International Journal of Preventive Medicine (Int J Prev Med)2008-7802002015062317992EN20150623Chronic hepatitis C virus&nbsp; (HCV) infection, that affects 3% of world&rsquo;s population, is associated with several hematological manifestations mainly benign cytopenias, coagulopathy and lymphoproliferative diseases. Immune or non‑immune‑mediated thrombocytopenia is a major challenge in chronic HCV infected patients especially in the setting of an advanced liver disease, with average prevalence of nearly 24%. Although several treatment modalities such as steroids, intravenous immunoglobulin, splenectomy and immunosuppresants have been tried with some success, their efficacy is not impressive and can result in an increase in viral load or other thrombotic complications. Even though a recent phase 2 study has shown promising role of a platelet growth factor, eltrombopag, in boosting platelets counts prior to antiviral treatment, its use in pre‑operative setting had unexpected complications. Unlike thrombocytopenia, anemia and neutropenia are more frequently seen in treated patients and are often the result of antiviral therapy. HCV infection also pre‑disposes to lymphoproliferative diseases, mainly non‑Hodking&rsquo;s lymphomas, likely as a result of chronic antigenic stimulation and mutation of several genes involved in carcinogenesis. Understanding of the role of HCV infection in these conditions has therapeutic implications. Whereas antiviral therapy has shown therapeutic role in HCV‑associated indolent lymphomas, monitoring of hepatic function and viral load is important in the management of diffuse large B‑cell lymphoma in HCV‑infected patients. Although our knowledge about the HCV infection and hematological manifestations has substantially grown in last few decades, further studies are important to advance our therapeutic approach.<br /><strong>Keywords:</strong> Anemia, bone marrow abnormality, hepatitis C virus, lymphoproliferative disorders, neutropenia, thrombocytopeniahttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1547http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1547/1836

International Journal of Preventive Medicine (Int J Prev Med)2008-780200201506231939EN20150623Hepatitis B virus&nbsp; (HBV) is a serious global health problem. It is estimated that 1.5&ndash;2.5 million people are suffering from this infection in Iran. A&nbsp; review on HBV infection prevalence in Isfahan, Iran is conducted in this article. It will help researchers for further studies and also will be helpful for control the infection. Medline, Embase, Ovid, Google Scholar, Scientific Information Database, Iranmedex, Magiran and Scientific Journal of Iran Blood Transfusion Organization and also students&rsquo; thesis and projects of Isfahan and Kashan universities of medical sciences were searched for key words &ldquo;HBV,&rdquo; &ldquo;HBsAg,&rdquo; &ldquo;prevalence,&rdquo; &ldquo;Isfahan,&rdquo; &ldquo;Esfahan,&rdquo; and &ldquo;Kashan in titles and/or abstracts. Overall, 24 articles, including 4, 14, 5 and 1 were assessed in Isfahan province, and Isfahan, Kashan, and Foulad‑shahr cities, respectively. The highest and lowest participants were 542705 and 73, respectively. The highest prevalence of HBsAg was reported in HIV‑infected patients and the lowest one was seen in the thalassemic patients. We collected the articles about the prevalence of HBV in Isfahan to help researchers and determine prevalence HBV in Isfahan province. The similar studies in other province of Iran are necessary for marking decision.<br /><strong>Keywords:</strong> Prevalence, epidemiology, hepatitis B virus, Isfahan, Kashanhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1540http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1540/1829

International Journal of Preventive Medicine (Int J Prev Med)2008-780200201506232007EN20150623Chronic hepatitis B virus&nbsp; (HBV) infection affects an estimated 370 million people worldwide. HBV is endemic throughout the world, and insidiously causes liver damage over years and decades without any warning symptoms or signs. Up to 25&ndash;35% of infected individuals eventually die due to complications of liver cirrhosis and hepatocellular carcinoma&nbsp; (HCC) induced by HBV. Screening those individuals at risk of acquiring hepatitis B, and universal vaccination for prevention, would help in limiting the spread and public health repercussions of the virus. Although many new antiviral therapies have been developed for the management of hepatitis B, they still do not offer the possibility of cure. Most individuals who begin oral suppressive therapy will be indefinitely treated. Continuous suppression of HBV replication in individuals with advanced liver disease prolongs life, decreases the need for liver transplantation, and potentially reduces the risk for HCC. In this clinical review, we present a practical approach to prevention of HBV, its natural history and life cycle, as well as its management.<br /><strong>Keywords:</strong> Antiviral treatment, diagnosis, hepatitis B, preventionhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1544http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1544/1833

International Journal of Preventive Medicine (Int J Prev Med)2008-7802002015062320812EN20150623<strong>Background:</strong> Students of medicine are prone to contact with various infectious agents such as hepatitis A virus&nbsp; (HAV). Infection with HAV may lead to morbidity and in rare cases, mortality. We evaluated the seroprevalence of HAV among 1st‑year medical students to assess the necessity of vaccination/preventive immunoglobulin in this at‑risk population.<br /><strong>Methods: </strong>This cross‑sectional study was carried out in 2007 among 403&nbsp; 1st‑year medical students in Isfahan, Iran. Participants filled out a questionnaire including items on demographic characteristics, medical history, and hygiene. Then, the anti‑HAV IgG antibody was assessed using the ELISA method&nbsp; (Diagnostic Bioprobes, Dia‑Pro, Milan, Italy).<br /><strong>Results:</strong> Among the 403 students invited to attend the study, 361 ones&nbsp; (89.5%) agreed to participate&nbsp; (61.1% female), with a mean age of 19.8&nbsp; &plusmn; &nbsp; 2.6&nbsp; years. Of the participants, 272&nbsp; (75.3%) students were seropositive. Seropositivity was not associated with gender&nbsp; (P&nbsp; = 0.222), but was associated with the number of family members&nbsp; (P&nbsp; &lt; 0.001), residence place&nbsp; (P&nbsp; = 0.003), age&nbsp; (P&nbsp; &lt; 0.001), and the type of drinking water&nbsp; (P&nbsp; = 0.008).<br /><strong>Conclusions:</strong> One of the four medical college students of our society is prone to hepatitis A infection. Accordingly, vaccination/preventive immunoglobulin is suggested for this population; however, whether a prior serological screening is cost‑effective needs further evaluation by epidemiologic data from our society.<br /><strong>Keywords:</strong> Epidemiology, health occupations students, Hepatitis A, Iran, prevention, vaccinationhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1543http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1543/1832

International Journal of Preventive Medicine (Int J Prev Med)2008-780200201506232138EN20150623<strong>Background:</strong> Vertical transmission of hepatitis B virus&nbsp; (HBV) from infected mothers to their neonates is one of the most important routes of infection. The exact prevalence rate of HBV in Iranian pregnant mothers is not well known but based on different studies it is estimated between 0.35% and 6.5%. The aim of this study was to determine the seroprevalence of hepatitis B surface antigen&nbsp; (HBsAg) in pregnant women of selected provinces in Iran.<br /><strong>Methods:</strong> At this cross‑sectional study, seven provinces supposed to be of high and low prevalence of hepatitis B in the general population selected. Multistage sampling was used to enroll 5261 parturient women who attended the target provinces birth facilities, during January to March of 2011, were recruited to study. To determine the statistically significant mean and proportion differences, t‑test and c2 test were used, respectively.<br /><strong>Results:</strong> Overall 1.2% was positive HBsAg of which 11% of them were hepatitis B e‑antigen positive as well. The eastern and north eastern provinces were considerably higher in HBsAg seropositivity than the west and northwest of the country.<br /><strong>Conclusions:</strong> In view of the considerable prevalence of hepatitis B in pregnant women, screening all pregnant women prioritizing the eastern and north‑eastern provinces is strongly recommended.<br /><strong>Keywords:</strong> Hepatitis B, Iran, pregnant women, prevalencehttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1545http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1545/1834

International Journal of Preventive Medicine (Int J Prev Med)2008-7802002015062321922EN20150623<strong>Background:</strong> Hepatitis G virus&nbsp; (HGV) is transmitted mainly by parenteral route and patients on maintenance hemodialysis&nbsp; (HD) are at risk for this infection. This study was conducted to estimate prevalence of infection through the presence of anti‑HGV and to evaluate the clinical significance of HGV envelope protein E2&nbsp; (anti‑E2) in HD patients in compare with volunteer blood donors in Isfahan‑Iran.<br /><strong>Methods:</strong> In a cross‑sectional study, a total of 40 HD patients as cases and 40 healthy volunteer blood donors as negative controls were selected randomly in summer 2008. The epidemiological data were obtained in all subjects, and duration of HD was obtained in HD patients as well. All samples were tested for anti‑E2 antibodies, hepatitis C virus&nbsp; (HCV)‑antibody and hepatitis B virus surface antigen&nbsp; (HBs‑Ag) by an enzyme‑linked immunosorbent assay and a recombinant immunoblot assay was employed to confirm anti‑HCV reactivity. Student&rsquo;s t‑test, Chi‑square test or Fisher exact test was used for data analysis and P&nbsp; &lt; &nbsp; 0.05 was considered as statistically significant.<br /><strong>Results: </strong>Ten of the 40 HD patients tested positive for anti‑E2&nbsp; (25%) and of 40 voluntary blood donors, 10&nbsp; (5%) were positive for anti‑E2&nbsp; (P&nbsp; = 0.012). Anti‑HCV antibodies and HBs‑Ag were found in 4 and 1 HD patients, respectively. In anti‑E2‑positive patients, co‑infection with HCV or hepatitis B virus was not significant. Furthermore, the mean duration of hemodialysis in anti‑E2 positive and anti‑E2 negative patients did not have significant differences.<br /><strong>Conclusions:</strong> HD patients are at increased risk of HGV infection in Isfahan‑Iran. Since hepatitis G is a good predictor for parenteral transmission, it is suggested to test all of the blood for transfusion for HGV infection.<br /><strong>Keywords:</strong> Hepatitis G, hemodialysis, Isfahanhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1546http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1546/1835

International Journal of Preventive Medicine (Int J Prev Med)2008-7802002015062322330EN20150623<strong>Background:</strong> About 2&nbsp; billion people were reported to be infected with hepatitis B virus&nbsp; (HBV) and among them; 350 million are chronically infected cases. This study was performed to determine the prevalence of hepatitis B in Kavar, southern Iran.<br /><strong>Methods:</strong> From August 2008 to March 2009, 3739 individuals aged between 1 and 88&nbsp; years were screened for infection with HBV in Akbar Abad Village, Kavar, Southern Iran. A&nbsp; questionnaire was used to record demographic data, history of vaccination and the correlated risk factors. Ten milliliter of the blood sample was taken from each subject. Sera were checked for hepatitis B surface antigen&nbsp; (HBs Ag) and hepatitis B core antibody&nbsp; (HBC Ab).<br /><strong>Results:</strong> Among subjects, 7.1% were positive for HBC Ab and 2.2% for HBS Ag. Out of positive cases for HBC Ab, 7.3% were female, and 7.6% were male. Out of positive cases for HBS Ag, 2.2% were female, and 2.5% were male. The minimal rates of HBC Ab and HBS Ag were noticed in the age group&nbsp; 1&ndash;15&nbsp; year old. The highest positivity was observed among unemployed individuals. Among subjects with low educational level, 7.5% were positive for HBC Ab and 2.4% for HBS Ag. The highest prevalence was visible in the widow group and the lowest in married persons. Opium addiction had a significant relationship with HBC Ab. The prevalence of HBV seropositivity was higher among drivers, those with a history of dental treatments and family history of liver diseases blood transfusion tattooing recipients.<br /><strong>Conclusions:</strong> Our results showed that screening of pregnant women for HBs Ag and vaccination of high‑risk individuals including family members of patients with hepatitis B should be implemented in future planning.<br /><strong>Keywords:</strong> Hepatitis B core antibody, hepatitis B antigen, hepatitis B virus, Iran, prevalencehttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1541http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1541/1830

International Journal of Preventive Medicine (Int J Prev Med)2008-780200201506232312EN20150623----http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1542http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1542/1831