MyMedR

Displaying all 7 publications

Abstract:

Sort:

Fulltext Trends and estimation of hepatitis b infection cases in Malaysia, 2003–2030

Rajamoorth, Yogambigai, Niazlin Mohd Taib, Khalid Abdul Rahim, Munusamy, Subramaniam

Malaysian Journal of Public Health Medicine, 2016;16(1):113-120.
MyJurnal

Hepatitis B virus (HBV) infection is an upcoming public health problem in Malaysia. This study analysed the
trend of Hepatitis B (HB) cases from 2003 to 2012 and project the cases for an 18-year period (2013–2030).
Based on the national data of annual reported cases and the Malaysian population projections (2010–2040),
trend/regression lines were fitted to analyse the trend and estimated HB incidence. The number of HB
cases decreased for six consecutive years and began to increase from 2010 onwards. During the 10-year
period (2003–2012), the highest number of HB cases was reported in Sabah, followed by Pahang and
Wilayah Persekutuan; the lowest was reported in Perlis. The exponential curve shows a decrease of HB
cases by an average of 6.3%. However, the polynomial curve shows fluctuations in the trend, with a higher
degree of R-square (0.8655). Most states appear to be at moderate vulnerability to HBV infection (Kedah,
Perak, Negeri Sembilan, Terengganu, Sabah, and Sarawak), except for Melaka, Wilayah Persekutuan, and
Selangor, which were at high risk of HB incidences. Overall, the estimated HB cases indicate that the
number of cases and the incidence rates will increase in the future in all states, except for Penang. As the
estimated HB cases and incidence rates show an increasing pattern, the government should strengthen
their strategies in the management of HB and take preventive measures such as educating the public
through awareness programmes, conducting compulsory blood screening, and sustaining the Expanded
Programme on Immunization effectively.
Fulltext Detection of leptospiral DNA in urine sample following prolonged hospitalization: a case report

Shuhaidah Othman, Noraini Philip, Niazlin Mohd Taib, Vasantha Kumari Neela, Hui-Yee Chee

Malaysian Journal of Medicine and Health Sciences, 2019;15(202):105-107.
MyJurnal

We described a case of positive molecular detection of leptospirosis in urine sample following prolonged hospital- ization. Relevant clinical history had raised suspicion to leptospirosis infection. A significantly high level of creat- inine kinase suggested possibility of rhabdomyolysis. Blood and urine samples collected on 4th day of admission were negative for leptospires culture and serological method showed no significant evidences of positive infection. Molecular detection of Leptospira spp. in blood sample was positive but not in urine sample. After seven weeks of infection, leptospiral DNA was detected in urine sample using molecular method.
Fulltext Prevalence, Clinical Manifestations and Predictors of Immune Reconstitution Inflammatory Syndrome among HIV-Infected Patients in Malaysia Infectious Disease Centre: A Retrospective Study

Nurul Suhaili Kamarudin, Niazlin Mohd Taib, Adilahtul Bushro Zaini, Hasni Mahayidin

Malaysian Journal of Medicine and Health Sciences, 2020;16(109):38-45.
MyJurnal

Introduction: Immune reconstitution inflammatory syndrome (IRIS) is paradoxical clinical deterioration experienced
by some HIV-infected patients in response to antiretroviral therapy (ART). There is still limited published data on
IRIS from this region including Malaysia. This study aimed to determine IRIS prevalence, clinical manifestations
and possible predictors among HIV-infected patients in an infectious disease centre in Peninsular Malaysia.
Method: This retrospective study was conducted in Hospital Sungai Buloh involving secondary data of 256
HIV-infected patients who were initiated on ART in the year 2017. Medical record of each patient was reviewed
for up to 12 months following ART initiation to identify IRIS diagnosis which was made by the treating physician.
Relevant clinical and laboratory information were retrieved from hospital electronic database. Results: IRIS has
occurred in 17.6% of patients. Infections by Mycobacterium tuberculosis (53.3%), Pneumocystis jirovecii (11.1%)
and Talaromyces marneffei (6.6%) were the commonest three aetiologies of IRIS. Subacute lupus erythematosus was
the only non-infectious IRIS identified. Baseline HIV viral load, CD4+ T-cell count and haemoglobin level between
IRIS and non-IRIS patients were significantly different. Risk of developing IRIS was increased seven times in patients
with CD4+ T-cell count < 100 cells/µL and four times in patients with HIV RNA viral load > 5.5 log10 copies/ml prior
to ART initiation. Conclusion: Mycobacterium tuberculosis infections were the highest IRIS manifestation. Although
rare, non-infectious IRIS does occur and should be part of the differential diagnosis. Patients with positive predictors
should be appropriately monitored for possible IRIS development once initiated on ART.
Fulltext Expression of Human Cytokine Genes Associated with Chronic Hepatitis B Disease Progression

Hudu SA, Niazlin MT, Nordin SA, Saeed MI, Tan SS, Sekawi Z

Iran J Immunol, 2017 Dec;14(4):281-292.
PMID: 29276181 DOI: IJIv14i4A3

BACKGROUND: Hepatitis viruses are non-cytopathic viruses that lead to the infection and pathogenesis of liver diseases as a result of immunologically mediated events.
OBJECTIVE: To investigate the expression of human inflammatory cytokines in chronic hepatitis B patients according to the severity of the infection.
METHODS: We recruited a total of 120 patients, 40 of whom from cirrhotic, 40 non-cirrhotic, and 40 acute flare chronic hepatitis B and 40 healthy controls. For all groups total cellular RNA was extracted from whole blood samples, genomic DNA was eliminated, and cDNA was synthesized using the RT2 first strand kit, as instructed by the manufacturer. The real-time profiler PCR array was performed on a master cycler ep realplex and the data were analyzed using an online data analysis software.
RESULTS: Non-cirrhotic chronic hepatitis B patients were found to significantly upregulate interleukin 10 receptors that regulate the balance between T helpers 1 and 2. On the other hand, patients with cirrhosis were found to have significant upregulated interleukin 3 gene expression.
CONCLUSION: Our finding suggests that upregulation of anti-inflammatory and downregulation of pro-inflammatory cytokines may play a role in the progression of non-cirrhotic chronic hepatitis B patients to cirrhotic and acute flare. However, a multi-center study with a larger sample size is needed to confirm our findings.
Fulltext Genetic diversity of hepatitis B co-infection with hepatitis C, D and E viruses among Malaysian chronic hepatitis B patients

Hudu SA, Niazlin MT, Nordin SA, Tan SS, Omar H, Shahar H, et al.

Afr Health Sci, 2018 Dec;18(4):1117-1133.
PMID: 30766578 DOI: 10.4314/ahs.v18i4.33

Background: Hepatitis B virus co-infection with other strains of viral hepatitis is associated with increased risk of liver cirrhosis and hepatic decompensation.
Objectives: This is a prevalence study that assessed the genetic diversity of chronic hepatitis B patients and coinfection.
Methods: Chronic hepatitis B patients enrolled in this study were tested for antibodies of other hepatitis viruses using ELISA kits. Patient clinical profiles were collected and partial genes of HBV, HCV, and HEV were amplified, sequenced, and analyzed using phylogenetic analysis. The associations between variables were determined using the chi-squared test.
Results: Of the 82 patients recruited for this study, 53.7% were non-cirrhotic, 22.0% cirrhotic, 20.7% acute flare and 3.7% hepatocellular carcinoma. Majority (58%) of patients had a high level of ALT (≥34 U/L). Sequence analysis showed HBV (63.9%) belonged to genotype B, HEV belonged to genotype 4 while HCV belonged to genotype 3a and the genotypes were found to be significantly associated with the clinical stage of the patients (χ2=56.632; p<0.01). Similarly, Hepatitis B e antigen was also found to be significantly associated with the clinical stage of infection (χ2=51.952; p<0.01).
Conclusion: This study revealed that genetic diversity was found to have a significant impact on the severity of infection.
Fulltext Isolated hepatitis B core antibody positive among vaccinated cohort in Malaysia

Hudu SA, Malik YA, Niazlin MT, Harmal NS, Alshrari AS, Sekawi Z

Ann Saudi Med, 2013;33(6):591-4.
PMID: 24413864 DOI: 10.5144/0256-4947.2013.591

BACKGROUND AND OBJECTIVES: Hepatitis B core antibodies (anti-HBc) are detected in almost every patient with previous exposure to hepatitis B virus (HBV). However, with this marker alone, one cannot understand the activity of the disease; therefore, this study aimed to identify the implication of isolated hepatitis B core antibody and evaluate the effect of hepatitis B vaccine booster in isolated anti-HBc among adults who received the HBV vaccine as infants.
DESIGN AND SETTINGS: A prospective cohort study of vaccinated undergraduate students of University Putra Malaysia.
PATIENTS AND METHODS: A total of 408 undergraduate students who received infant hepatitis B vaccination volunteered for this study; 5 mL of venous blood was taken from the volunteers. Hepatitis B surface antigen (HBsAg) and core antibodies were tested using a commercially available enzyme-linked immunosorbent assay kit according to the manufacturer's instructions (DRG international Inc., USA). Molecular detection of hepatitis B viral DNA was performed using nested polymerase chain reaction.
RESULTS: The prevalence of isolated anti-HBc among the vaccinated cohort was found to be 5.0%, out of which 80% had a hepatitis B surface antibodies (anti-HBs) titer higher than 10 IU/L, while 20% had less than 10 IU/L anti-HBs titer. All the anti-HBc positivesubjects had detectable hepatitis B viral DNA in their serum. Anamnestic response was found to be 100% among isolated anti-HBc with negative antibody.
CONCLUSION: Isolated anti-HBc developed protective levels of anti-HBs after a single dose of recombinant hepatitis B vaccination. HBV DNA was detected in all isolated anti-HBc indicating occult chronic HBV infection with undetectable HBsAg.
Fulltext Antibody and immune memory persistence post infant hepatitis B vaccination

Hudu SA, Malik YA, Niazlin MT, Harmal NS, Adnan A, Alshrari AS, et al.

Patient Prefer Adherence, 2013;7:981-6.
PMID: 24101865 DOI: 10.2147/PPA.S49776

This study aimed to evaluate the level of hepatitis B immunity among undergraduate students 23 years after commencement of the nationwide hepatitis B childhood immunization program in Malaysia.