Prevalence and determinants of hepatitis B co-infection among a United States Veterans Administration cohort with hepatitis C

Background and aim. Hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection is associated with increased risk of cirrhosis, decompensation, hepatocellular carcinoma, and death. Yet, there is sparse epidemiologic data on co-infection in the United States. Therefore, the aim of this study was to determine the prevalence and determinants of HBV co-infection in a large United States population of HCV patients. ^ Methods. The National Veterans Affairs HCV Clinical Case Registry was used to identify patients tested for HCV during 1997–2005. HCV exposure was defined as two positive HCV tests (antibody, RNA or genotype) or one positive test combined with an ICD-9 code for HCV. HCV infection was defined as only a positive HCV RNA or genotype. HBV exposure was defined as a positive test for hepatitis B core antibodies, hepatitis B surface antigen, HBV DNA, hepatitis Be antigen, or hepatitis Be antibody. HBV infection was defined as only a positive test for hepatitis B surface antigen, HBV DNA, or hepatitis Be antigen within one year before or after the HCV index date. The prevalence of exposure to HBV in patients with HCV exposure and the prevalence of HBV infection in patients with HCV infection were determined. Multivariable logistic regression was used to identify demographic and clinical determinants of co-infection. ^ Results. Among 168,239 patients with HCV exposure, 58,415 patients had HBV exposure for a prevalence of 34.7% (95% CI 34.5–35.0). Among 102,971 patients with HCV infection, 1,431 patients had HBV co-infection for a prevalence of 1.4% (95% CI 1.3–1.5). The independent determinants for an increased risk of HBV co-infection were male sex, positive HIV status, a history of hemophilia, sickle cell anemia or thalassemia, history of blood transfusion, cocaine and other drug use. Age >50 years and Hispanic ethnicity were associated with a decreased risk of HBV co-infection. ^ Conclusions. This is the largest cohort study in the United States on the prevalence of HBV co-infection. Among veterans with HCV, exposure to HBV is common (∼35%), but HBV co-infection is relatively low (1.4%). There is an increased risk of co-infection with younger age, male sex, HIV, and drug use, with decreased risk in Hispanics.^

Research on competition in the financing and delivery of health services : future research needs : proceedings of a conference held at the Hubert H. Humphrey Building, Washington, D.C., on March 4, 1982 /

"October 1982."

Henry D. Flood. Memorial addresses delivered in the House of representatives of the United States in memory of Henry D. Flood, late a representative from Virginia.

Running title: Memorial addresses. Representative Flood.

Proceedings of the 3rd International Symposium on the Epidemiology and Control of Salmonella in Pork : Renaissance Mayflower Hotel, Washington, D.C., August 5 to 7, 1999 /

Includes bibliographical references.

Proceedings of the first conference on Computerized Adaptive Testing, Washington, D.C., June 12 and 13, 1975.

Mode of access: Internet.

Bank drafts, &c. Letter from the secretary of the Treasury, transmitting correspondence with the president of the Bank of the United States, in relation to bank drafts, &c. December 27, 1834.

Levi Woodbury, secretary.

Proceedings of the second Ecumenical Methodist Conference held in the Metropolitan Methodist Episcopal Church, October 1891, Washington, D.C., /

Mode of access: Internet.

Ambassador von Staden and Secretary Califano signing the U.S.-German Social Security Agreement; Washington, D.C.

Digital Image

ARAB MUSICIANS IN WASHINGTON, D.C. AREA: ETHNICITY AND IDENTITY

Musicians living in the Arab Diaspora around the Washington, D.C. metro area are a small group of multi-faceted individuals with significant contributions and intentions to propagate and disseminate their music. Various levels of identity are discussed and analyzed, including self-identity, group/ collective identity, and Arab ethnic identity. The performance and negotiation of Arab ethnic identity is apparent in selected repertoire, instrumentation, musical style, technique and expression, shared conversations about music, worldview on Arabic music and its future. For some musicians, further evidence of self-construction of one's ethnic identity entails choice of name, costume, and venue. Research completed is based on fieldwork, observations, participant-observations, interviews, and communications by phone and email. This thesis introduces concepts of Arabic music, discusses recent literature, reveals findings from case studies on individual Arab musicians and venues, and analyzes Arab identity and ethnicity in relation to particular definitions of identity found in anthropological and ethnomusicological writings. Musical lyrics, translations, transcriptions, quotes, discussions, analyses, as well as charts and diagrams of self-identity analyses are provided as evidence of the performance and negotiation of Arab identity.

Improving the Timeliness and Response to an Aerosolizedanthrax Attack in the Metropolitan Washington, D.C. Region

Our research was conducted to improve the timeliness, coordination, and communication during the detection, investigation and decision-making phases of the response to an aerosolized anthrax attack in the metropolitan Washington, DC, area with the goal of reducing casualties. Our research gathered information of the current response protocols through an extensive literature review and interviews with relevant officials and experts in order to identify potential problems that may exist in various steps of the detection, investigation, and response. Interviewing officials from private and government sector agencies allowed the development of a set of models of interactions and a communication network to identify discrepancies and redundancies that would elongate the delay time in initiating a public health response. In addition, we created a computer simulation designed to model an aerosol spread using weather patterns and population density to identify an estimated population of infected individuals within a target region depending on the virulence and dimensions of the weaponized spores. We developed conceptual models in order to design recommendations that would be presented to our collaborating contacts and agencies that would use such policy and analysis interventions to improve upon the overall response to an aerosolized anthrax attack, primarily through changes to emergency protocol functions and suggestions of technological detection and monitoring response to an aerosolized anthrax attack.

Documentos relativos al Congreso Postal Universal reunido en la Ciudad de Washington, D.C. el 5 de mayo de 1897

UANL

Análisis de la Política Exterior Rusa en materia energética, comercial y militar hacia la República de Moldavia (Período 2000-2010)

Rusia sufrió grandes cambios tras la desintegración de la URSS en 1991. No obstante, con la llegada de Vladimir Putin al poder, los intereses geoestratégicos de Rusia sobre el espacio postsoviético revivieron con nuevo ímpetu debido a una mayor cantidad de recursos a disposición del Estado. La República de Moldavia es un claro ejemplo del resurgir de la política exterior rusa hacia el espacio postsoviético, siendo incluso, una región clave en la lucha de la Federación Rusa por recuperar su zona de influencia.