV genotype B sequences. Further research is required to investigate the hepadnaviruses within the murine rodent and Asian house shrew populations to uncover the origin and zoonotic potential of HBV.

Keywords: Hepatitis B Virus; Hepadnavirus; Wildlife.


High #prevalence of latent #tuberculosis and #bloodborne virus #infection in a #homeless population (Thorax, abstract)

[Source: Thorax, full page: (LINK). Abstract, edited.]

High prevalence of latent tuberculosis and bloodborne virus infection in a homeless population

Robert W Aldridge1,2, Andrew C Hayward1,2,3, Sara Hemming1,2,4, Susan K Yates1,2,4, Gloria Ferenando1,2,4, Lucia Possas1,2,4,Elizabeth Garber1,2,4, John M Watson1, Anna Maria Geretti5, Timothy Daniel McHugh6, Marc Lipman4,7, Alistair Story8

Author affiliations: Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK; Department of Infectious Disease Informatics, The Farr Institute of Health Informatics Research, London, UK; Institute of Epidemiology and Health Care, University College London, London, UK; Royal Free London NHS Foundation Trust, London, UK; Institute of Infection and Global Health, University of Liverpool, Liverpool, UK; Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK; UCL Respiratory, Division of Medicine, University College London, London, UK; Find&Treat, University College London Hospitals, London, UK

Correspondence to Dr Andrew C Hayward, Research Department of Infectious Disease Informatics, Farr Institute of Health Informatics Research, University College London, London NW1 2DA, UK; a.hayward@ucl.ac.uk




Urban homeless populations in the UK have been shown to have high rates of active tuberculosis, but less is known about the prevalence of latent tuberculosis infection (LTBI). This study aimed to estimate the prevalence of LTBI among individuals using homeless hostels in London.


We performed a cross-sectional survey with outcome follow-up in homeless hostels in London. Our primary outcome was prevalence of LTBI. Recruitment for the study took place between May 2011 and June 2013. To estimate an LTBI prevalence of 10% with 95% CIs between 8% and 13%, we required 500 participants.


491/804 (61.1%) individuals agreed to be screened. The prevalence of LTBI was 16.5% (81/491; 95% CI 13.2 to 19.8). In UK-born individuals, a history of incarceration was associated with increased risk of LTBI (OR 3.49; 95% CI 1.10 to 11.04; P=0.018) after adjusting for age, length of time spent homeless and illicit drug use. Of the three subjects who met English treatment guidelines for LTBI at the time of the study, none engaged with services after referral for treatment. Prevalence of past hepatitis B infection was 10.4% (51/489; 95% CI 7.7 to 13.1), and 59.5% (291/489; 95% CI 55.1 to 63.9) of individuals were non-immune. Prevalence of current hepatitis C infection was 10.4% (51/489; 95% CI 7.8 to 13.1).


This study demonstrates the high prevalence of LTBI in homeless people in London and the associated poor engagement with care. There is a large unmet need for LTBI and hepatitis C infection treatment, and hepatitis B vaccination, in this group.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

DOI: http://dx.doi.org/10.1136/thoraxjnl-2016-209579


Key messages

  • What is the key question?
    • What is the prevalence of latent tuberculosis infection (LTBI) and bloodborne viral infections among homeless people in London, and what are the outcomes in those referred to healthcare services?
  • What is the bottom line?
    • People experiencing homelessness in London have a very high prevalence of LTBI, hepatitis B and hepatitis C infection and coinfection, compounded by poor engagement with care.
  • Why read on?
    • We report for the first time on the burden of LTBI and bloodborne viruses among homeless people in a metropolitan UK setting. The findings highlight the need to ensure recent improvements in diagnostics, and therapeutic can benefit the most vulnerable and excluded populations.

Keywords: UK; Society: Tuberculosis; Hepatitis B; Hepatitis C.


New #Avian #Hepadnavirus in Palaeognathous Bird, #Germany (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 23, Number 12—December 2017 / Research Letter

New Avian Hepadnavirus in Palaeognathous Bird, Germany

Wendy K. Jo1  , Vanessa M. Pfankuche1, Henning Petersen, Samuel Frei, Maya Kummrow, Stephan Lorenzen, Martin Ludlow, Julia Metzger, Wolfgang Baumgärtner, Albert Osterhaus, and Erhard van der Vries

Author affiliations: University of Veterinary Medicine Hannover, Foundation, Hannover, Germany (W.K. Jo, V.M. Pfankuche, H. Petersen, M. Ludlow, J. Metzger, W. Baumgärtner, A. Osterhaus, E. van der Vries); Center for Systems Neuroscience, Hannover (W.K. Jo, V.M. Pfankuche, W. Baumgärtner, A. Osterhaus); Wuppertal Zoo, Wuppertal, Germany (S. Frei, M. Kummrow); Bernhard Nocht Institute for Tropical Medicine, Hamburg (S. Lorenzen); Artemis One Health, Utrecht, the Netherlands (A. Osterhaus)



In 2015, we identified an avian hepatitis B virus associated with hepatitis in a group of captive elegant-crested tinamous (Eudromia elegans) in Germany. The virus’ full-length genome shares <76% sequence identity with other avihepadnaviruses. The virus may therefore be considered a new extant avian hepadnavirus.

Keywords: Hepadnavirus; Hepatitis B; Avihepadnavirus; Wild Birds.


Estimating the #burden of #disease attributable to #injectingdrug use as a #risk factor for #HIV, #hepatitis C, and hepatitis B: findings from the Global Burden of Disease Study 2013 (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]


Estimating the burden of disease attributable to injecting drug use as a risk factor for HIV, hepatitis C, and hepatitis B: findings from the Global Burden of Disease Study 2013

Prof Louisa Degenhardt, PhD, Fiona Charlson, PhD, Jeff Stanaway, PhD, Sarah Larney, PhD, Lily T Alexander, BA, Prof Matthew Hickman, PhD, Benjamin Cowie, PhD, Prof Wayne D Hall, PhD, Prof John Strang, MD, Prof Harvey Whiteford, PhD, Prof Theo Vos, PhD

Open Access / DOI: http://dx.doi.org/10.1016/S1473-3099(16)30325-5

© 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND license. Published by Elsevier Ltd.




Previous estimates of the burden of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) among people who inject drugs have not included estimates of the burden attributable to the consequences of past injecting. We aimed to provide these estimates as part of the Global Burden of Disease (GBD) Study 2013.


We modelled the burden of HBV and HCV (including cirrhosis and liver cancer burden) and HIV at the country, regional, and global level. We extracted United Nations data on the proportion of notified HIV cases by transmission route, and estimated the contribution of injecting drug use (IDU) to HBV and HCV disease burden by use of a cohort method that recalibrated individuals’ history of IDU, and accumulated risk of HBV and HCV due to IDU. We estimated data on current IDU from a meta-analysis of HBV and HCV incidence among injecting drug users and country-level data on the incidence of HBV and HCV between 1990 and 2013. We calculated estimates of burden of disease through years of life lost (YLL), years of life lived with disability (YLD), deaths, and disability-adjusted life-years (DALYs), with 95% uncertainty intervals (UIs) calculated for each metric.


In 2013, an estimated 10·08 million DALYs were attributable to previous exposure to HIV, HBV, and HCV via IDU, a four-times increase since 1990. In total in 2013, IDU was estimated to cause 4·0% (2·82 million DALYs, 95% UI 2·4 million to 3·8 million) of DALYs due to HIV, 1·1% (216 000, 101 000–338 000) of DALYs due to HBV, and 39·1% (7·05 million, 5·88 million to 8·15 million) of DALYs due to HCV. IDU-attributable HIV burden was highest in low-to-middle-income countries, and IDU-attributable HCV burden was highest in high-income countries.


IDU is a major contributor to the global burden of disease. Effective interventions to prevent and treat these important causes of health burden need to be scaled up.


Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council.

Keywords: Research; Abstracts; Illicit Drugs; HIV; Hepatitis C; Hepatitis B.


#Interventions to optimise the care continuum for #chronic #viral #hepatitis: a systematic review and meta-analyses (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]


Interventions to optimise the care continuum for chronic viral hepatitis: a systematic review and meta-analyses

Kali Zhou, MD†, Thomas Fitzpatrick, BA†, Nick Walsh, MD, Ji Young Kim, BA, Prof Roger Chou, MD, Mellanye Lackey, MSI, Julia Scott, MD, Ying-Ru Lo, MD, Joseph D Tucker, MD

†These authors contributed equally to this work

Article has an altmetric score of 10 / DOI: http://dx.doi.org/10.1016/S1473-3099(16)30208-0

© 2016 World Health Organization.




Advances in therapy for hepatitis B virus (HBV) and hepatitis C virus (HCV) have ushered in a new era in chronic hepatitis treatment. To maximise the effectiveness of these medicines, individuals must be engaged and retained in care. We analysed operational interventions to enhance chronic viral hepatitis testing, linkage to care, treatment uptake, adherence, and viral suppression or cure.


We did a systematic review of operational interventions, and did meta-analyses for sufficiently comparable data. We searched PubMed, Embase, WHO library, International Clinical Trials Registry Platform, PsycINFO, and CINAHL for randomised controlled trials and controlled non-randomised studies that examined operational interventions along the chronic viral hepatitis care continuum, published in English up to Dec 31, 2014. We included non-pharmaceutical intervention studies with primary or secondary outcomes of testing, linkage to care, treatment uptake, treatment adherence, treatment completion, treatment outcome, or viral endpoints. We excluded dissertations and studies of children only. Data were extracted by two independent reviewers, with disagreements resolved by a third reviewer. Studies were assessed for bias. Data from similar interventions were pooled and quality of evidence was assessed using GRADE. This study was registered in PROSPERO (42014015094).


We identified 7583 unduplicated studies, and included 56 studies that reported outcomes along the care continuum (41 for HCV and 18 for HBV). All studies except one were from high-income countries. Lay health worker HBV test promotion interventions increased HBV testing rates (relative risk [RR] 2·68, 95% CI 1·82–3·93). Clinician reminders to prompt HCV testing during clinical visits increased HCV testing rates (3·70, 1·81–7·57). Nurse-led educational interventions improved HCV treatment completion (1·14, 1·05–1·23) and cure (odds ratio [OR] 1·93, 95% CI 1·44–2·59). Coordinated mental health, substance misuse, and hepatitis treatment services increased HCV treatment uptake (OR 3·03, 1·24–7·37), adherence (RR 1·22, 1·05–1·41), and cure (RR 1·21, 1·07–1·38) compared with usual care.


Several simple, inexpensive operational interventions can substantially improve engagement and retention along the chronic viral hepatitis care continuum. Further operational research to inform scale-up of hepatitis services is needed in low-income and middle-income countries.


World Health Organization and US Fulbright Program.

Keywords: Research; Abstracts; Hepatitis B; Hepatitis C.