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      Hepatitis C virus surveillance and identification of human pegivirus 2 in a large Cameroonian cohort

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          Summary

          The prevalence of chronic hepatitis C virus ( HCV) and the presence of human pegivirus 2 ( HPgV‐2) have not been examined in Cameroon, although HCV has been associated with HPgV‐2 infections previously. Herein we aimed to characterize the burden and genetic diversity of HCV and the presence of HPgV‐2 in Cameroon. Retrospective plasma specimens collected from N = 12 369 consenting subjects in South Cameroon from 2013 to 2016 were included in the study. The majority (97.1%) of participants were patients seeking health care. All specimens were screened for HCV using the Abbott RealTi me HCV viral load assay and positive specimens with remaining volume were also screened for HPgV‐2 antibodies on the Abbott ARCHITECT instrument, followed by molecular characterization. Overall, HCV RNA was detected in 305 (2.47%; 95% CI: 2.21%‐2.75%) specimens. Notably, the prevalence of HCV RNA was 9.09% amongst participants over age 40 and 3.81% amongst males. Phylogenetic classification of N = 103 HCV sequences identified genotypes 1 (19.4%), 2 (15.5%) and 4 (65.1%) within the study cohort. Amongst HCV RNA‐positive specimens, N = 28 (10.6%; 95% CI: 7.44%‐14.90%) specimens also had detectable HPgV‐2 antibodies. Of these, N = 2 viremic HPgV‐2 infections were confirmed by sequencing and shared 93‐94 median % identity with strains found on other continents. This is the first study to determine the prevalence of chronic HCV in Cameroon, and the discovery of HPgV‐2 in this study cohort expands the geography of HPgV‐2 to the African continent, indicating a widespread distribution exists.

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          From non-A, non-B hepatitis to hepatitis C virus cure.

          The hepatitis C virus (HCV) was discovered in the late 1980s. Interferon (IFN)-α was proposed as an antiviral treatment for chronic hepatitis C at about the same time. Successive improvements in IFN-α-based therapy (dose finding, pegylation, addition of ribavirin) increased the rates of sustained virologic response, i.e. the rates of curing HCV infection. These rates were further improved by adding the first available direct-acting antiviral (DAA) drugs to the combination of pegylated IFN-α and ribavirin. An IFN-free era finally started in 2014, yielding rates of sustained virologic response over 90% in patients treated for 8 to 24 weeks with all-oral regimens. Major challenges however remain in implementation of these new treatment strategies, not only in low- to middle-income countries, but also in high-income countries where the price of these therapies is still prohibitive. Elimination of HCV infection through treatment in certain areas is possible but raises major public health issues.
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            Sero-epidemiology of human immunodeficiency virus, hepatitis B and C viruses, and syphilis infections among first-time blood donors in Edéa, Cameroon.

            Blood safety remains an issue of major concern in transfusion medicine in sub-Saharan Africa. Blood-borne agents such as the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Treponema pallidum are among the greatest threats to blood safety for the recipient. This study aimed to determine the seroprevalence and risk factors of HIV, HCV, HBV, and syphilis infections among first-time blood donors at the new hospital-based blood bank in Edéa, Cameroon. We carried out a retrospective analysis of blood donor data recorded between December 2011 and May 2012 at the blood bank of the Edéa Regional Hospital. Antibodies to HIV types 1 and 2 were screened with the Determine and ImmunoComb tests. Hepatitis B surface antigen and antibodies to HCV were detected using DIASpot test strips. Syphilis was diagnosed using the Venereal Disease Research Laboratory (VDRL) test and the Treponema pallidum hemagglutination assay (TPHA). A total of 543 blood donors were included, among whom 349 (64.3%) were family replacement donors. One hundred and fifteen donors (21.2%) were infected with at least one pathogen. The overall seroprevalence rates of HIV, HBV, HCV, and syphilis were 4.1%, 10.1%, 4.8%, and 5.7%, respectively. We found a total of 26 dual infections. The most common combinations were HBV-HCV and HBV-HIV. There was a significant association between HIV and HBV infections (adjusted odds ratio (aOR) 3.46, 95% CI 1.29-9.39; p=0.014), and between HBV and HCV infections (aOR 2.81, 95% CI 1.02-10.12; p=0.036). Compared to voluntary donors, family replacement donors were significantly more infected by at least one screened pathogen (aOR 1.81, 95% CI 1.14-2.88; p=0.013), and more infected specifically by HIV (aOR 3.66, 95% CI 1.07-12.55; p=0.039) and syphilis (aOR 2.81, 95% CI 1.05-7.46; p=0.039). Our findings indicate that blood safety remains a major problem in Cameroon where hospital-based blood banks and family replacement donors are predominant. There is an urgent need for a national blood transfusion program in Cameroon that will establish a nationally coordinated blood transfusion service based on the principles of voluntary regular non-remunerated blood donation. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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              Virome Analysis of Transfusion Recipients Reveals a Novel Human Virus That Shares Genomic Features with Hepaciviruses and Pegiviruses

              ABSTRACT To investigate the transmission of novel infectious agents by blood transfusion, we studied changes in the virome composition of blood transfusion recipients pre- and posttransfusion. Using this approach, we detected and genetically characterized a novel human virus, human hepegivirus 1 (HHpgV-1), that shares features with hepatitis C virus (HCV) and human pegivirus (HPgV; formerly called GB virus C or hepatitis G virus). HCV and HPgV belong to the genera Hepacivirus and Pegivirus of the family Flaviviridae. HHpgV-1 was found in serum samples from two blood transfusion recipients and two hemophilia patients who had received plasma-derived clotting factor concentrates. In the former, the virus was detected only in the posttransfusion samples, indicating blood-borne transmission. Both hemophiliacs were persistently viremic over periods of at least 201 and 1,981 days. The 5′ untranslated region (UTR) of HHpgV-1 contained a type IV internal ribosome entry site (IRES), structurally similar to although highly divergent in sequence from that of HCV and other hepaciviruses. However, phylogenetic analysis of nonstructural genes (NS3 and NS5B) showed that HHpgV-1 forms a branch within the pegivirus clade distinct from HPgV and homologs infecting other mammalian species. In common with some pegivirus variants infecting rodents and bats, the HHpgV-1 genome encodes a short, highly basic protein upstream of E1, potentially possessing a core-like function in packaging RNA during assembly. Identification of this new human virus, HHpgV-1, expands our knowledge of the range of genome configurations of these viruses and may lead to a reevaluation of the original criteria by which the genera Hepacivirus and Pegivirus are defined.
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                Author and article information

                Contributors
                mary.rodgers@abbott.com
                Journal
                J Viral Hepat
                J. Viral Hepat
                10.1111/(ISSN)1365-2893
                JVH
                Journal of Viral Hepatitis
                John Wiley and Sons Inc. (Hoboken )
                1352-0504
                1365-2893
                03 October 2018
                January 2019
                : 26
                : 1 ( doiID: 10.1111/jvh.2019.26.issue-1 )
                : 30-37
                Affiliations
                [ 1 ] Abbott Laboratories Abbott Park Illinois USA
                [ 2 ] Université de Yaoundé I Yaoundé Cameroon
                [ 3 ] University of Bamenda Bamenda Cameroon
                [ 4 ] Institute of Human Virology Abuja Nigeria
                Author notes
                [*] [* ] Correspondence

                Mary A. Rodgers, Abbott Laboratories, Abbott Park, IL.

                Email: mary.rodgers@ 123456abbott.com

                Author information
                http://orcid.org/0000-0001-8815-8651
                Article
                JVH12996
                10.1111/jvh.12996
                7379692
                30187640
                e68e8a7c-c2d3-4d59-b18e-84a29269ce40
                © 2018 The Authors. Journal of Viral Hepatitis Published by John Wiley & Sons Ltd

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 09 May 2018
                : 20 July 2018
                : 14 August 2018
                Page count
                Figures: 5, Tables: 1, Pages: 8, Words: 4999
                Funding
                Funded by: Abbott Laboratories , open-funder-registry 10.13039/100001316;
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                January 2019
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.5 mode:remove_FC converted:24.07.2020

                Infectious disease & Microbiology
                cameroon,chronic hcv,human pegivirus 2 (hpgv‐2),surveillance,viral diversity

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