Overview of the microbiota in the gut-liver axis in viral B and C hepatitis

Viral B and C hepatitis are a major current health issue,both diseases having a chronic damaging effect on the liver and its functions.Chronic liver disease can lead to even more severe and life-threatening conditions,such as liver cirrhosis and hepatocellular carcinoma.Recent years have uncovered an important interplay between the liver and the gut microbiome:the gut-liver axis.Hepatitis B and C infections often cause alterations in the gut microbiota by lowering the levels of‘protective’gut microorganisms and,by doing so,hinder the microbiota ability to boost the immune response.Treatments aimed at restoring the gut microbiota balance may provide a valuable addition to current practice therapies and may help limit the chronic changes observed in the liver of hepatitis B and C patients.This review aims to summarize the current knowledge on the anatofunctional axis between the gut and liver and to highlight the influence that hepatitis B and C viruses have on the microbiota balance,as well as the influence of treatments aimed at restoring the gut microbiota on infected livers and disease progression.

Viral Hepatitis B and C Detection among Ebola Survivors and Health Care Workers in Makeni, Sierra Leone

Viral hepatitis B and C infections are among the leading cause of death in Sub-Saharan Africa. Lack of knowledge and awareness in the general population as in health care settings may enhance the propagation of these diseases. We aimed at determining the prevalence of HBV and HCV in Ebola survivors and health care workers (HCWs) of the Makeni town in Sierra Leone. We conducted a cross-sectional study during the last 2013-2016 Ebola outbreak in Makeni among Ebola survivors (N = 68) and 81 Health care workers from Holy Spirit hospital and Loreto clinic, two health care facilities in Makeni district. Serological markers of HBV (HBs Ag, anti-HBs Ab and anti-HBc Ab) and anti-HCV antibodies detection were done using ELISA techniques. The positive detection rates for HBs Ag, anti-HBs Ab and anti-HBc antibodies in Ebola survivors were 23.53% (16/68), 32.35% (22/68) and 88.89% (16/18) respectively. Survivors with a current HBV infection had a positive rate of 38.89% (7/18) and 16.66% (3/18) of them were considered immune due to past HBV infection. HCV prevalence was 26.47% (18/68) and about 10.29% (7/68) were HBV/HCV co-infected. The positive detection rates of HBsAg, anti-HBs Ab and anti-HBc Ab were 37.07% (30/81), 33.33% (27/81) and 30.86% (25/81) respectively in health care workers. We observed that 4.94% (4/81) of the HCWs were currently infected with HBV. Participants considered as immune due to past infection represented 23.47% (19/81) and those immune due to vaccination represented 2.47% (2/81). The prevalence of HCV infection among health staff was 2.47% (2/81) with 1.23% (1/81) being HBV/HCV co-infection. Our findings showed that viral hepatitis infection is a burden for Sierra Leone government. There is an urgent need to develop and implement strategies that could improve population immunization against HBV and vulgarization of HCV treatment programs.

Knowledge Attitude and Practice of Viral Hepatitis B and C Screening by General Practitioners in Brazzaville

The involvement of general practitioners in the early detection of viral hepatitis B and C must be paramount. The objectives of this work were to assess GPs’ knowledge, attitude and practice with regard to screening for viral hepatitis B and C. We carried out a cross-sectional analytical study among GPs recruited by simple random sampling from the list of GPs in the city of Brazzaville. The judgement criteria were knowledge and practice of screening for viral hepatitis B and C, assessed according to a Likert scale divided into 3 categories: very good, good and bad. One hundred and twenty-one general practitioners were included, including 48 women and 73 men, with a sex ratio of 1.52;the average age was 33 years;52.89% of them worked in the private sector with an average period of activity of 4 years. The majority of the doctors had a good knowledge (69.42%) and a bad practice (56.20%) of screening for viral hepatitis B and C. The duration of activity was the factor linked to knowledge of viral hepatitis B and C (p = 0.006) while age was the factor linked to the practice of screening for viral hepatitis B and C (p = 0.0366). In conclusion, in Brazzaville, general practitioners’ knowledge of screening for viral hepatitis B and C is good in general, but the practices are poor and require targeted in-service training.

Chronic Viral Hepatitis C: Before and after Direct Acting Antivirals (DAA) in Morocco

For a long time, a combination of interferon and ribavirin has been used to treat viral hepatitis C, but the sustained virological response was only achieved in 45% of cases and side effects were serious [1]. Direct acting antivirals (DAA) have provided a cure for almost everyone with hepatitis C, with few side effects. The Purpose of Our Work is to compare the results of treatment for viral hepatitis C before and after DAA. Patients and Methods: This is a retrospective study, bringing together all patients with chronic viral hepatitis C treated between January 2009 and March 2020 at the University Hospital Hassan II in Fez, Morocco. The epidemiological, clinical, biological, virological characteristics of the included patients were collected from the two groups: A, treated with interferon and ribavirin or by triple therapy and B, treated with DAA. Results: 162 patients were included, the average age was 55 y/o, with 90 women and 72 men. 88 patients (54.3%) were already cirrhotic, of which 61 were compensated and 27 were decompensated. Genotype 1 was dominant with a frequency of 71.6%, 107 patients (66%) initially treated with old HCV treatments and 55 (34%) treated with DAA. Sustained viral response was obtained in 59 cases (55.14%) in group A versus 54 cases (98.18%) in group B with a very significant difference (p < 0.0001). Treatment failure was observed in 14 patients (13.1%) in group A and only one patient, i.e. 2% in group B (p = 0.019). 14 patients relapsed in group A (13.1%) versus 0 patient in group B (p = 0.003). The tolerance of the treatment was excellent in group B as a whole with only five patients (9%) reported side effects which were minor, not leading to the discontinuation of treatment while the side effects were major in 49 patients (45.7%) in group A with led to the permanent discontinuation of treatment in 6 patients. The difference in side effects between the two groups was very significant with (p Conclusion: Our study has shown the superiority of DAA in terms of efficacy and tolerance compared to the old treatments for chronic hepatitis C. In addition, these treatments allow almost systematic viral elimination and therefore consequently a reduction in the risk of complications hepatic with a short time of treatment.

Impact of IL28B gene polymorphisms rs8099917 and rs12980275 on response to pegylated interferon-α/ribavirin therapy in chronic hepatitis C genotype 4 patients

Host genetic factors may predict the outcome and treatment response in hepatitis C virus（HCV）infection.One of these factors is the single nucleotide polymorphisms of the interleukin 28B（IL28B）gene.We sought to evaluate the outcome of pegylated interferon and ribavirin therapy in association with IL-28B rs8099917 and rsl2980275 in patients infected with HCV genotype 4.A total of 180 patients with chronic hepatitis C were selected from Egyptians who have received combined therapy with pegylated interferon and ribavirin for 6 months and their response was evaluated after follow-up at 0,6,12,24 and 48 weeks from the beginning of the therapy.Blood samples were collected from responders and non-responders.Genomic DNA was extracted from whole blood and genotyping was carried out by polymerase chain reaction and restriction fragment length polymorphism（PCR-RFLP）.Our results showed that TT genotype of rs8099917 was associated with higher sustained viral response（SVR）rates and G allele represented a risk factor for failure of response（OR=3.7,CI=1.8：7.64）while rs12980275 was not significantly associated with SVR in genotype 4 Egyptian patients.The determination of 1L-28B SNPs may be useful in enhancing correct prediction of SVR achievement in treating this group of genotype 4 patients.

Current treatment for hepatitis C virus/human immunodeficiency virus coinfection in adults

Hepatitis C virus(HCV)/human immunodeficiency virus(HIV)coinfection is a major problem among HIV-infected patients,resulting in increased morbidity and mortality rates due to the acceleration of liver fibrosis progression by HIV,leading to liver cirrhosis and hepatocellular carcinoma.Although the efficacy of directacting antiviral therapy in patients with HIV/HCV coinfection and HCV monoinfection are similar in terms of sustained virologic response rate,there are some additional complications that arise in the treatment of patients with HIV/HCV coinfection,including drug-drug interactions and HCV reinfection due to the high risk behavior of these patients.This review will summarize the current management of HIV/HCV coinfection.

Post Hepatitis C Cirrhosis in Sub-Sahara Kidney Transplant, Treated with Sofosbuvir/Ledipasvir: Report of Case and Review of Literature

Background: Viral hepatitis C is a major public health problem in the world. The advent of direct-acting antivirals has revolutionized the taking in charge and prognosis of patients infected with the hepatitis C virus. The interest of this presentation is to draw attention to the problem of therapeutic care posed by viral hepatitis C in kidney transplant patients in C?te d’Ivoire, a country with limited resources where all direct-acting antivirals are not yet available. Patient observation: We report the case of a kidney transplant of 52 years old, chronic bearer of viral hepatitis C virus who after his kidney transplant presented, decompensated active cirrhosis. A treatment based on Sofosbuvir 400 mg/Ledipasvir 90 mg in this patient with genotype 2 for 12 weeks was initiated. A sustained virological response was observed 12 weeks after the end of treatment. Conclusion: Direct-acting antivirals offer the possibility of antiviral C treatment without interferon or ribavirin in cirrhotic renal transplant.