anti-HBc Antibodies Research Articles

Cardiac surgery and acute hepatitis B - Use of the Seraph™ 100 hemofilter.

We present a case of a 55-year-old male, presenting with angina symptoms with electrocardiographic changes and a panfocal systolic murmur radiating to the carotids. He had a primary HBV infection 8 months ago, without antiviral treatment. Echocardiography showed critical aortic valve stenosis (area: 0.53 cm2/m2). No coronary lesions were found on coronary angiography. Blood analysis revealed AST/GOT of 96 U/L and ALT/GPT 150 U/L. The serological profile revealed positive IgM anti-HBc, anti-HBc, anti-HBs and anti-HBe antibodies, with an increasing viral load (VL). The abdominal ultrasound identified mild hepatic fibrosis (F3) with minimal steatosis. Mechanical aortic prosthetic valve replacement was performed under CPB. The Seraph™ 100 filter was incorporated into the CPB circuit to reduce the risk of HBV contamination, infection and liver failure. The postoperative VL was monitored (Table 1). Liver function tests showed peak levels of bilirubin 0.66 mg/dL, AST/GOT 58 U/L, ALT/GPT 74 U/L at 6 hours post-surgery, with recovery of normal ranges at 48 hours post-surgery.

High prevalence of hepatitis B and HIV among women survivors of sexual violence in South Kivu province, eastern Democratic Republic of Congo.

Limited data are available on the prevalence rates of hepatitis B and acquired immunodeficiency syndrome (AIDS) among women survivors of sexual violence (WSSV) in South Kivu province, in the eastern part of the Democratic Republic of Congo (DRC), where armed conflicts persist. Here, we aimed to assess the prevalence of these two infections in this vulnerable local population. A total of 1002 WSSV, aged from 18 to 70 years old were enrolled from May 2018 to May 2020 at three healthcare facilities (Panzi, Mulamba and Bulenga hospitals), which are called "The One-Stop Centre Care Model" for the management of sexual violence in South Kivu. Blood samples were collected and tested for hepatitis B virus (HBV) and human immunodeficiency virus (HIV) antigens and antibodies using enzyme-linked immunoassay (ELISA) methods. Subsequently, viral load quantification for HBV and HIV were performed using the GeneXpert. Univariate and multivariate logistic regression models were used to assess factors associated with HIV-positive and HBV-positive status. For HBV, overall prevalence was 8.9% (95% CI; 7.2-10.8%), 32.1% (95% CI; 29.3-35.0%), and 14.5% (95% CI; 12.3-16.8%) for HBsAg, anti-HBc and anti-HBs antibodies, respectively. Among the 89 HBsAg-positive patients, 17 (19.1%) were HBeAg-positive. The median age of individuals with a positive HBsAg test was higher than those with a negative test (median: 40 years (IQR 30-52) compared to 36 years (IQR 24-48)). Risk factors for HBV infection were age (≥35 years) (AOR = 1.83 [1.02-3.32]; p = 0.041), having no schooling (AOR = 4.14 [1.35-12.62]; p = 0.012) or only primary school-level (AOR = 4.88 [1.61-14.75]; p = 0.005), and multiple aggressors (AOR = 1.76 [1.09-2.84], p = 0.019). The prevalence of HIV was 4.3% [95% CI: 3.1-5.7%]. HIV/HBV co-infection occurred only in 5 individuals (0.5%). The HBV viral load was detectable (> 1 log10 UI/mL) in 61.8% of HBsAg-positive subjects and 64.8% HIV-positive subjects had a high viral load (≥ 3 log10 copies/mL). This study revealed a high prevalence of HBV and HIV infections among WSSV in South Kivu. The results generated highlight the urgent need for systematic screening of HBV and HIV by integrating fourth-generation ELISA tests in HIV and HBV control programs.

Seroprevalence of transfusion-transmitted infections among blood donors in Makkah, Saudi Arabia.

Blood donation is vital for healthcare; however, transfusion-transmitted infections (TTIs) pose a serious risk. This study investigated the seroprevalence of TTIs among Saudi blood donors. This retrospective study included male blood donors aged ≥ 18 years who donated blood at Al-Noor Specialist Hospital in Makkah from January 2017 to December 2022. The blood units were screened for hepatitis B surface antigen (HBsAg) and core antibodies (HBc-IgG), hepatitis C antibodies (HCV-Abs), syphilis, HIV-1 antigen/antibody (HIV-1 Ag/Ab), human T-lymphotropic virus 1, 2 (HTLV-1/2), and malaria. There were 40,287 donors with an average age of 44.33 ± 18.12 years, and 62.3% (n = 25103) were Saudis. The overall rate of TTIs seropositivity was 7.4% (n = 2953); HBc-IgG (6.1%; n = 2473) was the most common, followed by HCV-Abs (0.4%; n = 177), and syphilis (0.34%; n = 136). All cases were negative for malaria, whilst HIV and HTLV positive donors were 0.06% (n = 24) and 0.13% (n = 52), respectively. Syphilis was more prevalent among non-Saudis (0.24%; n = 83) than among Saudis (0.1%; n = 53), whereas anti-HBc antibodies seropositivity was significantly higher among Saudi (3.4%; n = 1373) than non-Saudi donors (2.7%; n = 1100). Hepatitis B virus was the most frequently detected bloodborne pathogen, followed by hepatitis C virus and syphilis. Hepatitis B virus was also more prevalent among Saudi donors, whilst expatriates had higher rates of syphilis. Additional prospective multicenter studies are needed to accurately determine the prevalence of TTIs in Saudi Arabia.

#701 Occult hepatitis B infection in kidney transplant recipients and their donors

Abstract Background and Aims Occult hepatitis B infection (occult HBV infection—OBI) in kidney transplant recipients (KTRs) poses a potential risk of transforming into an overt process during immunosuppressive therapy. We aimed to evaluate the frequency of OBI occurrence in KTRs population and in the corresponding cohort of kidney donors. Method We analyzed 1222 consecutive KTRs transplanted between Jan 2012 and Jun 2023 and their 670 deceased donors. The diagnosis of seropositive OBI was based on the presence of anti-HBc antibodies without detectable HBs antigen. In eligible KTRs with pre-transplant OBI, the status of HBV infection was examined including the HBV-DNA and calculated aspartate aminotransferase to platelet ratio index (APRI) and Fibrosis-4 (FIB-4) indexes to assess the degree of liver fibrosis. Results Prior to transplantation, OBI was diagnosed in 178 (14.9%) KTRs [median age 49 (IQR, 38-59) years] and in 72 (10.7%) donors [median age 49 (38-58)]. OBI was significantly more frequent in KTRs than in general population (χ2=6.4, p<0.05). In a long-term follow-up period [median 84 (47-117) months], 5 out of 85 pre-transplant OBI patients (5.9%) presented the negative HBc status, whereas HBV viremia and HBs antigen, as determined using the high-sensitive method, were absent in all subjects. Among 85 pre-transplant OBI subjects, anti-HBs antibodies >10 mIU/ml were present in 84.7% and no liver fibrosis was found by APRI and FIB-4 indexes calculation. Conclusion 1. OBI is still a significant clinical problem not only in KTRs, but also in the general population, despite the widespread access to preventive vaccinations against HBV. 2. A separate analysis is necessary to evaluate the influence of OBI on kidney graft and liver function in KTRs.

Anti-HBc antibodies and occult hepatitis B infection (OBI) among blood donors in Lomé, Togo

Aims: Among the progressive forms of hepatitis B virus (HBV) infections, the HBs antigen (HBsAg) remains undetectable in 25% of cases. There is also a form of HBV infection called occult HBV infection (OBI) characterized by the presence of viral DNA in the blood and tissues with no detectable levels of HBsAg associated with or without anti-HBc Ab, or anti-HBs Ab out of the pre-seroconversion period, which constitutes an infectious risk in blood transfusion. Methods: To determine the prevalence of anti-HBc Abs and the HBV DNA in the blood of donors recruited at the blood transfusion center (CNTS) of Lomé. This is a cross-sectional study including 967 blood donations which were seronegative to HBs antigen during the biological qualification of the donation (BQD) from July 28 to August 19, 2022. The detection of total anti-HBc Abs (IgM and IgG) was performed by BIORAD enzyme-linked immunosorbent assay (ELISA) method; the viral load measurement was carried out according to the polymerase chain reaction method by amplification of COBAS AmpliPrep/TaqMan 4800 (Roche diagnostics). Data processing and analysis were performed using EXCEL 2013 software and SPSS software. Concerning the ethical aspect, we have obtained written consent from the donors and the agreement of the bioethics committee for health research No. 052/2022/CBRS. Results: The prevalence of anti-HBc Abs was 33.82% (CI: 30.83–36.80). Viral DNA was detected in 10 cases. The prevalence of occult hepatitis B was 3.05% (10/327) in blood donors carrying anti-HBc antibodies, and 1.03% (10/967) in the blood donors population that does not carry HBsAg. Conclusion: The presence of occult hepatitis B within the population of blood donors at the blood transfusion center of Lomé constitutes a real threat to transfusion safety. The association of the viral DNA detection by PCR to the serological tests that are currently carried out during the biological qualification of the donations could be a better approach to reduce the risk of transmission of HBV by blood transfusion at the CNTS of Lomé.

Hepatitis B virus DNA is absent in Lebanese blood donors who are positive for both anti-HBC and anti-HBS antibodies

Hepatitis B virus DNA is absent in Lebanese blood donors who are positive for both anti-HBC and anti-HBS antibodies

Low Prevalence of Anti-HBc Antibody and Lack of HBV DNA Among HBsAg-Negative Blood Donors in Iran: A Cross-sectional Study and Review of Literature.

Occult hepatitis B infection (OBI) refers to the presence of hepatitis B virus (HBV) DNA in the serum or liver of individuals who tested negative for HBV surface antigen (HBsAg). This study aimed to determine seropositivity for antibodies against HBV core antigen (anti-HBc) and the frequency of OBI among the HBsAg non-reactive blood donors in Mashhad, northeastern Iran. In this cross-sectional study, serum samples of HBsAg-negative blood donors were examined for anti-HBc during June and August 2018. Anti-HBc-positive samples were tested for antibodies against HBsAg (anti-HBs), and those with negative results were classified as isolated anti-HBc cases. The presence of HBV DNA in the C, S, and X gene regions was assessed by a qualitative real-time polymerase chain reaction method in all HBsAg-negative samples. OBI subjects were detected by the presence of at least one HBV genomic region. Of 540 HBsAg-negative donors, 29 (5.4%; 95% confidence interval: 3.6-7.6%) showed seroreactivity for anti-HBc, of whom 18 individuals were also seropositive for anti-HBs. All donors showed negative results for all three HBV genes regardless of their serum anti-HBc status. Based on our findings, we suggest routine screening of Iranian blood donation volunteers for serum anti-HBc and anti-HBs but not HBV DNA.

Clinical Significance and Remaining Issues of Anti-HBc Antibody and HBV Core-Related Antigen.

Currently, hepatitis B virus (HBV) core antibody (anti-HBc antibody) and HBV core-related antigen (HBcrAg) are widely used as serum markers for diagnosis based on the HBV core region. This review focused on anti-HBc antibodies and HBcrAg and aimed to summarize the clinical significance of currently used assay systems and the issues involved. While anti-HBc is very significant for clinical diagnosis, the clinical significance of quantitative assay of anti-HBc antibody has been reevaluated with improvements in diagnostic performance, including its association with clinical stage and prediction of carcinogenesis and reactivation. In addition, concerning the new HBcrAg, a high-sensitivity assay method has recently been established, and its diagnostic significance, including the prediction of reactivation, is being reevaluated. On the other hand, the quantitative level of anti-HBc antibody expressed in different units among assay systems complicates the interpretation of the results. However, it is difficult to standardize assay systems as they vary in advantages, and caution is needed in interpreting the assay results. In conclusion, with the development of highly sensitive HBcrAg and anti-HBc antibody, a rapid and sensitive detection assay system has been developed and used in clinical practice. In the future, it is hoped that a global standard will be created based on the many clinical findings.

Prevalence and risk factors of transmission of hepatitis delta virus in pregnant women in the Center Region of Cameroon.

Hepatitis B virus (HBV) and hepatitis delta virus (HDV) co-infection has been described as the most severe form of viral hepatitis, and can be co-transmitted from mother-to-child. A seroprevalence of 4.0% of HDV infection was reported in pregnant women in Yaoundé, and 11.9% in the general population in Cameroon. Our objective was to describe the rate of HDV infection in HBsAg-positive pregnant women and to determine risk factors associated with mother-to-child transmission of HDV. A cross-sectional, descriptive study was conducted from January 2019 to July 2022 among pregnant women attending antenatal contacts in seven health structures in the Centre Region of Cameroon. A consecutive sampling (non-probability sampling) was used to select only pregnant women of age over 21 years, who gave a written informed consent. Following an informed consent, an open-ended questionnaire was used for a Knowledge, Attitude and Practice (KAP) survey of these women, and their blood specimens collected and screened for HBsAg, anti-HIV and anti-HCV antibodies by rapid tests and ELISA. HBsAg-positive samples were further screened for HBeAg, anti-HDV, anti-HBs, and anti HBc antibodies by ELISA, and plasma HDV RNA load measured by RT-qPCR. Of 1992 pregnant women, a rate of 6.7% of HBsAg (133/1992) with highest rate in the rural areas, and 3.9% of hepatitis vaccination rate were recorded. Of 130, 42 (32.3%) were anti-HDV antibody-positive, and 47.6% had detectable HDV RNA viraemia. Of 44 anti-HDV-positive cases, 2 (4.5%) were co-infected with HBV and HCV, while 5 (11.4%) with HIV and HBV. Multiple pregnancies, the presence of tattoos and/or scarifications were significantly associated with the presence of anti-HDV antibodies. Of note, 80% of women with negative HBeAg and positive anti-HBe serological profile, had plasma HDV RNA load of more than log 3.25 (>10.000 copies/ml). These results show an intermediate rate of HDV infection among pregnant women with high level of HDV RNA viremia, which suggest an increased risk of vertical and horizontal co-transmission of HDV.

Receiver Operating Characteristic Analysis of Liver Function Tests in Patients with Chronic Viral Hepatitis B in Baghdad, Iraq

Hepatitis B virus (HBV) infection is a global health challenge, and clearance or persistence of HBV is mostly determined by host immune responses, Therefore, this study aimed to determine HBV effects in chronic HBV patients living in Baghdad receiver operating characteristic (ROC) analysis. The impact of HBV genotypes on liver-function parameters was explored A case-control study was conducted during June-October 2018 on 80 chronic HBV patients and 96 matched control. The results revealed that most patients were males 50 (62.5%), while female patients accounted for 30 (37.5%). The sera of patients were positive for anti-HBc (hepatitis B core antigen) IgG and -HbsAg (hepatitis B surface antigen) antibodies, while they were negative for anti-Hbc IgM antibody. Such profile is consistent with the interpretation of chronic HBV infection. Four liver-function tests (LFTs); total serum bilirubin (TSB), alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were assessed. Significantly increased levels of ALP, ALT and AST were observed in HBV patients compared to normal healthy control, while TSB showed no significant variation. However, in receiver operating characteristic (ROC) analysis, only ALP and AST occupied an excellent area under curve (AUC > 0.90).

The importance of triple panel testing for hepatitis B and the burden of isolated anti-hepatitis B core antibodies within a community sample

Within the United States (US), 2.4 million individuals are living with chronic hepatitis B, but less than 20% are diagnosed. Isolated anti-hepatitis B core (iAHBc) antibodies indicate serology in an individual that is positive for anti-HBc antibodies, while negative for surface antigen (HBsAg) and surface antibodies (anti-HBs). A result of iAHBc could indicate a chronic occult bloodstream infection, necessitating further testing. This study assesses the prevalence and risk factors associated with anti-HBc and iAHBc within community high-risk screening in Greater Philadelphia. Participants (n = 177) were screened for HBsAg, anti-HBs, and anti-HBc during community screening events in 2022. Chi-square tables and Firth logistic regression were used to describe the data and to assess the odds of iAHBc. The findings indicate that there was an iAHBc prevalence of 7.3% (n = 13) within our study. The odds of anti-HBc were increased for immigrants from the Western Pacific (4.5%) and Africa (11.9%). Individuals born in Africa had 7.93 greater odds for iAHBc than those born in the Americas, and these odds are multiplied by 1.01 for every 1-year increase in age. Our data show a high burden of iAHBc within high-risk and often hard-to-reach communities. Triple panel screening should be incorporated into all HBV screening programs, in accordance with current Centers for Disease Control and Prevention (CDC) universal screening recommendations, to ensure a comprehensive picture of the disease burden and reduce the risk of missing people with occult hepatitis B and those at risk for viral reactivation or liver complications.

Status of Hepatitis B Virus Surface Antigen (HBsAg) Deposition in Renal Tissue among Glomerulonephritis Patients

Background: Hepatitis B virus (HBV) related glomerulonephritis (GN) may be found in HBV seropositive as well as seronegative patients. HBV may present in the renal tissue of such patients. Objective: The purpose of the present study was to assess status of HBsAg deposition in renal tissue among glomerulonephritis patients. Methodology: This cross-sectional study was conducted in the Department of Nephrology at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period of July 2015 to June 2016. All diagnosed GN patients both HBV seropositive and seronegative aged more than 18 years of both sexes admitted in the department of Nephrology BSMMU were taken as the study population. Serological tests both HBsAg and anti-HBc (total) were done to identify the HBV seropositive and seronegative individuals by ELISA technique and Chemiluminescense Method respectively. Renal biopsy was done percutaneously through a posterior approach. Immunohistochemistry and one core were preserved in normal saline for direct immunofluorescence (DIF). Both test tubes were sent to find out histological features and presence of HBsAg in renal biopsy tissue in Pathology Department of Bangabandhu Sheikh Mujib Medical University, Dhaka. Results: HBsAg antigen in renal tissue was found in 2 patients among 7 patients who were seropositive for both HBsAg and Anti-HBc antibody (total), 2 patients among 8 patients who were HBsAg seronegative but Anti-HBc (total) seropositive, 2 patients among 38 patients who were seronegative for both HBsAg and Anti-HBc (total). There were no patients in this study who was HBsAg seropositive but Anti HBc (total) seronegative. Total 11.3% (6 patients) of renal biopsy specimens were found to have HBsAg deposits which included 3 cases of Membranoproliferative GN and one of each of Membranous nephropathy, Mesangial proliferative GN and IgA nephropathy. Conclusion: The high rate of HBsAg deposits has been found in renal tissue among GN patients. Bangladesh Journal of Medical Microbiology, January 2022;16(1):14-18

The position of Spy Tag/Catcher system in hepatitis B core protein particles affects the immunogenicity and stability of the synthetic vaccine

Presenting exogenous antigens on virus-like particles (VLPs) through “plug-and-display” decoration strategies based on SpyTag/SpyCatcher isopeptide bonding have emerged as attractive technology for vaccine synthesis. However, whether the position of ligation site in VLPs will impose effects on immunogenicity and physiochemical properties of the synthetic vaccine remains rarely investigated. Here in the present work, the well-established hepatitis B core (HBc) protein was used as chassis to construct dual-antigen influenza nanovaccines, with the conserved epitope peptides derived from extracellular domain of matrix protein M2 (M2e) and hemagglutinin (HA) as target antigens. The M2e antigen was genetically fused to the HBc in the MIR region, together with the SpyTag peptide, which was fused either in the MIR region or at the N-terminal of the protein, so that a recombinant HA antigen (rHA) linked to SpyCatcher can be displayed on it, at two different localizations. Both synthetic nanovaccines showed ability in inducing strong M2e and rHA-specific antibodies and cellular immunogenicity; nevertheless, the one in which rHA was conjugated by N-terminal Tag ligation, was superior to another one synthesized by linking the rHA to MIR region SpyTagged-HBc in all aspects, including higher antigen-specific immunogenicity responses, lower anti-HBc carrier antibody, as well as better dispersion stability. Surface charge and hydrophobicity properties of the two synthetic nanovaccines were analyzed, results revealed that linking the rHA to MIR region SpyTagged-HBc lead to more significant and disadvantageous alteration in physiochemical properties of the HBc chassis. This study will expand our knowledge on “plug-and-display” decoration strategies and provide helpful guidance for the rational design of HBc-VLPs based modular vaccines by using SpyTag/Catcher synthesis.

#5721 HEPATITIS B VIRUS REACTIVATION IN KIDNEY TRANSPLANT RECIPIENTS TREATED WITH BELATACEPT

Abstract Background and Aims Hepatitis B virus (HBV) reactivation in kidney transplant recipients may be associated with liver failure and graft loss, especially in anti-HBc antibody (HBcAb)-positive HBs antigen (HBsAg)-negative patients. Belatacept, a selective costimulation blocker, has been used in kidney transplantation for some time and has been associated with reactivation of other viruses as BK or CMV. However, there are few data on HBV reactivation among kidney recipients treated with belatacept. Method We performed a retrospective study in two French kidney transplantation centres including all transplant recipients receiving belatacept. Among HBcAb-positive patients, we analyzed HBV reactivation rate, outcomes and risks factors. Results 135 patients treated with belatacept were included, and 32 were HBcAb-positive. Seven patients reactivated HBV (21.9% of HBcAb-positive patients), including 5 HBsAg-negative patients (16.7%); reactivation occurred 54.8 (± 70.9) months after transplantation. There was no significant difference in survival between patients that reactivated HBV and patients that did not: 5-year patient survival of 100% (28.6; 100) and 83.4% (67.6; 100), respectively (p = 0.363) and 5-year graft survival of 100% (28.6; 100) and 79.8% (61.7; 100), respectively (p = 0.335). No factor, including HBsAb positivity and antiviral prophylaxis, was statistically associated with the risk of HBV reactivation. Conclusion Compared to the few studies that exist in this area, the HBV reactivation rate was high in patients treated with belatacept in our study. Our findings suggest that systematic antiviral prophylaxis for anti-HBc antibody (HBcAb)-positive HBs antigen (HBsAg)-negative patients should be considered and that there should be close monitoring of HBV serology and viral load in these patients to detect early HBV reactivation.

ABO blood types, but not Secretor or Lewis blood types, influence strength of antibody response to Hepatitis B vaccine in Black South African children.

Subunit vaccines for the Hepatitis B virus (HBV) have greatly reduced the prevalence of infection and morbidity through HBV-related liver cirrhosis and cancer. However, strength of immune response to vaccination varies considerably. While it is known that ABO blood types may influence HBV infection risk, the role of ABO and related blood types in strength of immune response to HBV vaccine has not been investigated. We examined 16 polymorphisms in the ABO, FUT2, and FUT3 genes and their related phenotypes for associations with strength of antibody response to HBV vaccine in Black South African infants. Anti-HBc and anti-HBs antibody levels were measured by CMIA assay 1-3months after the last dose of HBV vaccine. Prior infection occurred in 8/207 individuals (3.86%) who were removed from further study. Of the remaining 199 individuals, 83.4% individuals were strong responders (anti-HBs≥100 mIU/ml, median 973 mIU/ml), another 15.6% were weak responders (anti-HBs<100 mIU/ml, median 50 mIU/ml) and 1% were non-responders (anti-HBs<10 mIU/ml). The frequency of weak responders to HBV vaccine was not significantly affected by sex, birthweight, use of an additional booster dose of vaccine or cohort of origin. We characterised patterns of genetic variation present at the ABO, FUT2 and FUT3 loci by use of MassArray genotyping and used these data to predict ABO, Secretor and Lewis phenotypes. We observed significant association of ABO blood type with strength of antibody response to HBV vaccine in a Black South African cohort (p=0.002). In particular, presence of rs8176747G and expression of B antigen (whether in B blood type or AB blood type) was associated with decreased antibody response to HBV vaccine. Secretor and Lewis blood types were not associated with antibody response to HBV vaccine. This work increases our understanding of the impact that host genetic variation may have on vaccine immunogenicity.

Epidemiological and clinical aspects of chronic infections of hepatitis b virus at the Mohammed V military teaching hospital in Rabat – Morocco

Background: Infection with hepatitis B virus is a major public health problem worldwide. Globally hepatitis B virus’s prevalence is 5.4%, more than one million between them die each year from complications that are essentially cirrhosis and hepatocellular carcinoma. The objective of this study is to describe epidemiological and clinical aspects of patients with chronic viral hepatitis B monitored in the Military Teaching Hospital Mohammed V in Rabat. Patients and methods: This are a retro-prospective study carried out in the virology laboratory of the Mohammed V Military Teaching Hospital in Rabat, spread over a period of 15 years from January 2001 to January 2016. Were included in our study all Moroccan patients aged 18 years and over with chronic viral hepatitis B defined by the presence of HBsAg beyond 6 months and the absence of IgM anti-HBc antibodies. Results and discussion: Out of 104 infected persons, 71% are men and 50% of infected was discovered by screening, 19% of patients had fatigue as a primary symptom, 69% had dental care as a risk factor and 46% of patients were carriers of the active form of chronic hepatitis B. Currently, few studies relate the epidemiology of HBV in Morocco. The prevalence of HBsAg during the study period was 1.03, despite this, Morocco is so far considered, according to WHO's data, as having an intermediate prevalence of viral hepatitis B. Conclusion: Immunization, compliance with universal recommendations for the use of medical and paramedical equipment as well as education and awareness are the only guarantee to limit the spread of Hepatitis B virus.

Seroprevalence of hepatitis B virus infection in pre-mass vaccination era among children residing in a rural area of Bangladesh

Background and objectives: There are few details available regarding the prevalence of hepatitis B virus (HBV) infection in the general Bangladeshi population. There is a dearth of data on prevalence of HBV infection in children and adolescents who were born before the hepatitis B vaccine was introduced in the Expanded Program on Immunization (EPI). The objective of the current study was to use archived data to describe the seroepidemiology of HBV infection (HBsAg and anti-HBc Antibody) among school children in a particular rural area of Bangladesh. Also, the study correlated serum vitamin A level with the HBV infection status among a subset of children. Materials and method: The study analyzed the archived data of a study conducted in 2003 and 2004. The samples were collected from 1995 children, aged 5 to 15 years, from a purposively selected rural area located about 100 km north-east of capital Dhaka. HBsAg (HBV surface antigen) and anti-HBc antibody were determined by ELISA method. Vitamin A (retinol) in blood was assayed by HPLC technique. The prevalence rates of HBsAg and anti-HBc antibody was determined by simple percentages. All associations between different characteristics were tested by Chi square test. Results: Of the total 1995 children, 988 (49.5%) and 1007 (50.5%) were male and female respectively. Among them, 23 (1.2%) were HBsAg positive or HBV carriers and 79 (8.1%) were anti-HBc antibody positive. Neither HBsAg nor anti-HBc antibody positivity rate showed any difference in male and female children. There was also no significant difference of HBsAg positivity rate amongst children of different age groups; whereas, anti-HBc antibody positivity rate increased significantly (p &lt;0.005) with increase of age. Serum vitamin A was estimated in a subset of children. The mean serum vitamin A concentration was found significantly (p&lt;0.05) lower among HBsAg positive children compared to their age and sex matched healthy control group. Conclusion: This study has demonstrated that rural children are in risk of exposure to HBV infection. Increasing HBV seropositivity with age emphasizes the need for devising prevention strategies and to create awareness among the rural children. Further studies are necessary to find out the hitherto undetected sources namely occult hepatitis B cases and the ways of spread of HBV in the community. IMC J Med Sci. 2023; 17(2):007. DOI: https://doi.org/10.55010/imcjms.17.017 *Correspondence: M Abu Sayeed, Department of Community Medicine, Ibrahim Medical College, 1/A, Ibrahim Sarani, Segunbagicha, Dhaka 1000, Bangladesh; Email: sayeed1950@gmail.com; J. Ashraful Haq, Department of Microbiology, Ibrahim Medical College, Segunbagicha, Dhaka, Bangladesh; Email: jahaq54@yahoo.com

Hepatitis B Virus Reactivation in Kidney Transplant Recipients Treated With Belatacept

Hepatitis B virus (HBV) reactivation in kidney transplant recipients has been reported in 3% to 9% of anti-HBc antibody (HBcAb)-positive HBs antigen (HBsAg)-negative patients. It has not been studied in patients receiving belatacept, a selective costimulation blocker. We performed a retrospective study of all transplant recipients receiving belatacept in 2 kidney transplantation centers in France. Among HBcAb-positive patients, we analyzed HBV reactivation rate, outcomes, and risk factors. A total of 135 patients treated with belatacept were included: 32 were HBcAb-positive and 2 were HBsAg-positive. Seven patients reactivated HBV (21.9% of HBcAb-positive patients), including 5 HBsAg-negative patients (16.7% of HBcAb-positive HBsAg-negative patients). Reactivation occurred 54.8 (± 70.9) months after transplantation. One patient presented with severe hepatitis and 1 patient developed cirrhosis. There was no significant difference in survival between patients that reactivated HBV and patients that did not: 5-year patient survival of 100% (28.6; 100) and 83.4% (67.6; 100), respectively (P= 0.363); and 5-year graft survival of 100% (28.6; 100) and 79.8% (61.7; 100), respectively (P= 0.335). No factor, including HBsAb positivity and antiviral prophylaxis, was statistically associated with the risk of HBV reactivation. HBV reactivation rate was high in patients treated with belatacept when compared with previous transplantation studies. HBV reactivation did not impact survival. Further studies are needed to confirm these results. A systematic antiviral prophylaxis for these patients should be considered and evaluated.

Serological Analysis of HBsAg and Anti-HCV Antibody in Patients Received at the Mali Hospital Laboratory

Introduction: Viral hepatitis is a public health threat that has long been underestimated. This infectious disease is the seventh cause of death in the world and even ahead of HIV in terms of epidemiological prevalence. Objective: highlight the seroprevalence of hepatitis B and C viral infections in patients seen in the medical analysis and pathology laboratory department of the Mali hospital. Method: This is a prospective and retrospective study that took place from July 2021 to August 2022. This study included 1540 samples from eligible patients with HBsAg, Anti HBe IgG Antibody, Anti HBc Antibody, HBe Ag, Antibody Anti HBs and/or anti-HCV antibodies. Results: These different methodologies allowed us to have the results of 1540 samples concerning this study. The female sex was more represented with 62.92% compared to the male sex or 37.08%. The HBSAg was mainly found positive in the male sex with 5.45%. The average age was 38 ± 17 years with extremes ranging from 2 to 92 years. The age group 21-39 years was the most represented with 47.47% and the most affected by the positivity of the HBSAg with 5.65%. 64.03% of our patients were married and also with increasing positivity for HBS Ag and anti-HCV Ac with 5.91% and 0.91% respectively. The seroprevalence of HBV, HCV and HVB/HCV co-infection were 10.06, 0.9% and 0.84% respectively. Conclusion: Hepatitis B remains largely unknown to the general public but also to many medico-social actors. This lack of knowledge represents a major obstacle to prevention and screening. It also has as a corollary the stigmatization of people who are affected, in romantic encounters or at work in particular. A high seroprevalence of HBsAg obtained indicates the spread of hepatitis B in the Malian population.

Atypical serologic profiles of hepatitis B virus infection across clinical cohorts of patients in Southwestern Nigeria

ABSTRACT Hepatitis B virus (HBV) infection follows a natural course of events predicted by a dynamic interaction between viral antigen and the host immune system, which forms the basis for HBV serological diagnosis. These interactions may deviate from the typical serologic patterns. This study investigates the types of atypical HBV serologic profiles (AHBSP) across clinical cohorts of patients with HBV infection in southwestern Nigeria. This is a cross-sectional, hospital-based, multi-centered study. Patients’ sera were analyzed for HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc IgM, and anti-HBc IgG by ELISA from 279 study participants attending selected gastroenterology clinics between August 2019 and December 2020. The prevalence of atypical HBV serologic profiles was 27% (n = 76). The mean age of patients was 35.7 ± 11.2 years. The gender distribution involved 183 females (65.6%) and 96 males (34.4%). Across clinical cohorts of patients with atypical serologic profiles, HBeAg Negative, anti-HBe positive with detectable HBV DNA had the highest prevalence of 21% followed by isolated anti-HBc antibody positive, HBsAg negative and detectable HBV DNA, 5%. The atypical serologic profiles, HBeAg positive, HBsAg negative with detectable HBV DNA and concurrent anti-HBs with HBsAg, had the lowest prevalence, 0.4%, respectively. This study identified the considerable presence of atypical HBV serologic profiles across clinical cohorts of HBV infection in southwestern Nigeria.