Background & Aims: Increased morbidity and mortality from liver disease have been reported in chronic hepatitis B surface antigen (HBsAg) carriers, but data on survival are equivocal. To assess the impact of hepatitis B virus (HBV) infection on survival and liver-related complications, we re-evaluated, after a mean follow-up of 30 years, a cohort of 296 blood donors excluded from donation 30 years ago when HBsAg screening became mandatory.
Methods: Clinical and ultrasound examination and biochemical and virologic tests were performed. The cause of death was recorded and survival was compared with a control population of 157 HBV-negative blood donors selected at baseline.
Results: Thirty-two (10.8%) cases and 14 controls (8.9%) ( P = 0.625) had died; 3 of 32 (9.3%) and 1 of 14 (7.1%) deaths were liver-related. Hepatocellular carcinoma (HCC) caused death in 2 of 296 and 1 of 157 subjects (0.6% in each group). Alcohol-induced cirrhosis occured in the remaining subject. By Cox regression analysis, survival was independently predicted by older age, abnormal gamma-glutamyl transpeptidase (GGT) levels, and presence of medical comorbidities at baseline. Unequivocal liver disease was found in 4 carriers only. No disease decompensation occurred during follow-up. Fifty-nine (32.2%) carriers cleared HBsAg (yearly incidence, 1.0%). Full-length serum HBV DNA was present in 32.2% of persistently HBsAg-positive individuals (average titer always <10 5 copies/mL).
Conclusions: Over a 30-year period, chronic HBV carrier blood donors from Northern Italy did not develop clinically significant liver disease, hepatocellular cancer, or other liver-related morbidity or mortality at a higher rate than uninfected controls. The presence of medical comorbidities, older age at diagnosis, and abnormal GGT levels were independent predictors of death among chronic HBV carriers.
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http://dx.doi.org/10.1053/j.gastro.2004.06.021 | DOI Listing |
Int J Med Inform
January 2025
School of Geography and the Environment, University of Oxford, South Parks Road, Oxford OX1 3QY, United Kingdom. Electronic address:
Background: Coronavirus Disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, emerged as a global health crisis in 2019, resulting in widespread morbidity and mortality. A persistent challenge during the pandemic has been the accuracy of reported epidemic data, particularly in underdeveloped regions with limited access to COVID-19 test kits and healthcare infrastructure. In the post-COVID era, this issue remains crucial.
View Article and Find Full Text PDFWest Afr J Med
September 2024
Department of Paediatrics, Federal Teaching Hospital, Ido-Ekiti. Email: Tel: +2348035741951.
Background: The vital statistics in the third world countries are poor and have witnessed minimal improvement over the years with childhood mortality in Nigeria remaining one of the highest among the developing countries despite various child survival programmes. Child survival strategies can only be efficient if the major reasons for morbidity are known. The objective of this retrospective study was to review the patterns of childhood mortality at the emergency room of the Federal Teaching Hospital, Ido-Ekiti (FETHI).
View Article and Find Full Text PDFPort J Card Thorac Vasc Surg
January 2025
Division of Cardiovascular Surgery, Temple University Hospital, Philadelphia, Pennsylvania. USA.
Infective endocarditis carries a high risk of morbidity and mortality with recurrent infections and non-compliance. In the case of right-sided endocarditis, the indications for intervention are less clear. The Angiovac procedure provides a treatment for right-sided endocarditis that is a less-invasive and ideal for a complicated patient population.
View Article and Find Full Text PDFPort J Card Thorac Vasc Surg
January 2025
Department of Cardiothoracic and Vascular Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Introduction: Arteriovenous (AV) fistula creation is the most common surgical procedure for providing vascular access for haemodialysis in patients with chronic kidney disease (CKD). The functioning of fistula dictates the quality of dialysis and the longevity of patients. The most common circumstances that require surgical takedown of AV fistula are thrombosis and rupture.
View Article and Find Full Text PDFJ Infect Dev Ctries
December 2024
Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Introduction: Since the dawn of the new millennium, Candida species have been increasingly implicated as a cause of both healthcare-associated as well as opportunistic yeast infections, due to the widespread use of indwelling medical devices, total parenteral nutrition, systemic corticosteroids, cytotoxic chemotherapy, and broad-spectrum antibiotics. Candida tropicalis is a pathogenic Candida species associated with considerable morbidity, mortality, and drug resistance issues on a global scale.
Methodology: We report a case of a 43-year-old man who was admitted to our hospital for further management of severe coronavirus disease 2019 (COVID-19) pneumonia.
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