Hepatitis B and C co- infection in the Republic of Tajikistan (Clinical, epidemiological and molecular characterization
Project Status: 3 Approved without Funding
Duration in months: 24 months
Objective
Approximately 350 million people are infected with HBV worldwide, and the World Health Organization (WHO) estimates that approximately 170 million people are infected with HCV. HBV and HCV infection account for a substantial proportion of liver diseases worldwide. Because the two hepatotropic viruses share same modes of transmission, coinfection with the two viruses is not uncommon, especially in areas with a high prevalence of HBV infection and among people at high risk for parenteral infection. The exact number of patients infected with both HBV and HCV is unknown.
Central Asia belongs to the regions with high intensity of hepatitis viruses circulation, in particular, hepatitis B and C viruses, the level of "carriers" of which among healthy population fluctuates from 6 till 20% [V. D. Hope, I. Eramova, et all., 2014]. In this connection the system of measures for control of viral hepatitis (VH) was being developed in Central Asian region, particularly, in Dushanbe cities. In spite of some achieved successes in study of this problem, many of epidemiological and clinical aspects remain a mystery for today science and scientists. Wide spectra of clinical and morphological appearance of HBV- and HCV-infections, in pathogenesis of which are considered: virus replication in liver and outside of it; genotypes' heterogeneity and mutations of viruses genomes; immunogenotypic base of host; direct cytocidal viruses effect and immunological abnormalities induced by them. In pathogenesis of organs' affections, caused by HBV and HCV, the main thing is interaction of host and virus factors, which determines different clinical outcomes of these infections: starting from asymptomatic infection till chronic hepatitis, cirrhosis and hepatocellular carcinoma. Host factors (possibly genetic ones) determine measures against the infection: possibility of virus persistency and replication; production of antigens and natural immune response. HBV- and HCV-infections are accompanied by specific and non-specific humoral response and disorder of cell response. HBV-HCV co-infection involves complex viral interaction. Chu CJ, Lee SD. 2011; Chu CJ, Lee SD., 2008 ]. While liver disease activity and fibrosis progression are generally more severe in cases of HBV-HCV co-infection, an inverse relationship between the replication of each virus within some co-infected patients has been noted, suggesting direct or indirect viral interference [Chu CJ, Lee SD. 2011]. Challenging this notion, longitudinal studies revealed that the two viruses may replicate independently within some patients, causing fluctuations in the serum level of one virus that appear unrelated to the viremia of the other . Suppression of HBV replication has been observed in patients with chronic HBV infection after acute infection with HCV; similarly, inhibition of HCV replication has been observed in patients with chronic HCV superinfected with HBV [Park Y, Lee JH, Kim BS et all., 2010]. In this study, we will analyze the virological features of HBV/HCV and HIV co-infected.
The work will evaluate the role of different risk factors and genotypes diversity of delta infection among different population groups. Expected results and their application. We shall evaluate the role of various risk factors for HBV, HCV and HIV co-infected in different population groups and also determine association of virological factors.
The results of the work will delineate epidemiological, clinical, virological and immunological characteristics of HBV, HCV and HIV infection among patients with HIV infection and PWID. These data will help in early and reliable diagnostics of hepatitis C and HIV infection, formulation of prevention and control measures and timely referral of infected patients to care and treatment. Project correspondence to ISTC goals.
Explanation of the importance of the project in meeting ISTC goals.
Implementation of this project is very important for meeting ISTC goals and objectives, especially, in the field of reorientation of weapon scientists and experts and their involvement in the process of integration into international science society.
