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Epidemiology of hepatitis C in the middle east
Fallahian Farahnaz,Najafi Atabak
Saudi Journal of Kidney Diseases and Transplantation , 2011,
Abstract: The epidemiology of hepatitis C virus (HCV) infection is not well defined in the Middle East region. A review of the epidemiology and modes of transmission and spread of HCV infection in regions located in the Middle East, including Iran, Bahrain, Iraq, Oman, Qatar, Jordan, Kuwait, Saudi Arabia, United Arab Emirates, Cyprus, Sudan, Egypt, Pakistan, Syria, Turkey, Lebanon, Gaza Strip and West Bank, and Yemen, was undertaken. Public health strategies, well-programmed, population-based and certain HCV infection at-risk surveys, and transmission risk factors′ settings detection are insufficient in some countries of this region. Since significant diffe-rences in prevalence and epidemiology of HCV exist among the Middle East countries or even inside the countries, control strategies should take these differences into account.
Comparison of Seroepidemiology and Transmission Modes of Viral Hepatitis C in Iran and Pakistan
Seyed Moayed Alavian,Farahnaz Fallahian
Hepatitis Monthly , 2008,
Abstract: Hepatitis C virus (HCV) infection is a worldwide problem in health. The seroprevalence of HCV infection is estimated to be 3%. There is considerable geographic and temporal variation in the incidence and prevalence of HCV infection. The researchers conducted the literature search using the electronic database MEDLINE (1966 to January 2008), EMBASE (1980 to October 2007), OVID (1966 to October 2007) and Google (for local websites and medical journals). The following were used: 'Hepatitis C', 'Epidemiology', 'Iran', and 'Pakistan'. HCV infection in Pakistan is more common than in Iran. The most common modes of transmission in Pakistan consist of: IVDs, unsafe injections, transfusion, tattooing and sharing by barbers and in Iran consists of: IVDs, getting wounded in war, extramarital sexual contact and tattooing. The hepatitis C infection is an emerging disease in both countries and requires more governmental support. This article reviews the literature available so far on the epidemiology and potential risks of transmission of HCV and makes recommendations for implementing strategies for the prevention of such transmission in our region.
Impact of immunosuppression and chemotherapy on reactivation of Viral hepatitis
Fallahian Farahnaz,Alavian Seyed-Moayed,Fallahian Vida,Zamani Farhad
Saudi Journal of Kidney Diseases and Transplantation , 2010,
Abstract: Chemotherapy drugs, biological medications that are used to treat cancer, may cause hepatic side effects. Patients with pre-existing viral hepatitis may be more susceptible to exacer-bation of their underlying liver disease, and risk of drug-induced hepatotoxicity. We conducted a search on immunosuppression, and its impact on reactivation of viral hepatitis, using the electro-nic medical databases. Before starting chemotherapy, it is recommended to record the past history of liver disease and check for hepatitis B virus (HBV) and hepatitis C virus (HCV) serology. In immunosuppressed patients, radiation toxicity, graft versus host disease, hepatic veno-occlusive disease, acalculous cholecystitis, tumor infiltration, ischemia, other viruses such as CMV and her-pes virus, and systemic infection should also be considered. Transplant recipients with serologic evidence of previous infection with hepatitis B or C, or those who receive organs from a seropo-sitive donor, should have viral load levels monitored before and after transplantation and, may also require treatment. We believe that there is a role for prophylactic use of antiviral treatment in patients at risk for HBV reactivation.
Implementing strategies for hepatitis B vaccination
Alavian Seyed,Fallahian Farahnaz,Lankarani Kamran
Saudi Journal of Kidney Diseases and Transplantation , 2010,
Abstract: This study reviewed the effects of hepatitis B virus (HBV) vaccination programs on disease control and the need, if any, to introduce additional strategies taking into account the various risk factors of transmission. We performed a search conducted on vaccine administration, hepatitis B risk factors and the impact of HBV vaccination on prevention of disease, using the electronic database MEDLINE (1987 to 2008), EMBASE, OVID, Google (for Local websites and medical journals), Websites of Iranian universities and Iran medex in English and Persian language. We recommend in addition, to routinely practice the Extended Program of Immunization (EPI) schedules for infants as well as implementing HBV vaccination in selected adolescents at risk for HBV infection. Routine screening and immunization is mandatory in the following people: preg-nant women and adults at risk for HBV infection including health-care workers, police, fire fighters, barbers, people with certain risk behaviors such as inmates of correctional facilities, injection-drug users and persons at risk for sexual transmission, as well as patients exposed to blood and blood products and those on chronic hemodialysis. Vaccine providers in areas with high rates of chronic HBV infection should assess infection screening by performing serologic tests in sus-ceptible subjects to identify persons who require counseling and management. Also, additional studies are needed to determine the effectiveness of currently employed immunization strategies.
Seroepidemiologic Study of Hepatitis B Virus, Hepatitis C Virus, Human Immunodeficiency Virus and Syphilis Infections in Iranian Blood Donors
Hossein Khedmat,Farahnaz Fallahian,Hassan Abolghasemi,Seyed-Moayed Alavian
Pakistan Journal of Biological Sciences , 2007,
Abstract: To determine the frequency of hepatitis B, hepatitis C, Human Immunodeficiency Virus (HIV) and syphilis infections in Iranian blood donors. The prevalence of serological markers of hepatitis B, hepatitis C, HIV and syphilis infections were evaluated in 318029 consecutive volunteer blood donors attending to Tehran blood transfusion service from March 2005 to March 2006. Those positive for hepatitis B surface antigen, anti-HCV, anti-HIV1/2 and VDRL (venereal disease research laboratory) reactivity were analyzed with a second independent HBsAg enzyme immunoassay (EIA) and neutralization assay; an additional independent anti-HCV EIA and HCV-RIBA assay; second independent anti-HIV1/2 test, HIV western blot and fluorescent Treponemal Antibody Absorbed (FTA-ABS), respectively. In 318029 participants, prevalence of positive HBsAg, HCV RNA, HIV western blot and FTA-ABS was 1684 (0.487%), 323 (0.093%), 11 (0.003%) and 19 (0.005%), respectively. In 1014 subjects randomly selected from these 318029 participants, besides standard interview, physical exam and routine serologic tests; anthropometric and biochemical were studies. In this selected group frequency of HBsAg was 3 (0.29, 95% CI: 0-0.64%); frequency of anti-HCV was 21 (2.07%), but it was (0.09%, 95% CI: 0-0.30%) by confirmatory HCV RNA test; frequency of HIV-Ab1, 2 was 8 (0.78%), but it was 2 (0.19%, 95% CI: 0-0.48%) by confirmatory test; frequency of RPR was 0 (0%, 95% CI: 0-0.30%). Despite excluding subjects with high-risk behaviors by standard interview and physical examination, still a few asymptomatic hepatitis B, hepatitis C, HIV-infected subjects existed among volunteer blood donors with demographic and biochemical findings similar to non-infected ones.
Comparison of Seroepidemiology and Transmission Modes of Viral Hepatitis B in Iran and Pakistan
Seyed-Moayed Alavian,Farahnaz Fallahian,Kamaran Bagheri Lankarani
Hepatitis Monthly , 2007,
Abstract: Hepatitis B virus (HBV) infection is endemic in the Middle East region and is associated with significant morbidity and mortality. Strict strategies are needed for prevention, diagnosis and management of HBV infection. Reviewing literature about seroepidemilogy and modes of infection transmission in Iran and Pakistan performed. Iran is in low endemicity and Pakistan in intermediate endemicity of HBV infection, now. Therapeutic injections, vertical transmission, transfusion, cultural and special traditions like ear, nose piercing, and high risk groups are important risk factors in Pakistan. Prevalence of HBV infection is still significant in children. High risk behaviors, including injection drug use (IDU) and sexual contact are main routes of HBV transmission in Iran. Intensifying vaccination of high risk groups and control on interfamily transmission in both countries is necessary. Effective coverage of HBV vaccination, has more control on therapeutic injections, screening pregnant women for HBV infection, and follow-up of babies of the HBsAg positive mothers in Pakistan is recommended. Regional collaboration of the two countries may overcome the spread of infection by promoting universal vaccination in all provinces of Pakistan, screening of hepatitis B, education, and surveillance in high risk groups of Iran. To implicate effective vaccination by regional and international health units, and addiction control in neighboring countries is necessary.
Immune response to hepatitis B vaccine in health-care workers
Zamani Farhad,Fallahian Farahnaz,Hashemi Forough,Shamsaei Zeinab
Saudi Journal of Kidney Diseases and Transplantation , 2011,
Abstract: This study was performed to study the immune response to hepatitis B virus (HBV) vaccine in health-care workers. Through a cross-sectional study, relevant information and blood samples from 151 healthcare workers at the Firuzgar hospital were studied. The age range of the study individuals was 20-59 years, with the mean and standard deviation being 35.11 and 10.06, respectively. There were 24 males (15.9%) and 127 females (84.1%). The mean and median of months after HBV vaccination was 63.42 and 49.00, respectively. The mean and median of anti-HBs titer in those who received HBV vaccination was 164.81 and 200 milli international units per milliliter (mIU/mL), respectively. Of the 129 HBV-vaccinated subjects, 103 (68.2%) had anti-HBs titer >10 and 26 (17.2%) had anti-HBs titer <10. There was no association between gender and anti-HBs titer, but vaccination and adequate completion of its courses were associated with higher anti-HBs titer (P < 0.05). Also, the logistic regression method showed that the association between duration after vaccination and age with anti-HBs titer was not statistically significant. Our study suggests that the HBV vaccine immunization program had obtained excellent efficacy. There is need for further investigation among subjects who are not vaccinated against HBV but are positive for anti-HBs as well as in HBV-vaccinated subjects with low anti-HBs titers, about possible low-level viremia and other causes of lower vaccine efficacy, particularly in health-care workers.
Epidemiology and transmission of hepatitis G virus infection in dialysis patients
Fallahian Farahnaz,Alavian Seyed-Moayed,Rasoulinejad Mehrnaz
Saudi Journal of Kidney Diseases and Transplantation , 2010,
Abstract: Hepatitis G virus (HGV) or GB-virus type C (GBV-C) is distributed globally and is present in the volunteer blood donor population. For epidemiological studies, HGV is of interest in hemodialysis patients who are at risk of parenterally transmitted infections. The role of HGV in producing illness and hepatic disease has yet to be determined. A review of literature was performed in 2009 to summarize scientific reports on epidemiology and pathogenesis of the HGV infection and its exposure through hemodialysis.
E-Selectin Gene Polymorphisms in Iranian Chronic Hepatitis B Patients
Mehrdad Hajilooi,Amir-Houshang Mohammad Alizade,Mitra Ranjbar,Farahnaz Fallahian
Hepatitis Monthly , 2007,
Abstract: Background and Aims: The aim of this study is to detect the substitutions Ser128Arg (A128C) and Leu554Phe (T554C) which responsible for E-selectin polymorphisms in patients with chronic hepatitis B and healthy controls. We investigated association of the Ser128Arg, Leu554Phe gene polymorphisms in the E-selectin gene as prototypical inflammatory molecules for susceptibility to chronic hepatitis B.Methods: Sixty-three patients with chronic hepatitis B virus infection and 150 healthy subjects were recruited sequentially as they presented to clinic. Genomic DNA was isolated from anti-coagulated peripheral blood Buffy coat using Miller's salting-out method. The presence of the E-selectin gene polymorphisms was determined by using polymerase chain reaction amplification refractory mutation system (ARMS).Results: Distribution of E-selectin 128 (A+C-, A+C+, A-C+) genotypes and E-selectin genotype 554 (C+T-, T+C-, C+T+) genotypes were not statistically significant different in chronic hepatitis B patients and controls by Chi-square test (P=0.41 & 0.96, respectively). Also, Two groups had not statistically significant difference in distribution of frequencies of allele 128 A by Chi-square test (P=0.41), 128 C (P=0.15), allele 554 C (P=0.85), and allele 554 T (P=0.76). Carrying allele 128 A (OR=0.587, 95% CI=0.162-2.124), 128 C (OR=1.526, 95% CI=0.849-2.745), 554 C (OR=1.245, 95% CI=0.128-12.089), and allele 554 T (OR=0.880, 95% CI=0.384-2.014) were not risk factors for susceptibility to chronic hepatitis B infection.Conclusions: Carrying E-selectin gene polymorphisms of Ser128Arg and Leu554Phe are not risk factors for susceptibility to chronic hepatitis B.
Hudson Bay Climate Change and Local Winter Wind Circulation  [PDF]
Farahnaz Fazel-Rastgar
American Journal of Climate Change (AJCC) , 2019, DOI: 10.4236/ajcc.2019.84029
Abstract: The meteorological mechanisms causing the recent increase in winter wind speed on Hudson Bay are investigated by examining the NARR dataset (The North American Regional Reanalysis Model) for the past several decades. Winter seasonal changes for atmospheric variables are examined and their interconnections are studied. Yearly mean near-surface temperatures are analyzed from 1948 to denote a rapid warming over Hudson Bay from late 1998 onwards. The surface albedo, air temperatures, mean sea level pressure and wind vector anomalies from 1998 to 2015 have also been studied. The comparison of the 1000 hPa wind vector mean and departures from 1981-2010 (normal period) averages have shown an intensification of anti-cyclonic anomaly pattern over most parts of Hudson Bay. The structure of the wind vector anomalies has revealed a contrast between cyclonic and anti-cyclonic local wind circulations mostly in the east, north and north-west regions along with wind speed increasing at 10 m, increases in near-surface air temperature and decreasing of the surface albedo. The anomalies of the wind vector analysing at different pressure levels show the change in wind direction mostly from northwesterly (zonal wind weakening) to south and easterlies. The polar jet wind vectors at 200 mb during anomaly time (1998-2015) have revealed the changes in magnitude and position. During winter anomaly time, the polar jet at 200 mb has been shifted mostly from rather mean colder north westerly currents to the rather warmer south and easterly anomaly currents over Hudson Bay areas. The yearly historical total accumulated Hudson Bay ice coverage during 1980-2015, using Canadian Ice Service data has shown a slight reduction in the north, north-west and eastern Hudson Bay. The linear regressions of the winter temperature anomaly at 2 m against albedo anomaly, alongside the wind speed anomaly at 10 m against air temperature at 2 m, have shown a relationship between these variables. Also, there is a statistically meaningful relation between decreased albedo and increased evaporation.
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