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.^

Decisions of the Federal Maritime Board, and Maritime Administration, Department of Commerce.

Mode of access: Internet.

Essential United States foreign trade routes.

Mode of access: Internet.

Annual report of the United States Food Administration.

Report for 1917 (August 10- December 31) issued as House doc. 837, 65th Cong.

Emergency cargo ship construction. Hearings before the subcommittee of the Committee on Appropriations, United States Senate, Seventy-seventh Congress, first session, on H.J. Res. 77, a joint resolution making an appropriation to the United States Maritime commission for emergency cargo ship construction, and for other purposes.

Alva B. Adams, chairman.

Merchant ship automation study; final report. Contract number MA-2228, U.S. Department of Commerce, Maritime Administration, Washington.

v.1.Summary and recommendations.--v.2.Automatic ship control and communications systems.--v.3.Appendices to 262 R 0012.--v.3.Appendices to 262 R 0012.--v.4.automatic control of engineering functions.--v.5.Appendices to 262 R 0014.--v.6.Powerplants and auxiliaries for automated ships.--v.7.Economic aspects of automation.--v.8.Legal implications of automation.

MARAD, the annual report of the Maritime Administration.

Some issues have distinctive titles.

Complications incurred because of delays in transferring patients to VA spinal cord injury treatment centers; report to the Congress [on the] Veterans Administration [and] Department of Defense by the Comptroller General of the United States.

"B-133044."

Improving the administration of justice by authorizing the Judicial Conference of the United States to establish institutes and joint councils on sentencing, to provide additional methods of sentencing ... : report [to accompany H.J. Res. 424]

Submitted by Mr. Willis, and ordered to be printed, June 23, 1958.

Reorganization of the U.S. Fire Administration : hearing before the Committee on Governmental Affairs, United States Senate, Ninety-seventh Congress, second session, April 21, 1982.

Mode of access: Internet.

The law of the sea: the United States, Canada and the deep seabed

The Falkland Islands War of 1982 was fought over competing claims to sovereignty over a group of islands off the east coast of South America. The dispute was between Argentina and the United Kingdom. Argentina claims the islands under rights to Spanish succession, the fact that they lie off the Argentine coast line and that in 1833 Great Britain took the islands illegally and by force. The United Kingdom claims the islands primarily through prescription--the fact that they have governed the islands in a peaceful, continuous and public manner since 1833. The British also hold that the population living on the islands, roughly eighteen hundred British descendants, should be able to decide their own future. The United Kingdom also lays claim to the islands through rights of discovery and settlement, although this claim has always been challenged by Spain who until 1811 governed the islands. Both claims have legal support, and the final decision if there will ever be one is difficult to predict. Sadly today the ultimate test of sovereignty does not come through international law but remains in the idea that "He is sovereign who can defend his sovereignty." The years preceding the Argentine invasion of 1982 witnessed many diplomatic exchanges between The United Kingdom and Argentina over the future of the islands. During this time the British sent signals to Argentina that ii implied a decline in British resolve to hold the islands and demonstrated that military action did more to further the talks along than did actual negotiations. The Argentine military junta read these signals and decided that they could take the islands in a quick military invasion and that the United Kingdom would consider the act as a fait accompli and would not protest the invasion. The British in response to this claimed that they never signaled to Argentina that a military solution was acceptable to them and launched a Royal Navy task force to liberate the islands. Both governments responded to an international crisis with means that were designed both to resolve the international crisis and increase the domestic popularity of the government. British Prime Minister Margaret Thatcher was facing an all-time low in popularity for post-War Prime Ministers while Argentine President General Galtieri needed to gain mass popular support so he could remain a viable President after he was scheduled to lose command of the army and a seat on the military junta that ran the country. The military war for the Falklands is indicative of the nature of modern warfare between Third World countries. It shows that the gap in military capabilities between Third and First World countries is narrowing significantly. Modern warfare between a First and Third World country is no longer a 'walk over' for the First World country.

Production of meat in the United States and its distribution during the war,

Mode of access: Internet.

Reorganization plan no. 21 of 1950 : providing for abolition of the Maritime Commission and the transfer of its functions to the Department of Commerce : report (to accompany S. Res. 265)

Also in Congressional serial volume 11368.

Veterans in the United States : a statistical portrait from the 1980 census /

Item 985

Expansion of the Soviet Merchant Marine into the U.S. maritime trades.

Includes bibliographical references.