Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019163 (hepatitis B)
 38,309 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The KC60 diagnostic code information provides an epidemiological monitor of sexually transmitted infection (STI) and a means of standardizing clinical workload in genitourinary medicine (GUM) departments. We aimed to assess the coding process and its uniformity within the Trent region by means of a confidential self-administered coding exercise with simulated case presentations. The correct coding for STIs ranged from 59.4% to 100% in different scenarios. Difficulty was identified in the coding of vulvitis and balanitis where no organism was isolated, as represented by a wide range of codes. HIV pre-test counselling without testing was coded by only 57.8% of respondents. Over 95% indicated correctly the first hepatitis B vaccine dose but 21% failed to code once only for the course. Coding practice also varied within individual sites with a 21-100% discordance. In parts diagnostic accuracy was good but there were areas of non-uniformity both within sites and cross-regionally. Regional discussions have resulted in increased training opportunities and guidelines have been developed to increase uniformity and achieve consensus in uncertain areas.
Int J STD AIDS 1999 Aug
PMID:An audit of diagnostic coding in genitourinary medicine clinics. Trent Region Genitourinary Medicine Audit Group. 1047 Oct 97

Studies of heterosexual HIV transmission have consistently found anal intercourse to be a highly predictive risk factor for seroconversion. Yet most AIDS prevention messages targeted at heterosexuals, presumably influenced by cultural taboos against acknowledging this sexual practice, continue to emphasize vaginal and, increasingly, oral sex transmission. The health risks of anal sex appear to be severely underestimated by a substantial proportion of sexually active women and men in North and Latin America as well as parts of South Asia, Africa, and other regions. Among heterosexuals reported rates of condom use are nearly universally lower for anal than for vaginal intercourse. This review examines anal sex among the general population, including its prevalence in various world regions, related sociocultural factors, and other associated health problems including anorectal STDs, Hepatitis B infection, and HPV-related anal cancer in women. U.S. survey and other data suggest that, in terms of absolute numbers, approximately seven times more women than homosexual men engage in unprotected receptive anal intercourse. Research among higher risk subpopulations, including bisexual men, injecting drug users, female sex workers, inner-city adolescents, and serodiscordant heterosexual couples, indicates that persons particularly at risk of being infected by or transmitting HIV are also more likely to practice anal sex. Considering this finding, along with the much greater efficiency for HIV infection as well as lower rates of condom usage, a significant proportion of heterosexual transmission in some populations is due to anal intercourse. This typically stigmatized and hidden sexual practice must be given greater emphasis in AIDS/STD prevention, women's care, and other health promotion programs.
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PMID:Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks, Part I. 1074 35

A survey was carried out in 2 drug use treatment centres (TCs) in Rio de Janeiro, Brazil, to assess risk behaviours, HIV infection and other sexually transmitted infections/blood-borne infections (STIs/BBIs). Two hundred and twenty-five drug users (195 males and 30 females) were interviewed and clinically examined, and their blood and urine were tested for STIs/BBIs. Prevalences (%) for these infections were as follows--HIV: 0.9, hepatitis B virus (HBV): 14.7, hepatitis C virus (HCV): 5.8, syphilis: 5.3, gonorrhoea/chlamydia (CT/NG): 4.7. In bivariate analyses CT/NG infection was associated with younger age (P=0.003); current genitourinary symptoms (odds ratio [OR]=6.2) and a mainly illegal source of income (OR=9.1). Hepatitis C infection was associated with a history of ever having injected any drug (OR=19.6), and with each one of the injected drugs. After multiple logistic regression, lower educational level (adjusted odds ratio [AOR]=3.70) and 'ever having injected drugs' (AOR=3.69) remained as independent risk factors for hepatitis B infection. In conclusion, TCs must implement programmes directed towards the prevention of STIs/BBIs.
Int J STD AIDS 2000 Jun
PMID:Sexual behaviour and infection rates for HIV, blood-borne and sexually transmitted infections among patients attending drug treatment centres in Rio de Janeiro, Brazil. 1087 12

Our objective was to identify barriers to the use of genitourinary medicine (GUM) services for off-street female sex workers in a provincial city, using self-administered anonymous questionnaires distributed to premises during outreach sessions by a clinic health adviser. Questionnaires were completed by 85 (56%) of the estimated 150 women working in the 13 targeted premises. The main obstacles to service use were the length of time spent in clinic (83%), dislike of needles (28%), difficulty getting to clinic (18%) and dislike of examinations (16%). The majority (71%) rejected sex worker-only sessions. Women using the local service, which provided outreach sessions, were more likely to have disclosed their occupation to the service (82% vs 36%; P=0.035). GUM clinics may optimize their accessibility to sex workers by minimizing the time required per visit, and introducing non-invasive screening methods where possible. Outreach visits by clinic staff may encourage women to disclose their occupation, enabling them to assess vaccinations for hepatitis B.
Int J STD AIDS 2000 Sep
PMID:Off-street sex workers and their use of genitourinary medicine services. 1099 2

Healthcare workers who are in contact with patients and/or clinical material are at continuous risk of acquiring blood-borne viral infections, in particular, infection with hepatitis B virus, hepatitis C virus and the human immunodeficiency virus (HIV). Prevention of occupational exposure is dependent on education. Prevention strategies include immunization, exposure avoidance by the use of universal precautions at all times, and post-exposure advice and prophylaxis. This article will review the risks to healthcare workers associated with exposure to hepatitis B, hepatitis C, and HIV. It will discuss post-exposure management in the United Kingdom (UK) and briefly outline the risks to patients from infected healthcare workers.
Int J STD AIDS 2000 Oct
PMID:Blood-borne virus infection: the occupational risks. 1105 33

For many years it has been the practice in Brazil to question donors and to test blood to be used in blood banks for HIV, Chagas' disease, hepatitis B and C, and syphilis. Counseling and blood testing programs have recently been established to assist in identifying and treating those with HIV. In a blood bank center in Campo Grande, Mato Grosso do Sul State (MS), we evaluated the frequency and age of patients with positive tests for T.cruzi in order to determine whether the frequency and age distribution indicated that this infection should be added to the counseling and testing programs. A group of 476 first time blood donors were enrolled to answer a questionnaire and to be tested serologically for Chagas' disease, HIV, hepatitis B and C, and syphilis. A standard ELISA and an IFA test were used for Chagas' disease patients. Five patients (1.1%) were serologically positive for T.cruzi infection. All five were male between 22 and 35 years of age. None of the five had been born in Mato Grosso do Sul State. Four donors donated blood in order to obtain serologic test results, only one donated blood as a social responsibility. One was HIV positive and related previous STD, and one had received a blood transfusion between 1980 and 1986. Each had had only one sexual partner in the last six months. The age range and the frequency of 1.1% suggest that it would be beneficial to include this disease in counseling and testing program in Brazil. The limitations of this approach are the relatively low attendance at such centers in Mato Grosso do Sul (1.7 people/day compared to a national average of 2.9 people/day), the slow reporting time for results (1 week compared to 1 day for the blood bank reporting), and the absence of a standard disease-specific testing procedure. We recommend increasing the use of serologic tests for T.cruzi and designing appropriate questionnaires in counseling and testing programs now used primarily for HIV, assuming the existing limitations can be overcome.
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PMID:Serologic Testing for Chagas' Disease and HIV in Counseling Programs and Blood Banks in Midwest Brazil. 1108 64

The Centers for Disease Control and Prevention (CDC) are currently reviewing the guidelines for handling HIV-positive health care workers (HCWs). The Advisory Committee on HIV and STD Prevention and the Hospital Infection Control Practices Advisory Committee are working together to change these recommendations based on problems arising under the present regulations. Worker's lack of confidentiality in disclosing their HIV status to patients, and ambiguous terminology stating that HCWs should not perform procedures that are exposure-prone, are among the problems that need to be addressed. Current practices have shown that health care personnel with HIV and hepatitis B (HBV) should be dealt with separately, and disclosure of HIV status should not be mandated because the risk of transmission to patients is very low. The group suggests that self-disclosure is warranted in specific cases, and may be mitigated by a supervisor who could oversee the worker's health condition. Additional recommendations include concentrating efforts on preventing injury to health care workers, studying transmission risks for hepatitis C, and analyzing the methods for preventing transmission. Results from a look-back study conducted by the CDC suggest that there is no data to demonstrate transmission between 53 HIV-positive health care providers and their 22,759 patients. The working group also recognizes the need for review panels, but feels that they should be decentralized to fit the needs of individual health care providers.
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PMID:Pressure mounts for CDC to change guidelines for infected HCWs. Centers for Disease Control and Prevention. 1136 9

Chronic hepatitis B infection is frequently diagnosed within the genitourinary clinic setting with sexual transmission the commonest route of acquisition in the United Kingdom. Only 3--5% of adults who contract acute hepatitis B will progress to chronic infection, and these individuals can be identified by the presence of hepatitis B surface antigen (HBsAg) in the bloodstream 6 months after infection. Individuals at highest risk of long-term complications such as cirrhosis and hepatocellular carcinoma, carry HBeAg and have high levels of circulating hepatitis B virus (HBV) deoxyribonucleic acid (DNA). Therapy should be targeted towards this group of patients. Two forms of therapy are now licensed for use in chronic hepatitis B infection: interferon-alpha and lamivudine. Seroconversion occurs in 30--40% of patients treated with interferon and treatment is often limited by toxicity. Lamivudine is well tolerated with seroconversion rates of 15--20% at one year, rising with increasing duration of therapy. Long-term monotherapy is limited however by the development of resistance mutations and combination nucleoside therapy is likely to become the treatment of choice in the future. Patients with chronic hepatitis B should be counselled regarding transmission, partner vaccination and alcohol intake and co-infection with other hepatitis viruses should be excluded.
Int J STD AIDS 2001 Jun
PMID:The management of chronic hepatitis B infection. 1180 40

We assessed to what extent gay men are motivated to obtain vaccination against hepatitis B virus (HBV), as well as the social cognitive determinants of this motivation. A cross-sectional survey was conducted among homosexual men by means of a written questionnaire that contained assessments of intention, knowledge and social-cognitive determinants of intention (i.e. attitude, social norm and perceived behavioural control towards vaccination, perceived severity and perceived vulnerability regarding HBV infection). Four hundred and thirty-three homosexual men completed the questionnaire. We conducted a linear regression analysis to determine the contribution of social-cognitive variables in explaining intention to be vaccinated. Attitude, social norm and perceived vulnerability were significant predictors of intention. Usually, health education emphasizes the severity of a disease, but from this analysis we can conclude that gay men should be convinced of their personal vulnerability to HBV, the benefits of vaccination, and that important referents of the targeted person think positively about vaccination.
Int J STD AIDS 2002 Feb
PMID:Why do gay men want to be vaccinated against hepatitis B? An assessment of psychosocial determinants of vaccination intention. 1183 62

This paper evaluates the effectiveness of a bar-based, peer-led community-level intervention to promote sexual health amongst gay men. The intervention consisted of peer education within bars, gay specific genitourinary medicine (GUM) services and a free-phone hotline. Data were collected at baseline (1996) and at follow-up (1999) in gay bars in Glasgow (intervention city) and Edinburgh (control city). During the intervention peer educators interacted with 1484 men and new clients increased at the gay specific GUM service. However, the hotline was under-utilized and abused. The outcome measures were: reported hepatitis B vaccination; HIV testing; unprotected anal intercourse (UAI) with casual partners; negotiated safety; and amongst men reporting UAI with a regular partner, the proportion who knew their own and their partner's HIV status. Significant differences in sexual health behaviours were observed across locations and across time, but the only significant intervention effects were amongst men who had direct contact with the intervention, with higher uptake of hepatitis B vaccination and HIV testing. The intervention did not produce community-wide changes in sexual health behaviours. These results question the replication and transferability of peer-led, community-level sexual health promotion for gay men outwith the USA and across time.
Int J STD AIDS 2002 Feb
PMID:Does bar-based, peer-led sexual health promotion have a community-level effect amongst gay men in Scotland? 1183 64


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