HBc Ab Research Articles

Seroprevalence of Hepatitis B Virus among Blood Donors at National Blood Transfusion and Research Center-Taiz Branch, Yemen

Hepatitis B Virus (HBV) represents one of the most health problems. Almost more than 350 million infected persons were reported universally. Blood transfusion is commonly the most common route of transmission of HBV. Recently, Hospitals in Yemen are increasing demands for blood and blood products due to war injury, anemia, and malnutrition. The risk of transfusion transmission of infection relatively increases. This study aimed to determine hepatitis B virus prevalence among blood donors at the National Blood Transfusion Center -Taiz branch (NBTRC- TB). Data was collected from the National Blood Transfusion and Research Center (Taiz branch) from 1/4/2020 to 16/12/2020. A total of 3174 blood donors donated blood at the center. A descriptive cross-sectional study was conducted on them. Blood donor information was registered at the reception department, and all blood screening tests were performed. Data of HBsAg and total anti-HBc were analyzed statistically by using IBM SPSS version 26. Among 3174 blood donors, male blood donors were 3158 (99.5%) and female blood donors 16 (0.5%). Furthermore, 41 (1.3%) were positive for HBsAg (which all the positive results were for male donors and no positivity were for female donors) while 353 (11.1%) were positive for total anti- HBc Ab which is distributed at ratio of 11% (350) for males and 0.1% (3) for females. On the other hand, the result of HBsAg and total anti-HBc Ab together showed three levels of positivity as the (HBsAg positive / anti-HBc negative) were 12 (0.4%) in which was a low percentage and reversely, the (HBsAg negative/ HBcAb positive) were 316 (10.2%), While the HBsAg positive / anti-HBc positive were 27 (0.9%). So this study shed light on the result of HBsAg negative/ anti-HBc positive which the percentage (10.2%) of which statistically significant (p. value = 0.000) and was the highest result indicates donors with post HBV infection or have low HBV infection. This study showed the high prevalence of post-HBV infection among blood donors. Using both markers HBsAg and total anti-HBc Ab will improve the detection of HBV before blood transfusion.

Assessment of cytotoxic T-lymphocyte antigen-4 (CD152) Levels Associated with HBV in Patients with Diabetes Mellitus

Background: Diabetes mellitus is a chronic disease characterized by an imbalance in glucose homeostasis. The hepatitis B virus is a liver-attacking virus that can cause viral hepatitis, cirrhosis, and liver cancer. A cytotoxic T-lymphocyte antigen-4 called CTLA-4 is an immune checkpoint protein that is necessary for T cells to control immune responses and stop the HBV infection from spreading. It does this by acting as an inhibitory receptor, limiting liver damage during an acute infection, and making it easier for the infection to stay in the body during a chronic case. Objective: The study aims to assess CTLA-4 levels in relation to HBV infection in diabetes mellitus patients. Subjects and methods: A cross-sectional study was conducted from July to October 2023. The serum was obtained from 200 diabetic patients who were Iraqis. All of the patients were tested using an ELISA technique for CTLA-4 and HBc IgG. They were tested using a five-panel kit for HBsAb, HBsAg, HBcAb, HBeAg, and HBeAb and measured blood sugar levels. The statistical analysis approach was conducted using SPSS version 26. Results: Serum CTLA-4 levels were correlated with serum HBc IgG positivity (P = 0.000), total HBc Ab positivity (P = 0.000), and HBs Ab positivity (P = 0.000), and CTLA-4 level was correlated with diabetes mellitus (P = 0.034). Conclusions: The study concluded that elevated serum CTLA-4 levels in diabetic patients with HBV infection and type I diabetes compared to type II diabetes. This suggests that diabetes affects the immune system's response to HBV.

Effect of obligatory Hepatitis B vaccination program on the prevalence of occult hepatitis B among pregnant women in Egypt: A cross sectional study

Hepatitis B virus (HBV) infection is a global health problem. HBV is of intermediate endemicity in Egypt. “Occult” HBV (OBI) indicates replication of HBV-DNA in the liver of individuals with negative serum HBsAg. This study aimed to determine the prevalence of OBI among pregnant women in Egypt and to compare this prevalence among HBV vaccinated and unvaccinated women (received obligatory vaccination). This cross-section study included 474 pregnant women in the third trimester divided in two groups. Group I: (n=247) assumed received obligatory hepatitis B vaccination and group II: (n=227), did not receive HBV vaccination. Study participants were screened for HBsAg, anti HBs, anti HBc total, anti HBc IgM, HBeAg, anti HBe, HCV Ab, and HIV Ab by immunoassays and HBV-DNA by Real-Time PCR. Anti HBs was detected in 65 (13.7%) of pregnant women, 36 (14.6%) in the vaccinated group and 29 (12.8%) in the unvaccinated group. The anti HBs levels were significantly higher in the unvaccinated group. HBc Ab showed positive results in 6 cases (2.4%) in the vaccinated group, and 14 cases (6.2%) in unvaccinated group. HBcAb and/or HBsAb were detected in 72 (15.1%) of pregnant women, 39 (15.8%) in the vaccinated group and 33 (14.5%) in the unvaccinated group. HBV-DNA was detected only in one vaccinated pregnant woman. HB vaccination program in Egypt, since 1992 affected the frequency of OBI in pregnant women (p=0.04). In conclusion, HBV infection may persist lifelong in the hepatocytes even when viral functions are suppressed, HBsAb and anti-HBc-positive individuals are present. The levels of HBsAb were higher in unvaccinated pregnant women compared to vaccinated pregnant women. HBV infection in OBI pregnant women may not transmit to the new-born.

Rate of occult hepatitis B virus infection among individuals with tuberculosis in northeastern Iran: A molecular epidemiological study

One third of the world population has a history of exposure to the hepatitis B virus (HBV), and two billion people are infected with latent tuberculosis (TB). Occult hepatitis B infection (OBI) is defined as the presence of replicative-competent HBV DNA in the liver with detectable or undetectable HBV DNA in the serum of individuals testing negative for the HBV surface antigen (HBsAg). Screening with HBV DNA could identify OBI and significantly reduce carriers and complications of chronic hepatitis B (CHB). This study aims to assess HBV serological markers and OBI molecular diagnosis among people with TB in Mashhad, northeastern Iran. We have performed HBV serological markers (HBsAg, HBc antibodies (Ab) and HBs Ab) in 175 participants. Fourteen HBsAg+ sera were excluded for further analysis. The presence of HBV DNA (C, S, and X gene regions) was assessed by the qualitative real-time PCR (qPCR) method. Frequencies of HBsAg, HBc, and HBs Ab were 8% (14/175), 36.6% (64/175), and 49.1% (86/175), respectively. Among these 42.9% (69/161) were negative for all HBV serological markers. The S, C, and X gene regions were positive in 10.3% (16/156), 15.4% (24/156), and 22.4% (35/156) of participants, respectively. The total OBI frequency was estimated at 33.3% (52/156) when based on detecting one HBV genomic region. Twenty-two and 30 participants had a seronegative and seropositive OBI, respectively. Thorough screening of high-risk groups with reliable and sensitive molecular methods could lead to OBI identification and decrease CHB long-term complications. Mass immunization remains critical in preventing, reducing, and potentially eliminating HBV complications.

Premarital screening of the viral hepatitis among Saudi nationals.

Blood borne sexually transmitted infections are among the most serious health problems worldwide. Many people possessing these infections do not have symptoms and may remain undiagnosed. The current study aimed to screen premaritally the incidence of blood borne viruses among Saudi nationals. A retrospective longitudinal study was conducted, using a total of 91,000 medical records, in the blood bank from a single center in the Western region of Saudi Arabia. All persons who underwent premarital examination during the period 2016-2021 for the presence of hepatitis B and C viruses as a part of the national screening program in Saudi Arabia were included in the study. Serological tests were used to screen the presence of HBc Ab and HBs Ag. Both anti-HCV antibodies and the presence of virus RNA using real-time reverse transcriptase polymerase chain reaction (RT-PCR) were also performed. The study reported the presence of 378/91000 (0.42%) infections with hepatitis B virus (HBV) as indicated by the presence of HBc Ab and HBs Ag. Meanwhile, 208 (0.23%) cases were found to be exposed to HCV including 49/91000 (0.05%) active HCV cases, positive for the HCV RNA, while 159/91000 (0.17%) persons were found to possess positive HCV antibodies in the absence of detectable HCV RNA. It was concluded that there is a low prevalence of HBV and HBV among Saudi citizens who were subjected to premarital screening.

Seroprevalence of Hepatitis B Virus and Hepatitis C Virus Infections Among People with Severe Mental Illness in Tehran, Iran

Background: High-risk behaviors in people with severe mental illnesses, such drug injection by shared equipment and unprotected sex, expose them to the risk of blood-borne infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. Objectives: This study aimed to determine the prevalence of HBV and HCV serum markers in people with severe mental illnesses in Tehran, Iran. Methods: In this cross-sectional study, people with mental illnesses, such as schizophrenia, bipolar disorder, and depression, were studied. The participants were recruited using a non-random convenience sampling method from Roozbeh and Razi hospitals in Tehran between December 2019 and March 2020. Blood samples were evaluated for HCV-Ab, HBs Ag, HBs Ab, and HBc Ab using an enzyme immunoassay technique. Results: A total of 257 participants were recruited for this study; their mean age was 35.77 years, and 70.0% of whom were male. Bipolar disorder (40.5%) and schizophrenia (35.8%) were the most frequent severe mental disorders in the participants. The prevalence of HBV and HCV seromarkers was as follows: HBs Ag: 0.3% (95% CI: 0.0 - 2.0%), HBc Ab: 7.3% (95% CI: 4.6 - 11.3%), HBs Ab: 18.7% (95% CI: 14.1 - 24.0%), and HCV Ab: 3.1% (95% CI: 1.3 - 6.9%). In logistic regression analysis, tattooing (OR = 4.94, 95% CI: 1.73 - 14.13) and age (OR= 1.06, 95% CI: 1.01 - 1.11) were associated with HBV infection (HBc Ab positivity), and only tattooing (OR= 6.33, 95% CI: 1.19 - 33.80) was significantly associated with exposure to HCV. Conclusions: The results of this study showed that the prevalence of HBsAg positivity in people with severe mental illness was not higher than that in the general population of Iran; however, HCV Ab positivity was more prevalent in people with severe mental illness than in the general population of Iran. Preventive, diagnostic, and therapeutic interventions for HCV infection are needed in this population in Iran.

Treatment of Pulmonary Sarcoidosis Using Allogenic Bone Marrow-Derived Mesenchymal Stem Cell Therapy is Safe: A Case Report

Mesenchymal stem cells have a proven potent immunomodulatory effect both in vitro and in vivo. We report a case of a 67-year-old male patient, first diagnosed with sarcoidosis in 2005, that responded well clinically and biologically to ImmunoARTTM (developed by Educell Ltd.) allogenic, HLA-incompatible, and non-related bone marrow-derived MSCs in a dose of 106/kg. The patient presented to St. Catherine Specialty Hospital in 2021 with an exacerbation of respiratory symptoms. After a clinical and radiological examination with laboratory workup, radiological findings were consistent with pulmonary sarcoidosis, while laboratory work revealed increased leucocytes at 14.2 g/L, CRP at 51.2 mg/L, and lymphocytes at 4.25 g/L. The patient was then administered intravenous application of MSCs on three occasions in the out-patient clinic. MSC doses were prepared from a young, healthy donor who agreed to donate bone marrow for allogeneic treatment and who was negative for viral markers (HBs Ag, HBc Ab, HCV Ab, HIV 1-2 Ab, TPHA, HBV NAT, HCV NAT, HIV NAT) according to EU legislation. Cells were prepared in a controlled and verified laboratory for “Hospital exemption” cell preparation in the cleanroom facility in safety cabinet class A and expressed CD105, CD 73, and CD 90 but lacked the expression of CD45 and CD34. Before the treatment, standard print and detailed verbal information were provided to patients undergoing treatment. Immediately after the informed consent form (ICF) was signed by the patient. Throughout MSC therapy, the patient showed an improvement clinically and biologically with a decrease in inflammatory parameters. Laboratory values were assessed on days 2, 5, and 7. On day 7, leucocytes were 11.2 g/L, CRP 5.1 mg/L, and lymphocytes 4.0 g/L. In the follow-up period, the patient felt subjectively better, without any side effects of the MSC therapy. Unfortunately, the patient dropped out from follow-up, therefore, the prolonged effects of this therapy were not able to be assessed. Therefore, systemic MSC therapy presents an opportunity to treat sarcoidosis that needs to be further researched.

Prevalence, genotype distribution and mutations of hepatitis B virus and the associated risk factors among pregnant women residing in the northern shores of Persian Gulf, Iran.

Considering perinatal transmission and the high rate of chronic hepatitis B virus (HBV) infection in infants, diagnosis of HBV infection during pregnancy and timely interventions are of great importance. Therefore, this study was performed to investigate the prevalence and genotype distribution of HBV infection and the associated risk factors among pregnant women in the northern shores of the Persian Gulf, South of Iran. Serum samples of 1425 pregnant women were tested for the presence of HBsAg and HBcAb by ELISA (HBsAg one-Version ULTRA and HBc Ab ELISA kits, DIA.PRO, Milan, Italy). The seropositive samples were tested for the presence of HBV DNA by nested PCR, targeting S, X, pre-core (pre-C), and basal core promoter (BCP) regions of the HBV genome. The amplified fragments were sequenced by Sanger dideoxy sequencing technology to evaluate the genotype distribution and mutations of HBV infection by using the MEGA 7 software. The HBV seropositive pregnant women were tested for HCV and HIV coinfections by ELISA (HCV Ab and HIV Ab/Ag ELISA kits, DIA.PRO, Milan, Italy). Of 1425 participants, 15 pregnant women (1.05%, 95% CI: 0.64%-1.73%) were positive for HBsAg, 41 women (2.88%, 95% CI: 2.10%-3.88%) were positive for HBcAb, and 5 women (0.35%, 95% CI: 0.15% -0.82%) had HBV viremia with genotype D, sub-genotype D3 and subtype ayw2. One of the viremic samples was positive for HBcAb but negative for HBsAg, which is indicative of an occult HBV infection. HBsAg seroprevalence was higher among pregnant women aged 20 to 29 years, women in the third trimester of pregnancy, residents of Khormuj city, Afghan immigrants, illiterate women, and pregnant women with a history of tattoo and HBV vaccination. The highest rate of HBcAb seroprevalence was observed in residents of Borazjan city, Turk ethnicity, the age group >39 years, and those women with more parities and a history of abortion. Nevertheless, HBV seroprevalence among pregnant women was not statistically associated with these variables. In contrast, HBcAb seropositivity was significantly associated with the history of tattoo (P = 0.018). According to mutations analyses, seven amino acid substitutions in the HBsAg, one point mutation in the pre-C region, and five points mutations in the BCP region were detected. Besides, the BCP mutations caused amino acid substitutions in the X protein. Of note, the conversion of Ala → Val at amino acid 168 (A168V) and Thr → Pro at amino acid 127 (T127P) were detected in HBsAg of the occult HBV strain. These results indicate a relatively low prevalence of HBV infection among pregnant women in the South of Iran, while tattooing is a risk factor for exposure to HBV infection. Moreover, all of the HBV-positive pregnant women were asymptomatic and unaware of their infection. Therefore, routine screening for HBV markers during pregnancy, appropriate treatment of HBV-infected women, and HBV vaccination are recommended to decrease mother-to-child transmission of HBV.

Prevalence of hepatitis B in HIV-positive patients in Zabol

Today, due to the increase in life expectancy in HIV-infected patients, the incidence of related diseases such as hepatitis B and C due to similarity in transmission routes has become a major concern of the health community. Therefore, this study was performed to determine the prevalence of hepatitis B among HIV + patients in Zabol. This descriptive cross-sectional study was performed on 37 HIV-infected patients in Zabol city (2021-2022). In the present study, HIV-infected patients were screened for hepatitis B by measuring serum levels of HBC Ab and HBs Ag. Finally, the data in SPSS V21 software were analyzed. In the present study, a total of 37 HIV-infected patients with a mean age of 40.81- 11.64 years were evaluated. The present study's prevalence of HIV and HCV co-infection was 21.6%. Also, 13.5% of HIV patients had HBV and HCV simultaneously. Examination of risk factors for viral hepatitis in HIV-infected patients showed that unprotected sex (100%), injecting drug use or IDU (87.5%), dental procedures (75%), history of imprisonment (62.5%) and tattooing (50.5%) were the most common factors in HIV patients. Family history of hepatitis B (12.5%), alcohol (12.5%), transfusion (12.5%) and cupping (25%) were among the lowest cases in these patients. the frequency of HBV infection and co-infection with HCV and HBV in HIV-positive patients were relatively high. Except for the history of tattoos, there is no significant relationship between other risk factors and hepatitis B among HIV-positive patients.

Abstract 50: Factors Affecting the Aggressiveness of Hepatocellular Carcinoma among Hepatitis C Related Cirrhosis Patients

Abstract Purpose: The study was conducted to assess possible epidemiological, clinical and laboratory factors predicting the aggressiveness of Hepatocellular carcinoma (HCC) in HCV-related liver cirrhosis patients. Methods: A comparative hospital-based cross-sectional study was conducted. Exclusion criteria were HBsAg positive patients, and patients undergoing any treatment modalities for HCC. Complete history was taken focusing on signs and symptoms of the chronic liver disease, and clinical examination was done. Results: Among 173 patients, only 14.4% of the patients were classified as Child A. In near percentages, patients with Child B represented 43.4%, and patients with Child C were 42.2% of the studied patients. Most of the patients were males (75.7%), while the rest were females (24.3%). Patients were divided to 2 groups: group (I) included 36 patients with non-aggressive HCC (score = 4), and group (II) included 137 patients with aggressive HCC (score > 4) according to the aggressiveness index (AgI) described by Carr et al that takes in count AFP, Maximum Tumor Diameter, number of nodules and presence of portal vein thrombosis. HCC patients in group (II) were 1.9 times more likely to have positive HBc Ab as compared to patients in group (I) where (OR = 1.9, CI = 1.3 - 3.6). Multiple logistic regression analysis for predicting the aggressiveness of HCC explains that 86.7% of factors (age, Child Pugh score, BCLC staging, Gamma glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), Platelets, HBcore ab and AFP) were contributing to aggressiveness among HCC-Hepatitis C related cirrhosis patients (R 2 = 0.867) with overall significant where chi-square = 21.876, p = 0.001. Conclusion: In conclusion, age, platelets, Child Pugh score, BCLC staging, HBcore ab, ALP, GGT and AFP are significant predictors for the aggressiveness of HCC. Citation Format: Randa Salah Abd Elmoneim, Fathalla Sedki, Aida Mohey, Ehab Hassouna, Eman Tayae. Factors Affecting the Aggressiveness of Hepatocellular Carcinoma among Hepatitis C Related Cirrhosis Patients [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 50.

Hepatitis B virus infection among patients with Rheumatoid Arthritis in Suez Canal University Hospital

Background: About 350 million individuals are considered having hepatitis B virus (HBV) infections worldwide, and 6.8% of cases have been observed of a reactivation of HBV triggered by immunosuppressive medications. Due to HBV reactivation, biologic or non-biological Synthetic antirheumatic disease-modifying drugs may be involved. For rheumatologists, HBV infection is a big concern. Patients and Methods: A descriptive cross-sectional study was carried out at Rheumatology outpatient clinic at Suez Canal University Hospital, Ismailia, during the period from 22 of January to 30 of July 2020 and included 200 patients with a history of Rheumatoid Arthritis. Patients were asked about their demographics and possible risk factors, and blood samples were collected for detection of HBV markers. Results: Evidence of present or past HBV infection with positive anti-HBc was found in 12% of patients (n=24). Among them, 4 patients had Overt HBV infection with positive HBsAg (2%) and another 4 patients had Occult hepatitis B, with negative HBsAg and positive HBV DNA (2%). Regarding HBV vaccination status, we found that 4 patients (16.7%) of HBc Ab positive patients were vaccinated and 69 patients (39.2%) of HBc Ab negative patients were vaccinated. Conclusion: This research indicates that HBV among rheumatoid arthritis patients is comparatively prevalent. Moreover, HBV carriers experience rheumatological symptoms. Risk factors for HBV infection in patients with Rheumatoid Arthritis included history of needle stick injury, dental visits, and prior surgical procedures.

Determination of the prevalence of the HBs antigen and evaluation of the vaccination status against Hepatitis B among the staff of the Dschang district hospital in West Cameroon

Hepatitis B infection is a major global health problem. Sub–saharan Africa is particularly affected. The aim of this study was to determine the prevalence of HBs antigen (HBs Ag) and to assess the hepatitis B vaccine status among medical and paramedical staff at Dschang District Hospital. A descriptive cross-sectional study was conducted at Dschang District Hospital from November 2018 to June 2019. All medical and paramedical staff of the Dschang District Hospital were included, regardless of sex or age, vaccinated and unvaccinated. We assessed the level of knowledge of hepatitis B, investigated hepatitis B markers like HBs antigen (HBs Ag), HBc antibody (HBc Ab), HBs antibody (HBs Ab); we performed HBs Ab assay, investigated hepatitis B risk factors, and low hepatitis B immunization factors, among an average of 171 health personnel aged 36.48 ± 9.58. Of these, 94.7 % said they knew hepatitis B. The prevalence of hepatitis B was 7%. Nursing and paramedical professions were the main concerned by the HBs Ag positivity. The risk factors found in HBs Ag carriers were unprotected sex, scarification and blood exposure accident. There was an association between HBs antigen portage and unprotected sex (P=0.021), blood exposure accident (P=0.021) and piercing (P=0.004). However, there was no association between HBs Ag carrying and age group (P=0.779), sex (P=0.248) and marital status (P=0.779). On the basis of the statements, without a certificate, 57% of the staff said they had already been vaccinated against hepatitis B; of these, 89% had received at least 3 doses of vaccine, of which 53.3% had acquired immunity from HBV. Advanced age (over 40 years) and overweight were associated with a low response to hepatitis B vaccine. In addition, sex and smoking were not associated with low hepatitis B seroprotection. In conclusion, this study found that the prevalence of HBs Ag is still high in our context and low hepatitis B seroprotection in the study population. Hence the need for awareness-raising, systematic screening and vaccination of health personnel, training of vaccinators and monitoring of the vaccination chain.

Association of Routine Hepatitis B Vaccination and Other Effective Factors with Hepatitis B Virus Infection: 25 Years Since the Introduction of National Hepatitis B Vaccination in Iran.

Background: One of the main health problems in the world is hepatitis B virus (HBV) infection. Vaccination and other factors can affect HBV infection. As various effective factors have been reported in different regions and studies, this study aimed to investigate the association between HBV infection and routine vaccination and other effective factors 25 years since the launch of the national vaccination program in Iran.Methods: This cross-sectional study, conducted in 2017 in Shiraz (Iran), investigated factors such as demographic variables such as gender, education, and occupation, vaccination status, and the potential risk factors for HBV infection. Hepatitis B surface antigen (HBsAg) and anti-hepatitis B core antibody (HBc Ab) tests were performed to determine HBV infection status. The data were analyzed using R software (version 3.5.2), using multivariate logistic regressions and machine learning methods. The level of significance was considered below 0.05.Results: A total of 2720 individuals were enrolled in the study (194 cases with HBV infection). Based on the logistic regression analyses, factors such as a family history of the disease (OR=2.53, P<0.001), vaccination (OR=0.57, P=0.004), a history of high-risk behaviors (OR=1.48, P=0.022), and occupation (OR=1.80, P=0.035) were significantly associated with HBV infection. Based on the conditional tree method, a family history of infection (P<0.001) and vaccination (P=0.023) were two important factors in classifying individuals for HBV infection.Conclusion: Based on the different methods applied in this study, HBV infection was affected by factors such as a family history of the disease, national HBV vaccination, and occupation. It appears that HBV vaccination, launched by the Iranian Ministry of Health and Medical Education in 1993, has reduced HBV infection.

Hepatitis B Seroprevalence among Egyptian University students in the postinfant compulsory vaccination period

Background The three doses constituting the hepatitis B (HB) vaccine series administered intramuscularly at birth, 1 month, and 6 months induce a protective antibody response (anti-HBs &gt;10 IU/l) in more than 90% of recipients. Aim To analyze the long-term immunity and effectiveness of hepatitis B virus (HBV) vaccination and to detect hepatitis B infection situation and its risk factors among an adequate number of the university students in the postcompulsory infant vaccination period. Patients and methods A total of 400 university students (aged 17–25 years) were screened for quantitative detection of hepatitis B surface antibody, hepatitis B surface antigen (HBs Ag), and total hepatitis B core antibody (HBc Ab) using commercially available kits. HBV DNA PCR was evaluated in repeatedly positive HBs Ag and/or total HBc Ab. Results Nonprotective titer less than 10 IU/l was detected in 218/400 (54.5%), whereas protective titer more than or equal to 10 IU/l was detected in 182/400 (45.5%). Overall, 29/400 (7.3%) were positive for HBs Ag and 50/400 (12.5%) were positive for total HBc Ab, whereas only six (1.5%) were positive for HBV DNA PCR. Moreover, 45/400 (11.4%) students had a history of HBV vaccine booster dose in the protective group. Conclusions Marked reduction in HBs Ab titer was observed among university students where nonprotective titer less than 10 IU/l was detected in 54.5%. Chronic HBV inactive carrier was detected in 5.3%, chronic hepatitis B was detected in 1.5%, and resolved HBV infection was detected in 11%.

Role of Innate Immunity in Patients with HBV Infection

Background: The hepatitis B virus [HBV] is an infectious disease and its one of the great public health problem, its outcome depends on the kinetics of the virus-host interaction and specifically on the strength of the innate and adaptive, humoral and cellular immune response. Thus interactions between the virus and the components of immune systems plays an important role in the pathogenesis of the disease. This study aimed to evaluate innate immune response in different clinical courses of HBV infection by estimation serum levels of granulocytemacrophagecolony stimulating factor (GM-CSF), Interleukin-1 (IL-1 ), Interleukin-8 (IL-8 ) , immunoglobulin A (IgA), IgM, IgG and Complement component (C3and C4) levels. Aim of study: to evaluate role of immune response in clinical course of hepatitis B infection Patients and Method: This study based on 78 patients with HBV infection attending the Public Health Laboratories. Their ages ranged from (14-65) years, (58 males and 20 females) compared with 20 healthy subjects (12 males and 8 females) as control group. This study extended from first of January 2015 to first of January 2017. The patients were classified to three groups on the bases of serologic markers (HBsAg, HBe Ag, HBc Ab IgM) according to WHO department of communicable disease surveillances and response, liver function tests which are used as supportive indicator for the liver injury, history of the illness, and full clinical assessment. The first group includes twenty-eight patients with acute HBV infection, second group include twenty cases identified as chronic healthy HBsAg carriers group and the last third group include thirty cases of chronic HBV group Results: By using enzyme immuno assay [ELISA] technique, serum levels of interleukin1alpha [IL-1α], interleukin-8 [IL-8], and granulocyte-macrophage-colony stimulating factor [GM-CSF] were measured in all patients compared to that of healthy control group. The mean levels of IL-1α and IL-8 showed a significant increase in serum of patients with newly infected (acute) HBV and chronic HBV compared with studied control group [P=0.04 and P=0.001 respectivel]. However, the mean serum levels for IL-1α and IL-8 recorded a non significant increase in patients with chronic healthy HBsAg carriers [P=0.17 and P=0.4 respectively]. While the mean serum levels of GM-CSF showed a significant rise in acute HBV only [P=0.01]. Moreover, serum immunoglobulins [IgG, IgM, IgA] and complement component [C3, C4] levels also evaluated by using single radial immunodiffusion test (SRID). The mean serum IgA, IgG and IgM levels showed a significant increase in chronic HBV group as compared to that of control group [ P=0.000 ,P=0.000 and P=0.001 respectively].. The mean serum C3 and C4 levels showed a significant lower serum level in all groups compared to control studied group [P=0.000]. Conclusion: this data demonstrate that immunological differences do exist between different clinical groups with HBV infection and may reflect the role of the innate immune system in host defense and disease

Hepatitis B virus reactivation in kidney transplant patients with resolved hepatitis B virus infection: Risk factors and the safety and efficacy of preemptive therapy.

Hepatitis B virus (HBV) reactivation is associated with complications and adverse outcomes in patients with clinically resolved HBV infection who are seronegative for hepatitis B surface antigen (HBs Ag), and seropositive for hepatitis B core antibody (HBc Ab) and/or hepatitis B surface antibody (HBs Ab) before kidney transplantation (KT). We retrospectively analyzed 52 patients with resolved HBV infection who were HBV-DNA negative. HBV-DNA after KT was evaluated, and the occurrence of HBV reactivation and outcomes were monitored. We defined HBV reactivation as seropositivity for HBV-DNA at or above the minimal detection level of 1.0log IU/mL and treated preemptively (using entecavir) when the HBV-DNA level was at or above 1.3log IU/mL, in accordance with the Japanese Guidelines for HBV treatment. Among the 52 patients, the mean age was 57.2±10.8years. The median HBc Ab titer was 12.8 (interquartile range, 4.6-42.6) cutoff index, and five (9.6%) cases of HBV reactivation occurred. No patients developed graft loss and died due to HBV reactivation. Statistical analysis showed that age and HBc Ab titer were significant risk factors for HBV reactivation (P=.037 and P=.042, respectively). No significant differences were found between graft survival and the presence or absence of HBV reactivation. These results suggest that HBc Ab titer and age could be significant risk factors for HBV reactivation. Resolution of HBV infection did not appear to be associated with patient or graft survival, regardless of whether HBV reactivation occurred, when following our preemptive strategy.

Usefulness of nucleic acid testing among negative HBs Ag blood donors in Egypt

IntroductionHepatitis B viral infection has been transmitted from donors with HBV infections who have negative HBs Ag. Many countries have implemented nucleic acid testing (NAT) to screen donors with non- reactive HBs Ag for detection of HBV DNA and enhance safety of blood transfusion, while it is restricted to limited blood banks in Egypt. ObjectiveTo evaluate the significance of NAT technology in detection of HBV DNA in the Egyptian blood donors with HBs Ag non- reactivity. MethodsThe study included 36,584 collected blood samples from volunteer blood donors at the blood bank of Zagazig University Hospitals. Each specimen was tested for HBs Ag; non- reactive sera were further tested for qualitative detection of HBV-DNA by NAT testing. All positive HBV-DNA donors were tested for anti- HBc and anti- HBs by electro-chemiluminescence immunoassay and confirmed by quantitative RT-PCR. ResultsAmong 34,671 donors non-reactive to HBs Ag, 34,657 (99.96%) were tested negative for HBV- DNA and 14 specimens (0.04%) were positive for HBV via NAT testing. Among HBV NAT positive donors, HBs Ab reactive only in (2); HBc Ab reactive only in (3); HBs and HBc Abs reactive in (3) while HBs and HBc Ab non-reactive in (6). All tested sera 14 (100%) showed low viral load for HBV (<50 IU/ml) confirmed by RT- qPCR. ConclusionOur results highlighted the significance of the HBV NAT technique to reduce the potential risk of HBV transfusion-transmission and the critical need to enforce the usage of NAT technology in all blood banks in Egypt.

Retracted: The relationship between multiple sclerosis and recombinant hepatitis B vaccine

Introduction: Multiple sclerosis is a neurological disease, a demyelinating inflammation that can be caused by complex genetic conditions and environmental factors (infection with viruses such as hepatitis B) or other foreign illnesses. But there is the question of whether hepatitis vaccination can be linked to the disease. The purpose of this case-control study was to investigate the relationship between hepatitis B vaccine and multiple sclerosis Materials and Methods: In this descriptive-analytic study, multiple sclerosis patients referred to the neurology clinic and neurology part of Imam Reza Hospital and Razi Tabriz were enrolled during the period from April 2014 to April 2012. In this study, 125 patients were considered as patients and 125 were considered as healthy. Serum HBs Ab and HBc Ab tests were performed and data were analyzed using statistical software SPSS 17. Statistical analysis was performed. Results: In this study, 125 patients with multiple sclerosis and 125 healthy subjects were compared. In each study group, 50 (40) patients were male and 75 (60) were female. In the study, no significant difference was found between the two groups in the HBs - Ab (p = 0.73) and HBc - Ab (p = 0.066) headings. Conclusion: Vaccination does not seem to have an effect on multiple sclerosis, or the effect on the immunization of the disease is not caused by the disease.

Hepatitis B virus DNA in Blood Donors Positive of Anti-Hepatitis B Core Antibodies and Negative for Surface Antigen in Hawler Major Blood Bank, Kurdistan Region, Iraq

Background: Occult Hepatitis B virus infection (OBI) among blood donors is an important medical concern.Objectives: This study was done to detect the presence of occult hepatitis B virus infections among blood donors with negative hepatitis B surface antigen and positive total anti-hepatitis B core antibodies in Hawler Major Blood Bank in Hawler city/Kurdistan Region of Iraq.Methods: A total number of 12,185 blood donors in Hawler Major Blood Bank were screened for HBsAg and total anti-HBcAb using ELISA technique, and then positive results were retested by confirmatory technique by Chemiluminescence assay. All HBsAg-/HBcAb+ were selected as the study group; HBV DNA was tested among HBsAg-/HBcAb+ by conventional PCR and Real time-PCR. Clinical and demographic data of study group were recorded.Results: Among the 12,185 blood donors, HBsAg was positive in 27 (0.22%) donors using Chemiluminescence assay, the frequency of HBs Ag -/ HBc Ab+ was 276 (2.27%), and then the total prevalence of HBV infection in all blood donors was 2.49%. Among the 276 HBs Ag-/HBcAb+, occult hepatitis B virus infection (OBI) was positive in 39.1% (108/276) using conventional PCR and Real time-PCR techniques, while the prevalence among all blood donors (n=12,185) was 0.09%. Testing of HBV-DNA in HBs Ag -/ HBc Ab+ group for OBI was done by qualitative PCR (positive HBV-DNA=102/276) or by quantitative Real time-PCR (positive HBV-DNA=108/276).Conclusions: The OBI is frequently detected among blood donors in Hawler city especially those have HBsAg-/HBcAb+, and the total anti-HBcAb is an essential serological marker for screening HBV among blood donors. The risk factors for developing OBI among blood donors should be elucidated.&#x0D; &#x0D; الحامض النووي الريبوزي منقوص الأكسجين للفايروس الكبدي نوع ب في دم المتبرعين والموجب لأضداد اللب للفايروس وسالب للستضد السطحي للفايروس في مصرف الدم الرئيسي في اربيل/كردستان العراق&#x0D; رشا نزار حسن&#x0D; علي حاتم حسين&#x0D; نظرة اولية: ان تواجد الاصابة بالفايروس الكبدي نوع ب لدى المتبرعين بالدم يعتبر من الحالات الطبية التي يجب الانتباه اليها.&#x0D; الاهداف: تم اجراء هذه الدراسة على المتبرعين بالدم في مصرف الدم الرئيسي في مدينة اربيل/كردستان العراق , لغرض التحري عن وجود الاصابات الكبدية الفايروسية نوع ب المخفية لدى المتبرعين بالدم والذين يكون المستضاد السطحي الفايروسي الكبدي نوع ب (HBsAg) سالبا لديهم ويكون المضاد اللبي الكلي لنفس الفايروس(anti-HBcAb) موجبا.&#x0D; طريقة البحث: تم فحص اثنا عشر الفا ومائه وخمس وثمانين متبرع بالدم في مصرف الدم الرئيسي في مدينة اربيل لغرض الكشف عن (HBsAg) و (anti-HBcAb) وان النتائج الموجبة تم اعادة فحصها بطرق فحص تأكيدية. ان كل المتبرعين ذوو النتائج (السالبة HBsAg ) / و (الموجبة anti-HBcAb) تم انتقئهم كمجموعة الدراسة وتم فحص وجود الحامض النووي الريبوزي منقوص الأكسجين للفايروس الكبدي نوع ب لديهم في الدم بطريقتين: طريقة تفاعل البوليميراز المتسلسل التقليدية وطريقة تفاعل البوليميراز المتسلسل اللحظي. كما تم تسجيل البيانات الديموغرافية والسريرية لمجموعة الدراسة.&#x0D; النتائج: لدى فحص المتبرعين البالغ عددهم اثنا عشر الفا ومائه وخمس وثمانين متبرع تبين وجود سبعة وعشرون اصابة (0.02%) بالمستضاد (HBsAg) اما عدد المتبرعين الذين ليس لديهم / HBsAg والموجبة للمضاد anti-HBcAb فقد كان 276 (2.27%) وقد تبين ان نسبة انتشار الخمج البدي الفايروسي نوع ب لدى المتبرعين كان 2.49%.&#x0D; عند فحص مجموعة الدراسة البالغ عددها 276 والذين كانت نتيجة فحصهم موجبة للمضاد /HBcAb,وسالبة للمستضاد HBsAg ,تبين وجود الخمج الفايروسي الكبدي نوع ب المخفي في 39.1% (108/276), بينما كانت نسبة انتشار نفس الخمج لدى مجموع المتبرعين الكلي البالغ 12185 هو 0.09%. لقد كانت نتيجة فحص وجود الحامض النووي الريبوزي منقوص الأكسجين للفايروس الكبدي نوع ب بالطريقة القليدية هي 102 متبرع من مجموعة الدراسة الباغة 276 اما النتيجة لنفس مجموعة الدراسة لنفس الحامض النووي بطريقة تفاعل البوليميراز المتسلسل اللحظي كانت 108.&#x0D; الاستنتاج: لقد بينت هذه الدراسة وجود وجود الخمج الفايروسي الكبدي نوع ب المخفي بصورة متكررة لدى المتبرعين بالدم في مدينة اربيل وخاصة الذين تكون حالتهم موجبة للمضاد /HBcAb, وسالبة للمستضاد HBsAg كما بينت الدراسة ان فحص المضاد اللبي للفايروس الكبدي نوع ب هو ضروري عند التحري عن وجود وجود الخمج الفايروسي الكبدي نوع ب لدى المتبرعين بالدم, كما انه من الضروري التقصي عن عوامل الخطورة التي تؤدي الى الاصابة بالخمج الفايروسي الكبدي نوع ب المخفي.&#x0D; الكلمات المفتاحية: المتبرعون بالدم, الخمج الفايروسي الكبدي نوع ب المخفي, مدينة اربيل, مصرف الدم, تفاعل البوليمراز المتسلسل التقليدي واللحظي

Hepatitis B virus DNA in Blood Donors Positive of Anti-Hepatitis B Core Antibodies and Negative for Surface Antigen in Hawler Major Blood Bank, Kurdistan Region, Iraq

Background: Occult Hepatitis B virus infection (OBI) among blood donors is an important medical concern.Objectives: This study was done to detect the presence of occult hepatitis B virus infections among blood donors with negative hepatitis B surface antigen and positive total anti-hepatitis B core antibodies in Hawler Major Blood Bank in Hawler city/Kurdistan Region of Iraq.Methods: A total number of 12,185 blood donors in Hawler Major Blood Bank were screened for HBsAg and total anti-HBcAb using ELISA technique, and then positive results were retested by confirmatory technique by Chemiluminescence assay. All HBsAg-/HBcAb+ were selected as the study group; HBV DNA was tested among HBsAg-/HBcAb+ by conventional PCR and Real time-PCR. Clinical and demographic data of study group were recorded.Results: Among the 12,185 blood donors, HBsAg was positive in 27 (0.22%) donors using Chemiluminescence assay, the frequency of HBs Ag -/ HBc Ab+ was 276 (2.27%), and then the total prevalence of HBV infection in all blood donors was 2.49%. Among the 276 HBs Ag-/HBcAb+, occult hepatitis B virus infection (OBI) was positive in 39.1% (108/276) using conventional PCR and Real time-PCR techniques, while the prevalence among all blood donors (n=12,185) was 0.09%. Testing of HBV-DNA in HBs Ag -/ HBc Ab+ group for OBI was done by qualitative PCR (positive HBV-DNA=102/276) or by quantitative Real time-PCR (positive HBV-DNA=108/276).Conclusions: The OBI is frequently detected among blood donors in Hawler city especially those have HBsAg-/HBcAb+, and the total anti-HBcAb is an essential serological marker for screening HBV among blood donors. The risk factors for developing OBI among blood donors should be elucidated.&#x0D; &#x0D;