Term
| Number of people living with HBV globally? |
|
Definition
| 350 million. 3 million are coinfected with HIV |
|
|
Term
| Number of people coinfected with HCV and HIV? |
|
Definition
|
|
Term
| % of PLWHIV with chronic HBV infection? |
|
Definition
| 5% in the west. 20% in endemic regions in SSA and SEA. 15% are superinfected with hepatitis D virus |
|
|
Term
| Changes observed in the natural history of HBV in PLWHIV? |
|
Definition
| Increase HBV DNA, HBeAg seropositivity, increase in HBV polymerase activity |
|
|
Term
| How is chronic hepatitis defined? |
|
Definition
| The persistence of HBsAg for more than 6 months |
|
|
Term
| How are the genotypes for HBV classified? |
|
Definition
| There are 8 different genotypes, from A-H. The variation in their genome is of a minimum of 8%. Genotypes B and C are found in SEA and are associated with increased risk of HCC |
|
|
Term
| Name some of the risk factors that have been postulated for the increased prevalence of HCV among MSM since 2000? |
|
Definition
| High risk sexual practices, ulcerative STI (e.g. syphilis), number of sexual partners |
|
|
Term
| % of PLWHA who will have chronic HCV? |
|
Definition
| 80%. In HIV -, 30% of people HCV + will clear the HCV spontaneously in the first 12 wks. |
|
|
Term
| How are tx outcomes for HCV-HIV coinfected px? |
|
Definition
| Less response to HCV tx in HIV infected, although response to tx is improved if tx in the acute phase vs chronic |
|
|
Term
| Changes in HCV natural hx in px coinfected with HIV? |
|
Definition
| Increase risk of chronicity, faster progression to fibrosis. |
|
|
Term
| What is the prevalence of multiple hepatitis in PLWHIV? |
|
Definition
| 5% in developed countries, higher in developing. Replication of one hepatitis virus is usually favored over the others, and is usually HCV the predominant. Progression of liver disease is further accelerated in HCV/HBV coinfected. Mortality is increasaed |
|
|
Term
|
Definition
| Most F cause of HCC. 170 million globally infected. An increase in the incidence of HCC was observed during the 60-80's associated to IDU. Conversion to HCC or end stge liver disease is 1.9/1000py in IDU |
|
|
Term
| Risk factors for HCV and HCC |
|
Definition
| >18 yrs, male, genotype, obese, alcohol consumption |
|
|
Term
| Natural hx of HCV infection? |
|
Definition
| HCV infection 100% > 90% develop chronic infection > 15% cirrhosis > 1-3% HCC |
|
|
Term
| What is social epidemiology? |
|
Definition
| study of the distribution of health outcomes and their social determinants. it builds in the classic epidemiological triangle of host, agent and environment to focus explicitly on the role of social determinants |
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