Integrating Gender in Medical Education

Viral hepatitis is a major global health issue affecting nearly 400 million people worldwide. In observance of World Hepatitis Day, May 19, we are focusing more about hepatitis from a gender perspective. Gender differences prevail in the infections caused by the Hepatitis virus. Women and men react differently to the Hepatitis virus; the symptoms also differ among the genders. Study shows that there are gender differences in the health-seeking behaviour of men and women with hepatitis. For an effective hepatitis treatment gender-specific health education and support is needed.

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 Gender and Hepatitis
Gender Disparity in Infections of Hepatitis B Virus 
Gender differences prevail in the infections caused by the Hepatitis B virus. Four hundred and seventy two patients with HBV infection were selected for the study. The frequency of hepatic infection in males was 79.5% (n=375) and in females 20.5% (n=97), with a male to female ratio of 3.8:1. Out of 472 patients, 49% had acute hepatitis, 26% were carriers, 18% had chronic hepatitis, 6% had cirrhosis and 3% patients had hepatocellular carcinoma. Male dominance was found to be consistent in all categories of patients. When the patients were divided into groups according to age, the male to female ratio increased during the reproductive years. There may be an influence of estrogen in the protection and defense of hepatic cells against the development of chronic liver disease. Find out more →

Gender Influence on Treatment of Chronic Hepatitis C Genotype 1 
Although various studies have been published regarding the treatment of chronic hepatitis C (CHC) with peginterferon (Peg-IFN) and ribavirin, little is known regarding the real impact of gender on the characteristics that influence the effectiveness and safety of antiviral treatment for CHC patients. The objective of this study was to evaluate the influence of gender on HCV treatment outcomes. This study suggests that women and men react differently to combined therapy, especially in relation to the incidence of adverse events and the need for dose modification. Nevertheless, these differences do not influence the SVR rate. Find out more →

 Gender Difference in Hepatitis & Mental Health
Gender Differences in Hepatitis C Infection and Risks Among Persons with Severe Mental Illness 
The authors assessed gender differences in hepatitis C infection and associated risk behaviors among persons with severe mental illness. The sample consisted of 777 patients (251 women and 526 men) from four sites. Across sites, the rate of hepatitis C infection among men was nearly twice that among women. Clear differences were noted in hepatitis C risk behaviors. Men had higher rates of lifetime drugrelated risk behaviors: needle use (23.1 percent compared with 12.5 percent), needle sharing (17.6 percent compared with 7.7 percent), and crack cocaine use (45.2 percent compared with 30.8 percent). Women had significantly higher rates of lifetime sexual risk behaviors Find out more →

Gender Based Differences in Depression and Social Support among Patients of HIV, Gonadal Cancer, Hepatitis B and Hepatitis C
To examine the gender based differences in depression and social support among patients of HIV, gonadal cancer and hepatitis B & C in tertiary care public hospitals and different organization at Karachi. A cross sectional study was conducted on 300 patients (100 HIV, 100 gonadal cancer, 100 hepatitis B & C) , at Jinnah Postgraduate Medical College, Civil hospital, Sindh Government hospital, Pakistan Society for HIV patients & Sindh AIDS control program at Karachi, from July 2009 to October 2009. Urdu translated version of Siddiqui and Shah Depression scale and Indigenous Social Support Scale were administered. Find out more →

 Hepatitis in Pregnancy
Chronic Hepatitis B in Pregnancy 
Infection with the hepatitis B virus (HBV) can lead to both acute and chronic hepatitis. For more than 2 decades, the Centers for Disease Control and Prevention (CDC) has recommended that all pregnant women be screened for the marker of active hepatitis B, the hepatitis B surface antigen (HBsAg). According to a recent report from the Institute of Medicine (IOM), most obstetrical care providers do screen pregnant women for hepatitis B and advise that newborns of HBsAg-positive mothers receive both hepatitis B immune globulin and hepatitis B vaccine, ideally immediately after birth. Find out more →

Hepatitis B in Pregnancy: Specific Issues and Considerations
Chronic hepatitis B affects over 350 million people worldwide. Vertical transmission is known to be the leading cause of infection and perinatal infection is associated with a very high rate of chronicity (up to 90%). Up to 40% of chronically infected individuals will die prematurely from complications such as acute liver failure, cirrhosis and hepatocellular cancer. Addressing perinatal transmission through the use of immunoprophylaxis can help contain the spread of HBV. Pregnant mothers with chronic hepatitis B have unique challenges and require specialised management during and after pregnancy. Find out more →

 Male-Specific Hepatitis
Male-Specific Hepatitis B Virus Large Surface Protein Variant W4P Potentiates Tumorigenicity and Induces Gender Disparity 
The underlying mechanisms of carcinogenesis and gender disparity in hepatitis B virus (HBV)-induced hepatocellular carcinoma (HCC) remain unclear. Recently, we reported a novel HCC-related W4P/R mutation in the large surface protein (LHB) of HBV genotype C, which was found exclusively in male HCC patients. Although both WT and W4P variant LHBs enhanced cell proliferation by regulating the cell cycle and facilitated cell colony formation, the W4P variant demonstrated significantly higher activity. NIH3T3 cells expressing variant LHB, but not the WT, induced tumor in a nude mouse model. Find out more →

Male-Specific W4P/R Mutation in the Pre-S1 Region of Hepatitis B Virus, Increasing the Risk of Progression of Liver Diseases in Chronic Patients 
The issue of hepatitis B virus (HBV) mutations possibly leading to a gender disparity in the progression of liver diseases has not been explored. We aimed to elucidate the relationships of the novel pre-S1 mutations, W4P/R, with the progression of liver diseases and male predominance in a South Korean chronic cohort by use of a molecular epidemiologic study. We developed a fluorescence resonance energy transfer (FRET)-based real-time PCR (RT-PCR) assay for the detection of the W4P/R mutations and applied it to 292 chronic HBV patients. The pre-S1 mutations from 247 (84.6%) of a total of 292 patients were detected by this assay. Find out more →


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