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HBV contamination of medicine instruments in surgery department
Abstracts: Posters
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novel concept: occult HBV infection in the western region of Turkey
E. Akduman 1 , T. Sanlidag 1 , S. Akcali 1 , E. Ellidokuz 2, A. Celebi Kobak 2. 1Department of Microbiology, Celal Bayar University,
Medical Faculty, Manisa, Turkey, 2Department of Internal Medicine, Gastroenterology Division, Celal Bayar University, Medical Faculty, Manisa, Turkey Background and Aims: Occult hepatitis B is defined by the presence of HBV DNA in serum or liver in the absence of HBsAg. Low serum HBV DNA titers, in the range of 102 to 103copies/mL, are typical in occult HBV infection. The frequency of the diagnosis depends on the sensitivity of HBV DNA assays and the prevalence of HBV infection in population. Occult HBV infection rate ranges between 7% to 13% in the world. No studies have systematically screened HBV seronegative individuals for HBV DNA in our country. For this reason the aim of our study was to find out the prevalence of occult HBV infection in Manisa, Turkey. Methods: The serological markers of hepatitis B virus were examined using microparticle enzyme immunoassay method (Abbott lab., Germany). HBV DNA quantification was tested by real-time PCR assay (ABI Prism 7000; Applied Biosystems, Fosters City, Calif.). HBsAg (-) and HBV DNA (+) patients were evaluated as occult HBV infection. Results: Eight-hundred forty-three of 1778 patients were HBsAg and HBV DNA positive. Fifty-four of 935 HBsAg-negative patients had HBV DNA positivity. Occult HBV infection rate was 5,77%. Distribution of hepatitis B serological markers in patients with occult HBV is shown in table 1. Occult hepatitis B infection by serological patterns Occult HBV infection (n) Anti-HBc (-) Anti-HBs (-)
Anti-HBc (+) Anti-HBs (-)
Anti-HBc (+) Anti-HBs (+)
Anti-HBc (-) Anti-HBs (+)
54
9 (16.66%)
7 (12.96%)
11 (20.37%)
15 (27.77%)
Conclusions: We found that the prevalence rate of occult HBV infection tend to correlate with intermediate prevalence of hepatitis B infection in Turkey. Although the prevalence of occult HBV infection is higher in Anti-HBc positive patients, a significant finding is that Anti-HBc plus Anti-HBs negativity and Anti-HBs positivity are considerably high.
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Where is anti-HCV testing taking place in England?
L.J. Brant 1, M. Hurrelle 2, M.A. Balogun 1, R Klapper 3, M.E. Ramsay 2. On behalf of the Hepatitis Sentinel Surveillance
study group. 1Health Protection Agency Centre For Infections, 61 Colindale Avenue, London, UK, 2Health Protection Agency, Leeds laboratory, Seacroft Hospital, Leeds, UK, 3Manchester Medical Microbiology Partnership, Manchester Royal Infirmary, Manchester, UK In England anti-HCV testing is offered across the health and prison services. However where testing is taking place across these services and which service type most of the infections are identified in has not been previously described. Sentinel surveillance of hepatitis C testing started in January 2002 in eight centres across England with more laboratories contributing since September 2004. Demographic and testing data are extracted electronically from participating laboratory information systems, for people tested for anti-HCV and HCV RNA. Hepatitis A and B results and HCV genotype are also collected where available. Service type of requesting clinician were identified and grouped as GP, GUM clinic, prison, specialist drug services and hospital. In the pilot study (2002-2003), where service type could be fully identified, the highest proportion of positive tests occurred in specialist drug services (283/852, 33%) and prison services (284/1182, 24%), but the total number of tests from these services was low. Overall, 10% of tests were done in GP surgeries (n=5912, 7% positive), 7% in GUM clinics (n =956, 5% positive), and the rest in a hospital setting (n = 24,310, 5% positive). Geographical differences in testing were identified. Most anti-HCV positive people had a risk exposure of injecting drug use.
Full data for the period 2002-2005 are now available. Routine laboratory data, with supplemental questionnaires, has provided for the first time data where people are being tested for anti-HCV and from which environment most positives are identified. Laboratories can use this data to identify where more testing should be done.
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Lower hepatitis C virus infections in seropositive patients between 1999 and 2003
C. Payan 1,2, W. Mansour 1 , A. Pivert 1, V. Narbonne 2, H. Le Guillou-Guillemette 1 , I. Fouchard-Hubert 3, E Lunel 1 . 1Laboratoire
de Bact6riologie-Virologie-Hygiene Hospitaliere, CHU Angers, France, 2D~partement de Microbiologie EA3882, CHU Morvan, Brest, France, 3Service de M6decine A, R6seau 49, CHU Angers, France Background and Aim: Hepatitis C virus (HCV) infection has been estimated in 600,000 subjects in France, with about 80% of chronic infection. Only the use of PCR technology allows the diagnosis of HCV chronic infection. However, PCR is a laborious and cost effective method. We aimed to evaluate HCV chronic infection by using the serology testing. Methods: All new anti-HCV positive screened patients during 1999 and 2003 in Angers university hospital were included. Serum samples were prospectively assessed for anti-HCV antibodies, expressed in signal/cutoff (s/co) ratio, using AxSYM HCV v.3.0 (Abbott) and Vitros HCV (Ortho Clinical Diagnostics), and for HCV RNA, using the HCV Cobas Amplicor 2.0 assay (Roche Diagnostics, France). A third assay (HCV Architect Abbott) was assessed in Brest university hospital. Results: 386 out of 14951 (2.58%) screened patients were found anti-HCV positive (3.21% in 1999 and 2.19% in 2003). Good correlations were found between serological assays (0.89 to 0.97). 174 of them were HCV RNA positive (45.1%) but a decrease of HCV positive patients were significantly observed between 1999 and 2003 (60% and 30% respectively, p < 0.001). An anti-HCV cutoff value at 28, 18, 5 s/co using respectively AxSYM, Vitros and Architect allows the best predictive PCR results with 97-98% sensitivity and 89-93% specificity. Conclusion: We found a large decrease of HCV infected patients among anti-HCV positive patients between 1999 and 2003 that correlates the decrease of anti-HCV levels. Furthermore, high antiHCV levels were predictive of HCV infection in immune-competent, non treated patients.
~ H B V contamination of medicine instruments in surgery department M.M. Attarpour Yazdi, H. Baradaran. University of Shahed,
University of Tehran, Iran Background and Aims: Increase in occurrence of HBV among the medicine staffs and 3% prevalence of this infection in Iran and existence of the HBsAg positive individuals without any special symptom lead to general consideration about transmission of this infection by medicine instruments. Methods: The purpose of this study was evaluation of HBV contamination in surfaces (such as cabinet&door handles, telephones, water valves and electrical buttons) and equipments in the surgery department of the Cina hospital on 2006. Sampling was performed with steril cotton swabs in transport medium (BSAS: Bovine Serum Albumin in Sodium chloride). Samples were tested by PCR technique. Results: As a results, 54.5% (6 out of 11 samples)of surfaces and 37.9%(11 out of 29 samples) of equipments were contaminated before disinfection.27.3%(3 out of 11 contaminated samples)of equipments remained contaminated after disinfections. Discussion: There are high contamination percentage in the surfaces that expresses the necessity of effective and regulatory disinfection procedures in these site. According to the high level of infection in the surfaces and equipments in the surgery department, these approaches to disinfect equipments is not sufficient to omit HBV infection.
I
P
$39
•
A
novel concept: occult HBV infection in the western region of Turkey
E. Akduman 1 , T. Sanlidag 1 , S. Akcali 1 , E. Ellidokuz 2, A. Celebi Kobak 2. 1Department of Microbiology, Celal Bayar University,
Medical Faculty, Manisa, Turkey, 2Department of Internal Medicine, Gastroenterology Division, Celal Bayar University, Medical Faculty, Manisa, Turkey Background and Aims: Occult hepatitis B is defined by the presence of HBV DNA in serum or liver in the absence of HBsAg. Low serum HBV DNA titers, in the range of 102 to 103copies/mL, are typical in occult HBV infection. The frequency of the diagnosis depends on the sensitivity of HBV DNA assays and the prevalence of HBV infection in population. Occult HBV infection rate ranges between 7% to 13% in the world. No studies have systematically screened HBV seronegative individuals for HBV DNA in our country. For this reason the aim of our study was to find out the prevalence of occult HBV infection in Manisa, Turkey. Methods: The serological markers of hepatitis B virus were examined using microparticle enzyme immunoassay method (Abbott lab., Germany). HBV DNA quantification was tested by real-time PCR assay (ABI Prism 7000; Applied Biosystems, Fosters City, Calif.). HBsAg (-) and HBV DNA (+) patients were evaluated as occult HBV infection. Results: Eight-hundred forty-three of 1778 patients were HBsAg and HBV DNA positive. Fifty-four of 935 HBsAg-negative patients had HBV DNA positivity. Occult HBV infection rate was 5,77%. Distribution of hepatitis B serological markers in patients with occult HBV is shown in table 1. Occult hepatitis B infection by serological patterns Occult HBV infection (n) Anti-HBc (-) Anti-HBs (-)
Anti-HBc (+) Anti-HBs (-)
Anti-HBc (+) Anti-HBs (+)
Anti-HBc (-) Anti-HBs (+)
54
9 (16.66%)
7 (12.96%)
11 (20.37%)
15 (27.77%)
Conclusions: We found that the prevalence rate of occult HBV infection tend to correlate with intermediate prevalence of hepatitis B infection in Turkey. Although the prevalence of occult HBV infection is higher in Anti-HBc positive patients, a significant finding is that Anti-HBc plus Anti-HBs negativity and Anti-HBs positivity are considerably high.
~
Where is anti-HCV testing taking place in England?
L.J. Brant 1, M. Hurrelle 2, M.A. Balogun 1, R Klapper 3, M.E. Ramsay 2. On behalf of the Hepatitis Sentinel Surveillance
study group. 1Health Protection Agency Centre For Infections, 61 Colindale Avenue, London, UK, 2Health Protection Agency, Leeds laboratory, Seacroft Hospital, Leeds, UK, 3Manchester Medical Microbiology Partnership, Manchester Royal Infirmary, Manchester, UK In England anti-HCV testing is offered across the health and prison services. However where testing is taking place across these services and which service type most of the infections are identified in has not been previously described. Sentinel surveillance of hepatitis C testing started in January 2002 in eight centres across England with more laboratories contributing since September 2004. Demographic and testing data are extracted electronically from participating laboratory information systems, for people tested for anti-HCV and HCV RNA. Hepatitis A and B results and HCV genotype are also collected where available. Service type of requesting clinician were identified and grouped as GP, GUM clinic, prison, specialist drug services and hospital. In the pilot study (2002-2003), where service type could be fully identified, the highest proportion of positive tests occurred in specialist drug services (283/852, 33%) and prison services (284/1182, 24%), but the total number of tests from these services was low. Overall, 10% of tests were done in GP surgeries (n=5912, 7% positive), 7% in GUM clinics (n =956, 5% positive), and the rest in a hospital setting (n = 24,310, 5% positive). Geographical differences in testing were identified. Most anti-HCV positive people had a risk exposure of injecting drug use.
Full data for the period 2002-2005 are now available. Routine laboratory data, with supplemental questionnaires, has provided for the first time data where people are being tested for anti-HCV and from which environment most positives are identified. Laboratories can use this data to identify where more testing should be done.
•
Lower hepatitis C virus infections in seropositive patients between 1999 and 2003
C. Payan 1,2, W. Mansour 1 , A. Pivert 1, V. Narbonne 2, H. Le Guillou-Guillemette 1 , I. Fouchard-Hubert 3, E Lunel 1 . 1Laboratoire
de Bact6riologie-Virologie-Hygiene Hospitaliere, CHU Angers, France, 2D~partement de Microbiologie EA3882, CHU Morvan, Brest, France, 3Service de M6decine A, R6seau 49, CHU Angers, France Background and Aim: Hepatitis C virus (HCV) infection has been estimated in 600,000 subjects in France, with about 80% of chronic infection. Only the use of PCR technology allows the diagnosis of HCV chronic infection. However, PCR is a laborious and cost effective method. We aimed to evaluate HCV chronic infection by using the serology testing. Methods: All new anti-HCV positive screened patients during 1999 and 2003 in Angers university hospital were included. Serum samples were prospectively assessed for anti-HCV antibodies, expressed in signal/cutoff (s/co) ratio, using AxSYM HCV v.3.0 (Abbott) and Vitros HCV (Ortho Clinical Diagnostics), and for HCV RNA, using the HCV Cobas Amplicor 2.0 assay (Roche Diagnostics, France). A third assay (HCV Architect Abbott) was assessed in Brest university hospital. Results: 386 out of 14951 (2.58%) screened patients were found anti-HCV positive (3.21% in 1999 and 2.19% in 2003). Good correlations were found between serological assays (0.89 to 0.97). 174 of them were HCV RNA positive (45.1%) but a decrease of HCV positive patients were significantly observed between 1999 and 2003 (60% and 30% respectively, p < 0.001). An anti-HCV cutoff value at 28, 18, 5 s/co using respectively AxSYM, Vitros and Architect allows the best predictive PCR results with 97-98% sensitivity and 89-93% specificity. Conclusion: We found a large decrease of HCV infected patients among anti-HCV positive patients between 1999 and 2003 that correlates the decrease of anti-HCV levels. Furthermore, high antiHCV levels were predictive of HCV infection in immune-competent, non treated patients.
~ H B V contamination of medicine instruments in surgery department M.M. Attarpour Yazdi, H. Baradaran. University of Shahed,
University of Tehran, Iran Background and Aims: Increase in occurrence of HBV among the medicine staffs and 3% prevalence of this infection in Iran and existence of the HBsAg positive individuals without any special symptom lead to general consideration about transmission of this infection by medicine instruments. Methods: The purpose of this study was evaluation of HBV contamination in surfaces (such as cabinet&door handles, telephones, water valves and electrical buttons) and equipments in the surgery department of the Cina hospital on 2006. Sampling was performed with steril cotton swabs in transport medium (BSAS: Bovine Serum Albumin in Sodium chloride). Samples were tested by PCR technique. Results: As a results, 54.5% (6 out of 11 samples)of surfaces and 37.9%(11 out of 29 samples) of equipments were contaminated before disinfection.27.3%(3 out of 11 contaminated samples)of equipments remained contaminated after disinfections. Discussion: There are high contamination percentage in the surfaces that expresses the necessity of effective and regulatory disinfection procedures in these site. According to the high level of infection in the surfaces and equipments in the surgery department, these approaches to disinfect equipments is not sufficient to omit HBV infection.