OBJECTIVES: To explore the correlation of serum tryptophan level with 90-day mortality risk in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). METHODS: This retrospective study was conducted among 108 patients with HBV-ACLF, whose survival outcomes within 90 days after diagnosis were recorded. The correlation of baseline serum tryptophan levels measured by high-performance liquid chromatography with 90-day mortality of the patients was analyzed, and the predictive value of serum tryptophan for 90-day mortality was explored. RESULTS: Within 90 days after diagnosis, 53 (29.4%) of the patients died and 127 (70.6%) survived. The deceased patients had significantly lower baseline serum tryptophan levels than the survivors (7.31±3.73 pg/mL vs 13.32±7.15 pg/mL, P<0.001). Multivariate analysis suggested that serum tryptophan level was an independent factor correlated with mortality of HBV-ACLF after adjustment for confounding variables. The patients with serum tryptophan levels below the median level (10.14 pg/mL) at admission had significantly higher 90-day mortality risks than those with higher tryptophan levels (43.3% vs 15.6%, HR: 3.157, 95% CI: 1.713-5.817), and the complication by kidney dysfunction further increased the risk to 73.3% as compared with patients with higher serum tryptophan levels with normal kidney function (15.0%; HR: 7.558, 95% CI: 3.369-16.960). Serum tryptophan levels had an area under the receiver operating characteristic curve of 0.771 (95% CI: 0.699-0.844) for predicting 90-day mortality. CONCLUSIONS Serum tryptophan level is closely correlated with the survival outcomes of patients with HBV-ACLF, and a decreased tryptophan level indicates a high 90-day mortality risk, which can be further increased by the complication by kidney dysfunction.
Humans ; Tryptophan/blood* ; Retrospective Studies ; Acute-On-Chronic Liver Failure/virology* ; Male ; Female ; Middle Aged ; Adult ; Prognosis ; Hepatitis B/complications* ; Hepatitis B virus

OBJECTIVES: To evaluate the impact of HBV infection on pre- and postpartum health-related quality of life (HRQoL) in pregnant women. METHODS: A prospective matched cohort consisting of 70 HBV-infected and 70 healthy pregnant women was recruited from the Fifth Affiliated Hospital of Guangzhou Medical University between April 17 and September 25, 2023. HRQoL of the participants was assessed at 16-24 weeks of gestation, between 32 weeks and delivery, and 5-13 weeks postpartum. Mixed linear models were used for evaluating temporal trends of HRQoL changes, and univariate ANOVA with multiple linear regression was used to identify the predictors of HRQoL. RESULTS: Compared with healthy pregnant women, HBV-infected pregnant women had consistently lower total HRQoL scores across all the 3 intervals, with the lowest scores observed between 32 weeks of gestation and delivery, during which these women had significantly reduced mental component scores (74.27±13.43 vs 80.21±12.9, P=0.009) and postpartum mental (76.52±16.19 vs 85.02±6.51, P<0.001) and physical component scale scores (77.17±14.71 vs 83.09±10.1, P=0.009). HBV infection was identified as an independent risk factor affecting HRQoL during late pregnancy and postpartum periods. Additional independent risk factors for postpartum HRQoL reduction included self-pay medical expenses, spouse's neutral attitude toward the current pregnancy, and preexisting comorbidities (all P<0.05). CONCLUSIONS HRQoL of pregnant women deteriorates progressively in late pregnancy, and HBV infection exacerbates reductions of physical function and role emotion in late pregnancy and after delivery, suggesting the importance of targeted interventions for financial burdens, partner support and comorbid conditions to improve HRQoL of pregnant women with HBV infection.
Humans ; Female ; Pregnancy ; Quality of Life ; Prospective Studies ; Postpartum Period ; Hepatitis B, Chronic/psychology* ; Adult ; Pregnancy Trimester, Third ; Pregnancy Trimester, Second ; Pregnancy Complications, Infectious

OBJECTIVES: To investigate the impact of hepatitis B virus (HBV) infection on oral microbiota and metabolites in patients with metabolic dysfunction-associated fatty liver disease (MAFLD) and the underlying mechanisms. METHODS: This prospective study was conducted in 47 MAFLD patients complicated with chronic hepatitis B (CHB) and 48 MAFLD patients without CHB enrolled from November, 2023 to January, 2024. Fasting tongue coating samples were collected from the patients for analyzing microbial community structures and metabolites using high-throughput 16S rDNA sequencing and non-targeted metabolomics techniques, and their associations with clinical indicators and biological pathways were explored using correlation analysis and functional annotation. RESULTS: The levels of fasting blood glucose, total cholesterol (TC), gamma-glutamyl transferase (GGT), and severity of fatty liver were all significantly lower in MAFLD+CHB group than in MAFLD group. Microbiota analysis showed that the abundances of Patescibacteria (at the phylum level), Hydrogenophaga, and Absconditabacteriales (at the genus level) were significantly increased, while the abundance of Megasphaera was decreased in MAFLD+CHB group. The differential microbiota were significantly correlated with TC, GGT and low-density lipoprotein (r=-0.68‒0.75). Metabolomics analysis revealed that 469 metabolites (including lipids and amino acids) were upregulated and 2306 (including organic oxygen-containing compounds and phenylpropanoids) were downregulated in MAFLD+CHB group, for which KEGG enrichment analysis suggested abnormal activation of the linoleic acid metabolism and glycerophospholipid metabolism pathways. Correlation analysis between microbiota and metabolites indicated that Patescibacteria and Megasphaera, which were positively correlated with lipid metabolites and negatively with fatty acid metabolites, respectively, jointly affected glycolipid metabolism and oxidative stress pathways. CONCLUSIONS Compared to patients with MAFLD alone, MAFLD patients with concurrent chronic HBV infection showed lower levels in some lipid metabolism indicators and the degree of hepatic steatosis, accompanied by alterations in oral microbiota structure and metabolic profiles. The precise mechanisms involved require further investigation to be fully elucidated.
Humans ; Lipid Metabolism ; Prospective Studies ; Microbiota ; Hepatitis B, Chronic/microbiology* ; Male ; Female ; Adult ; Fatty Liver/microbiology* ; Middle Aged ; Mouth/microbiology* ; Metabolomics

OBJECTIVE: To investigate chronic hepatitis C virus (HCV) infection's effect on gestational liver function, pregnancy and delivery complications, and neonatal development. METHODS: A total of 157 HCV antibody-positive (anti-HCV[+]) and HCV RNA(+) patients (Group C) and 121 anti-HCV(+) and HCV RNA(-) patients (Group B) were included as study participants, while 142 anti-HCV(-) and HCV RNA(-) patients (Group A) were the control group. Data on biochemical indices during pregnancy, pregnancy complications, delivery-related information, and neonatal complications were also collected. RESULTS: Elevated alanine aminotransferase (ALT) rates in Group C during early, middle, and late pregnancy were 59.87%, 43.95%, and 42.04%, respectively-significantly higher than Groups B (26.45%, 15.70%, 10.74%) and A (23.94%, 19.01%, 6.34%) ( P < 0.05). Median ALT levels in Group C were significantly higher than in Groups A and B at all pregnancy stages ( P < 0.05). No significant differences were found in neonatal malformation rates across groups ( P > 0.05). However, neonatal jaundice incidence was significantly greater in Group C (75.16%) compared to Groups A (42.25%) and B (57.02%) ( χ ² = 33.552, P < 0.001). HCV RNA positivity during pregnancy was an independent risk factor for neonatal jaundice ( OR = 2.111, 95% CI 1.242-3.588, P = 0.006). CONCLUSIONS Chronic HCV infection can affect the liver function of pregnant women, but does not increase the pregnancy or delivery complication risks. HCV RNA(+) is an independent risk factor for neonatal jaundice.
Humans ; Female ; Pregnancy ; Adult ; Pregnancy Complications, Infectious/epidemiology* ; Retrospective Studies ; Pregnancy Outcome ; Infant, Newborn ; Viremia/virology* ; Hepatitis C ; Hepacivirus/physiology* ; Hepatitis C, Chronic/virology* ; Young Adult ; Alanine Transaminase/blood*

Viral infections are one of the main causes of deaths and economic losses around the globe, and effective virus detection methods are essential for epidemic prevention and control. Most existing detection methods have problems such as high false negative/positive rates, slow responses, high costs, and dependence on professional equipment and personnel, which are not conducive to the rapid and accurate detection of viruses. Field effect transistor (FET) biosensors have attracted widespread attention due to their advantages of label-free detection, high sensitivity, fast responses, real-time measurement, low power consumption, and small sizes for portability. This article first briefly describes the basic situation of viruses and the structure and detection principle of FET biosensors. Subsequently, it delves into the research achievements in the application of FET biosensors in the detection of influenza viruses, hepatitis viruses, human immunodeficiency virus, and severe acute respiratory syndrome coronavirus 2. Finally, we make a comprehensive summary and reasonable outlook on the role played by FET biosensors in biomedicine.
Biosensing Techniques/instrumentation* ; Transistors, Electronic ; Humans ; SARS-CoV-2/isolation & purification* ; Viruses/isolation & purification* ; Orthomyxoviridae/isolation & purification* ; Hepatitis Viruses/isolation & purification* ; Virus Diseases/virology* ; HIV/isolation & purification* ; COVID-19/diagnosis*

Hepatitis E is the liver inflammation caused by a hepatitis E virus infection.Immunocompetent patients with acute hepatitis E can spontaneously clear the infection,whereas immunosuppressed patients may not be able to clear the hepatitis E virus infection and develop chronic hepatitis.Most patients with hepatitis E are asymptomatic and present only with mild and persistent liver function abnormalities.This article reports a case of hepatitis E in an immunocompetent adult with elevated aminotransferases as the main manifestation.Hepatic fibrosis was detected by hepatic puncture biopsy.This report aims to remind other physicians to evaluate liver fibrosis when encountering acute hepatitis E,especially in patients with chronic liver disease.
Adult ; Humans ; Acute Disease ; Hepatitis E/complications* ; Liver Cirrhosis/etiology*

BACKGROUND

The World Health Organization (WHO) estimates that in 2015, approximately 325 million or 4.4% of the global population were living with chronic hepatitis B or hepatitis C infection. In the same year, around 1.34 million died from this disease.

This study aimed to estimate the burden of hepatitis B in the Philippines and to determine the costeffectiveness of possible interventions.

This study utilized the Center for Disease Analysis Foundation’s (CDAF’s) mathematical disease burden model of hepatitis B. Model inputs were collected using literature review, key informant interviews, expert panel interviews, and records review, and were validated through a series of round table discussions with experts.

Results show that in 2017, the prevalence of chronic hepatitis B infection in the Philippines was 9.7%, equivalent to 10 million infected individuals. Although the model projects a decreasing trend in chronic hepatitis B virus (HBV) infections, liver-related mortality and morbidity due to these viruses are expected to rise if the status quo is maintained. Results show that substantial increase in government subsidy for WHO elimination scenarios would be required to achieve cost-effective outcomes.

Hepatitis B remains a huge problem in the Philippines. The HBV modelling exercise reveal that it will be worthwhile and cost-effective to adhere to the WHO elimination targets. A substantial financial investment will be necessary to do so, specifically a significant scale up in the screening, diagnosis, treatment, and monitoring of patients with HBV. While this modelling exercise does not yield burden of disease as accurate as a prevalence survey, experts consulted in the round table discussions agreed with the modelling inputs.

BACKGROUND AND OBJECTIVE

Stigma remains a profound barrier to public health, particularly in managing diseases such as Hepatitis B, which is highly prevalent in hyperendemic regions like the Philippines. The social stigma associated with such health conditions can severely limit access to care and hinder adherence to treatment, exacerbating the overall disease burden. Despite the critical impact of stigma on health outcomes, there is a notable gap in the systematic evaluation of the tools used to measure stigma related to health conditions like Hepatitis B. This study aims to fill this gap by reviewing existing instruments for their methodologies, reliability, and validity to inform the development of a refined tool tailored to the Philippine context.

A systematic search was conducted across six databases, including PubMed, Cochrane Database of Systematic Reviews, Open Grey, DissOnline, Philippine Health Research Registry (PHRR), and Health Research and Development Information Network (HERDIN), following PRISMA guidelines. The search strategy focused on identifying quantitative and mixed-methods studies using questionnaires to measure HBV-related stigma and discrimination. Studies published between January 1, 1992, and December 31, 2023, were considered. The selection process involved screening for duplicates, reviewing titles and abstracts, and performing a full-text review based on predetermined eligibility criteria.

The initial search yielded 1,198 articles, with 24 duplicates removed. After title and abstract screening, 28 articles were considered for full-text review, resulting in 17 relevant articles in the final analysis with 15 unique instrumentations. The majority of studies employed cross-sectional designs (n=8), with a significant concentration in Asian countries (n=11), indicating a regional focus in HBV stigma research. The review identified a range of questionnaire methodologies, but most studies lacked specificity regarding the type of stigma measured. The Likert Scale was the most commonly used measurement tool, yet few studies provided cut-off values for stigma levels. Validity and reliability testing was reported in 12 articles, including pilot studies, Cronbach’s alpha, and factor analysis.

The lack of a universal methodology and specificity in existing instruments underscores the importance of developing a refined tool that can accurately capture the nuances of stigma and discrimination associated with HBV. The urgent need for standardized, reliable, and culturally sensitive questionnaires is evident, underscoring their importance in developing effective public health strategies and improving treatment outcomes for individuals living with HBV, especially in the Philippines.

BACKGROUND AND OBJECTIVES

Municipal solid waste workers (MSWWs) are important in the city’s waste management. With these vital contributions, they face unique occupational hazards and health risks. This study aims to determine the prevalence of occupational infections, such as soil-transmitted helminth infections (STHI) and hepatitis A virus (HAV), as well as the occurrence of Helicobacter pylori infection among the MSWWs of Baguio City.

This cross-sectional analytic study collected data from volunteer MSWWs using a questionnaire to gather information on age, duration of employment, use of gloves in the workplace, and hand hygiene practices. Stool samples were obtained from participants and were analyzed for STHI using the Formalin Ether Concentration Technique (FECT). H. pylori infection was detected using the SD Bioline rapid antigen test kit on stool samples while blood samples were collected and tested for HAV antibodies using the Aria IgG/IgM rapid test kit.

Of the 44 volunteer MSWWs tested, 25 were infected with hazardous pathogens. Specifically, six workers (13.6%) were infected with STHI, four (9.1%) were infected with HAV and 15 (34.1%) were infected with H. pylori. Among those infected with STHI, Ascaris lumbricoides and Endolimax nana were the predominant species, each with a prevalence rate of 33.3%. In contrast, Blastocystis hominis and hookworm infections each had a prevalence rate of 16.7%. A significant association was found between STHI prevalence and the preference for alcohol hand rubs over hand washing, with a p-value of 0.008.

The analysis revealed a significant association between the prevalence of STHI and the preference for alcohol hand rubs over hand washing, suggesting that MSWWs may have a false sense of security regarding their hygiene practices. The findings revealed the critical importance of proper hand washing in preventing STHI. Future research should expand data collection to encompass a broader range of socio-demographic, environmental, and lifestyle factors that may influence infection rates. Additionally, including a control group of individuals not exposed to waste management could help differentiate between factors specific to waste handling and those related to other occupations. This study emphasizes the need for collaborative efforts among researchers, public health authorities, and waste management agencies to enhance the health and safety of MSWWs while addressing broader public health concerns related to waste management practices.

Correctional facilities are a major hub of hepatitis C virus (HCV), with rates far higher than those observed in the general population. Once considered an intractable crisis, the current situation offers a unique opportunity. The advent of direct-acting antivirals has changed the HCV treatment landscape, making its elimination possible. This review summarises the scientific evidence and progress towards HCV elimination in correctional health systems. It outlines the evolution of 'test-and-treat' models, assesses micro-elimination success worldwide, especially in Singapore, and highlights collaborative efforts between Changi General Hospital and Singapore Prison Services. Their implementation of HCV treatment guidelines serves as a key case study in this context. This review also analyses the various barriers - structural, financial, clinical and logistical - that hinder progress. It consolidates strong evidence that prison-based HCV treatment is cost-effective, promotes health equity, supports the World Health Organization 2030 goals and reduces the societal burden of HCV.
Humans ; Singapore ; Antiviral Agents/therapeutic use* ; Hepatitis C, Chronic/epidemiology* ; Prisons ; Prisoners ; Disease Eradication ; Cost-Benefit Analysis ; Hepacivirus ; Correctional Facilities