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Jacobs C.,Tropical Gastroenterology and Nutrition Group | Jacobs C.,University of Otago | Chiluba C.,Tropical Gastroenterology and Nutrition Group | Phiri C.,Tropical Gastroenterology and Nutrition Group | And 6 more authors.
Journal of Infectious Diseases | Year: 2014

Background. Hepatitis E virus (HEV) infection causes major epidemics of infectious hepatitis, with high mortality rates in pregnant women. Recent reports indicate that HEV coinfections with human immunodeficiency virus (HIV) may have a more protracted course. However, the impact of HEV infections in communities heavily affected by HIV remains poorly studied. We set out to examine age-related seroprevalence in a community where we have previously carried out studies on environmental enteropathy.Methods. Blood samples from 194 children and 106 adults were examined for immunoglobulin G and immunoglobulin M antibodies for HEV. HEV data were correlated with HIV status and morphometric analysis of small intestinal biopsies.Results. Seroprevalence rose throughout childhood, from 8% in children aged 1-4 years, to 36% in children aged 10-14 years. In adults, the overall prevalence was 42%, with 28% in HIV-seronegative adults and 71% in HIV-seropositive adults (odds ratio, 6.2; 95% confidence interval, 2.2-18; P =. 0001). In adults, villous height and crypt depth measurements showed that HEV seropositivity was associated with worse enteropathy (P =. 05 and P =. 005, respectively).Conclusions. HEV infection is common in Zambia. In adults it is strongly associated with HIV status, and also with environmental enteropathy. © 2013 The Author. Source


Asombang A.W.,Tropical Gastroenterology and Nutrition Group | Mwanza-Lisulo M.,Tropical Gastroenterology and Nutrition Group | Mudenda V.,University of Zambia | Yarasheski K.,Endocrinology and Lipid Research | And 6 more authors.
American Journal of Clinical Nutrition | Year: 2013

Background: Gastric cancer is increasingly recognized in Zambia. Although nutritional factors contribute to gastric cancer risk, their effect in Zambia is unknown. Objective: The objective was to investigate the association between intake of dietary antioxidants, urinary 8-iso prostaglandin F2a (8-iso PGF2a) as a marker of oxidative stress, and gastric cancer. Design: This was a case-control study at the University Teaching Hospital in Zambia. Gastric cancer cases were compared with ageand sex-matched controls. Urine 8-iso PGF2a was measured primarily by ELISA, and by gas chromatography-mass spectrometry in a subset, expressed as a ratio to creatinine. Blood was collected for Helicobacter pylori, HIV serology, gastrin-17, and pepsinogen 1 and 2 concentrations. Clinical and dietary data were collected by using questionnaires. Food items were broadly classified into 7 major categories (fruit, vegetables, fish, meat, insects, cereals, and starches). Results: Fifty cases with gastric cancer (mean age: 61 y; n = 31 males) and 90 controls (mean age: 54 y; n = 41 males) were enrolled. Median urinary 8-iso PGF2a excretion was higher in cases (0.014; IQR: 0.008-0.021) than in controls (0.011; IQR: 0.006-0.018; P = 0.039). On univariate analysis, habitual fruit intake was lower in cases than in controls during the dry season (P = 0.02). On multivariate analysis, smoking (OR: 7.22; IQR: 1.38-37.9) and gastric atrophy (OR: 2.43; IQR: 1.12-5.13) were independently associated with cancer, and higher fruit intake was protective (OR: 0.44; IQR: 0.20-0.95). Isoprostane excretion was inversely correlated with total fruit intake (r = 20.23; n = 140; P = 0.006). Conclusion: Urinary 8-iso PGF2a excretion was associated with the risk of gastric cancer, as were smoking and gastric atrophy, but increased fruit intake conferred protection. This trial was registered at www. pactr.org as ISRCTN52971746. © 2013 American Society for Nutrition. Source

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