Abstract
Hepatitis B virus (HBV) infection is a major public health concern in many Southeast Asian, South Asian and African countries. HBV infection is transmitted sexually or by other parenteral routes. HBV causes an acute viral hepatitis or chronic infection, largely based on the age at which the infection is acquired. In the majority of infected infants, HBV causes a chronic protracted infection for decades without symptoms. After several decades, the infection might flare up to give rise to an active hepatitis followed by sero-conversion to anti-HBs. However, the vast majority of patients with chronic HBV (CHB) infection will have chronic liver disease. Some with CHB infection develop a primary liver cancer, hepatocellular carcinoma (HCC) later in life. Approximately 25 percent of chronically infected individuals die prematurely of cirrhosis or HCC. The prevalence of HBV infection in Sri Lanka is estimated to be less than 2%. Sri Lanka is therefore considered a country of low endemicity. This prevalence rate of HBV in Sri Lanka is very different to that in many other South Asian countries such as India and Bangladesh. Diagnosis of HBV infection in Sri Lanka is carried out in many private and state laboratories using immunochromatography based rapid assays or ELISAs for HBV surface antigen (HBsAg) detection. Those with latter stages of CHB are treated with currently available nucleotide / nucleoside analogues in some private sector hospitals where testing facilities for virus load during different stages of treatment is available. Sri Lanka has a policy of immunizing healthcare workers (HCW) who are at risk of acquiring HBV occupationally. Sri Lanka included HBV immunization in the Expanded Program of Immunization (EPI) with effect from 2003. In all HBsAg immunization programmes for HCW, testing for the protective anti-HBs response is mandatory in those who receive a complete course of immunization in order to ensure immunity in responders and to re-vaccinate non-responders.
Highlights
This review compiles what we know about the status of hepatitis B virus infection in Sri Lanka, using information from published peer reviewed journal papers and abstracts from 1996 to 2015 withReceived 24 May 2015 and revised version accepted 14 October 2015 the help of PubMed and Google search engines
This study showed that none of the exposed mothers had evidence of chronic hepatitis B virus (HBV) infection
The study showed that both the immunochromatography assays (ICA) (Biotech’s Onsite HBV surface antigen (HBsAg) assay and CORTEZ’S HBsAg one step assay) were less sensitive (80% and 97.82%, respectively) and had a low NPV (60% and 95.74%, respectively) compared to the enzyme immunoassays (EIA).[24]. These findings emphasize the need for regular validation of these ICAs with standard methods of detection such as EIA if the ICAs are to be used for routine diagnosis of HBV infection by Sri Lankan laboratories
Summary
This review compiles what we know about the status of hepatitis B virus infection in Sri Lanka, using information from published peer reviewed journal papers and abstracts from 1996 to 2015 with. The disease is a major global health problem affecting Asia, Africa, Southern Europe and Latin America and is the most serious type of viral hepatitis (Figure 1).[1,2] HBV endemicity can be categorized into 3 groups based on the sero-prevalence of HBV surface antigen (HBsAg) in a particular geographical area. Sri Lanka has a intermediate prevalence for HBV infection with a prevalence of HBsAg positivity of less than 1% and not more than 2.5% in the general population.[3] For example, according to the Epidemiology Unit, Ministry of Health data in 2010, viral hepatitis including those due to HBV infection has been reported from different parts of the country throughout the year.[4] this pooled data by the Epidemiology Unit, Ministry of Health does not clearly state the number of viral hepatitis caused by HBV. HBV infections are a major health problem in the South
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