HBsAg-positive Cases Research Articles

Prevalence of Hepatitis B Serological Markers Among People Who Referred to a Great Laboratory in Neyshabur, Northeast of Iran

Background: Iran has been known as an area with low-intermediate prevalence for the hepatitis B virus (HBV) infection. Objectives: This cross-sectional study was performed to assess the prevalence of serological markers and the potential risk factors of HBV infection among people who referred to the Neyshabur Lab of Academic Center for Education, Culture, and Research (ACECR), Razavi Khorasan Branch, northeast of Iran. Methods: The 2669 serum samples were assessed to detect the hepatitis B surface antigen (HBsAg) by enzyme-linked immunosorbent assay (ELISA) during June 2015 to February 2016. In the case of HBsAg positive, hepatitis B e antigen (HBeAg), hepatitis B e antibody (HBeAb), total hepatitis B core antibody (anti-HBc), and IgM anti-HBc were evaluated. Moreover, demographic data and risk factors related to HBV infection were assessed. Results: A total of 2099 (78.6%) females and 570 (21.4%) males with a mean age of 32.4 ± 13.1 years were enrolled. HBsAg seropositivity was observed in 90 (3.37%) individuals. ELISA tests for HBeAg, anti-HBe, total anti-HBc, and IgM anti-HBc were positive in 8 (8.9%), 75 (83.3%), 90 (100%), and 11(12.2%) of 90 HBsAg-positive cases, respectively. Age, sex, household size, and education level were significant risk factors for the infection. Conclusions: Prevalence of HBV infection in Neyshabur could be considered as an intermediate level. Although some reasons for which individuals referred, were suggesting hepatitis.

Prevalence of hepatitis B Virus in clinically suspected infectious hepatitis in Meerut, I

Objective:-Hepatitis B is noteworthy medical issues that may include the late continuation of liver cirrhosis and hepatocellular carcinoma. The present study aimed to know the seroprevalence of hepatitis B Virus in Meerut with different clinical conditions.
 Methods: The studyconducted on 4927 patients in Meerut, India, which was performed in central research center labortory of Microbiology at netaji subhash Chandra Bose Medical College and Hospital Between January 2013 to April 2017 The sera were separated and screened for HBsAg byimmune-chromatographic card test then HBsAg positive serum sampleswere tested again for HBsAg using ELISA kit. Positive samples for HBsAgwere tested for HBeAg ELISA kit.
 Results: In 245 positive cases 118 (48.16 %) were male and 127 (51.84%) were female. The seroprevalence rate of HBV was 4.97% in Meerut, India. Age group21–30 was the highest seroprevalence (7.46%) when compaired to other age group. Of the 245 HBsAg Positive case 55 (1.12%) were HBeAg positive. 20 were male, Highest HBeAg positive male were found in 21- 30age group. Out of 55 HBeAg cases, 35 were female and 92 female were negative for HBeAg, this was stastically significant (P< 0.039) by using Z test.
 Conclusions: The study uncovered that the seroprevalence of HBV was alarmingly higher in such a populace, which presumably mirrors a high foundation predominance of HBV contaminations ought to be mulled over and Implementation of group based preventive measures and enhanced procedures for safe blood supply may demonstrate valuable to diminish the seroprevalence
 Bangladesh Journal of Medical Science Vol.18(2) 2019 p.329-333

A system dynamics modelling simulation based on a cohort of hepatitis B epidemic research in east China community.

Hepatitis B constitutes a severe public health challenge in China. The Community-based Collaborative Innovation hepatitis B (CCI-HBV) project is a national epidemiological study of hepatitis B and has been conducting a comprehensive intervention in southern Zhejiang since 2009.The comprehensive intervention in CCI-HBV areas includes the dynamic hepatitis B screening in local residents, the normalised treatment for hepatitis B infections and the upcoming full-aged hepatitis B vaccination. After two rounds of screening (each round taking for 4 years), the initial epidemiological baseline of hepatitis B in Qinggang was obtained, a coastal community in east China. By combining key data and system dynamics modelling, the regional hepatitis B epidemic in 20 years was predicted.There were 1041 HBsAg positive cases out of 12 228 people in Round 1 indicating HBV prevalence of 8.5%. Of the 13 146 people tested in Round 2, 1171 people were HBsAg positive, with a prevalence of 8.9%. By comparing the two rounds of screening, the HBV incidence rate of 0.192 per 100 person-years was observed. By consulting electronic medical records, the HBV onset rate of 0.533 per 100 person-years was obtained. We generated a simulated model to replicate the real-world situation for the next two decades. To evaluate the effect of interventions on regional HBV prevalence, three comparative experiments were conducted.In this study, the regional hepatitis B epidemic in 20 years was predicted and compared with HBV prevalence under different interventions. Owing to the existing challenges in research methodology, this study combined HBV field research and simulation to provide a system dynamics model with close-to-real key data to improve prediction accuracy. The simulation also provided a prompt guidance for the field implementation.

Detection of Hepatitis B Genotypes in HBsAg & HBeAg Carriers

Objective:- Hepatitis B is noteworthy medical issues that may include the late continuation of liver cirrhosis and hepatocellular carcinoma. The present study aimed for the detection and diffrentiation of Hepatitis B virus HBsAg inactive non-replicative carriers, HBeAg-positive inactive replicative carriers, active carriers & HBeAg-negative chronic hepatitis B by Real Time PCR and their genotyping
 Methods: This research conducted on 245 positive for HBsAg, 118 (48.16 %) were male and 127 (51.84%) were female patients, which was performed in central research station labortory of Microbiology at netaji subhash Chandra Bose subharti Medical College and Hospital, Meerut Between march 2016 to November 2017 The sera were separated and screened for HBsAg by ELISA kit. Positive samples for HBsAg were tested for HBeAg ELISA kit and DNA Viral load then sequenced for genotying
 Results:. Of the 245 HBsAg Positive case 55 (1.12%) were HBeAg positive. In 16 PCR positive and HBV genotyping, In HBsAg inactive Non-Replicative 37.5% (n=6) genotype-B and 6.25% (n=1) genotype-A, In HBeAg inactive Replicative 12.5% (n=2) genotype-B and 12.5% (n=2) genotype-A and In HBeAg Active Chronic Hepatitis B 18.75% (n=3) genotype-B and 12.5% (n=2) genotype-A were detected
 Conclusions: Management strategy, using HBsAg, HBeAg and HBV DNA viral load, seems adequate for the confirmation and diffrentiation of Hepatitis B virus inactive, active carriers & HBeAg-negative chronic hepatitis B patients and genotype B was more prevalent in comparission to genotype A. Distribution of carriers & genotypes, help physicians to prescribe proper antiviral/interferon therapy according to current genotyping pattern in this region
 Keywords: Hepatitis B virus, Carrier State, HBsAg, HBeAg, RT-PCR

Peer-to-Peer Sessions in Primary Care to Improve the Hepatitis B Detection Rate in Seville, Spain

Introduction and aim. The detection of hepatitis B virus (HBV) depends on primary care center activity. The present study aims to investigate the impact of peer-to-peer sessions with hepatologists on hepatitis B screening efficacy in primary care centers.Material and methods. Peer-to-peer one-hour sessions were scheduled to improve the screening program for HBV in Seville, Spain. The sessions were focused on who should be tested for HBV and how positive cases should be referred. Fourteen out of 26 health care centers were selected to participate in peer-to-peer sessions. The centers were classified according to how many sessions they held (no sessions, one session or more than one session).Results. Over a five-year period, HBV screening was performed in 32 203 people. In Seville, the prevalence of HBsAg was 0.87% (283/32 203). The detection rates for new HBsAg-positive cases were 7.1, 16.9 and 21.3 cases/105 population/year in non-session, one-time session and more than one session centers, respectively (p < 0.05). The rate of patients who effectively visited centers as outpatients was significantly higher after peer-to-peer sessions-86/94 (91%) for one session and 81/89 (91%) for two session centers vs. 16/27 (67%) for non-session centers (p = 0.002). The only independent predictor of patient referral was peer-to-peer sessions (OR, 1.925 [95% CI, 1.002-3.699]; p < 0.05).Conclusions. Peer-to-peer sessions in primary care centers increased HBV detection and visitation rates.

Prevalence of chronic hepatitis B infection among residents of hilly tribal district in northern India

Background: Viral hepatitis B is a systemic infection affecting predominantly the liver, caused by hepatitis B virus. The similarity of hilly tribal’s in spiti and the Tibetans with documented high prevalence of HBsAg encouraged us to explore the burden of the hepatitis B infection in them as well. So the study was designed to document the prevalence of the chronic hepatitis B infection for timely intervention with the required prevention and control measures.Methods: 30 cluster villages from the 82 inhabitated villages were taken with 37 samples from each cluster village. Data was collected using interview schedule. Serum samples were taken and subjected to sandwich ELISA for the detection of HBsAg and positive samples were tested for the HBeAg then after.Results: The study included 1110 participants with 424 males. 99.7% of them were Buddhist and 98.5% belonged to Scheduled Tribe category. 60.1% were educated up to the middle and18% were illiterates. The prevalence of HBsAg was 21.9% (CI 19.6-24.6) with 22.6% in females and 20.9% in males. HBeAg was positive in 24.4% of HBsAg positive cases, higher in the 15-24 years age group and 30.5% in the reproductive females.Conclusions: The current study has reported hyper endemic (21.9%) sero-prevalence of HBsAg with infectivity rate of 24.4%, more in the young and reproductive population. The infection is homogenously distributed among the Buddhist tribal population in the study area.

Prevalence of Transfusion Transmissible Infections In Blood Donors

Background: Blood transfusion is a significant life-saving intervention in the present era of patient management system. As the blood and blood products are a potential source of infection and the necessity of transfusion is increasing day by day, transfusion transmissible infections (TTIs) have become a major threat to ensure safe transfusion.&#x0D; Objectives: The aim of this study was to assess the prevalence of some common and serious TTIs among blood donors as well as evaluate the pattern of seroprevalence in accordance with few other characteristics.&#x0D; Methods: It was a cross sectional study which was conducted at the Department of Transfusion Medicine of Armed Forces Institute of Pathology (AFIP), Dhaka Cantonment from January 2015 to June 2017. Donors were selected very carefully according to criteria of National Guidelines of Bangladesh Government and by using a detailed questionnaire. They were screened properly for HBV, HCV, HIV, Malaria and Syphilis. All positive cases were confirmed again by using more sensitive and specific tests. We analyzed the data as percentage and comparison.&#x0D; Results: A total of 32,625 donors were screened. Among them 28,775 were male and 3850 female. Total 135 were found reactive in the screening assays and among them no one was reactive in more than one assays. The prevalence of HBV and HCV in our study population was 0.38% and 0.03% respectively. It was found that percentage of HBV and HCV seropositivity was more among civilian donors. There was no positive case of Malaria, Syphilis and HIV. The number of seropositive cases were found to be decreased gradually in consecutive years. The study also revealed that both HBsAg and Anti-HCV positive cases were more prevalent amongyoung donors.&#x0D; Conclusion: Our study revealed that a significant number of donors were positive for TTIs who might be a potential source of transfusion related infections. It justifies the necessity of stringent screening of blood donors to prevent the transfusion transmissible infections.&#x0D; Bangladesh J Med Microbiol 2018; 12 (1): 20-23

Hepatitis B and C Viruses, their coinfection and correlations in chronic liver disease patients: A tertiary care hospital study

Introduction:There has been a rapid increase in the cases of viral hepatitis in Malwa region of Punjab. Quantification of seroprevalence of hepatitis B virus (HBV)/hepatitis C virus (HCV) and their coinfection among liver disease patients in tertiary care settings is needed to know the associated disease burden.Aim:The aim of this study is to analyze the seroprevalence of HBV, HCV, their coinfection, and implications in liver disease patients.Materials and Methods:This prospective study was conducted from June 2015 to August 2015 on a total of 100 chronic liver disease (CLD) patients. Venous blood samples were tested for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies by performing required serological tests using sandwich ELISA technique and solid-phase immunochromatography.Results:Out of 100 cases, 80 (80%) were male and 20 (20%) were female with mean age of 47.44 ± 14.56 years. Out of 100 cases of hepatic disorders, 26 were HBsAg positive and 40 were anti-HCV positive. Majority of the HBsAg-positive cases had alcohol as a risk factor (27%) and were diagnosed with cirrhosis (38.5%). Maximum number of anti-HCV-positive cases had blood transfusion as risk factor (30%) and were diagnosed with cirrhosis (45%). Out of total 62 seropositive cases, 4 had coinfection of HBV and HCV. Coinfected patients did not demonstrate greater risk of developing cirrhosis or progressing to hepatocellular carcinoma than mono-infected patients.Conclusion:HBV and HCV are the major causes of CLD at the place of study. Patients with dual HBV and HCV infection do not have greater risk of developing cirrhosis or progressing to HCC than mono-infected patients.

Current prevalence of chronic hepatitis B and C virus infection in the general population, blood donors and pregnant women in the EU/EEA: a systematic review.

This systematic review aimed at estimating chronic hepatitis B (HBV) and C virus (HCV) prevalence in the European Union (EU) and Economic Area (EEA) countries in the general population, blood donors and pregnant women. We searched PubMed©, Embase© and Cochrane Library databases for reports on HBV and HCV prevalence in the general population and pregnant women in EU/EEA countries published between 2005 and 2015. Council of Europe data were used for HBV and HCV blood donor prevalence. HBV general population estimates were available for 13 countries, ranging from 0·1% to 4·4%. HCV general population estimates were available for 13 countries, ranging from 0·1% to 5·9%. Based on general population and blood donor estimates, the overall HBV prevalence in the EU/EEA is estimated to be 0·9% (95% CI 0·7-1·2), corresponding to almost 4·7 million HBsAg-positive cases; and the overall HCV prevalence to be 1·1% (95% CI 0·9-1·4), equalling 5·6 million anti-HCV-positive cases. We found wide variation in HCV and HBV prevalence across EU/EEA countries for which estimates were available, as well as variability between groups often considered a proxy for the general population. Prevalence estimates are essential to inform policymaking and public health practice. Comparing to other regions globally, HBV and HCV prevalence in the EU/EEA is low.

Efficacy and Safety of Vaccination Against Hepatitis B Virus Without Prior Screening Test

Hepatitis B virus infection is a major global health problem. There is no specific treatment for acute hepatitis B infection. A safe and effective vaccine, which has been available for more than 30 years, is 95% effective in preventing the development of chronic infection. The employee of Bangladesh Bank and their family member had received 4 doses of Engirex B according to schedule 0, 1,6,12 months without any prior screening test. They received 4th booster dose in 2009.The goal of this study to find out and compare the efficacy and safety of vaccination against HBV without prior screening test. The employee (more than 50years old) underwent annul health check up and their serum HBsAg and Anti-HBs (quantative) were measured in the Immunology department of Bangladesh Institute of Research &amp; Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) and Popular diagnostic center. HBsAg is measured by MEIA method. Anti-HBs (quantative) are measured by chemiluminescence EIA method. 491 subjects have been studied. Among them 480(97.76%) are HBsAg negative and 11(2.24%) cases are HBsAg positive. Ten out of eleven HBsAg positive cases are male. The average anti- HBs titer of the employee is 610.9958(0- &gt;2000 m IU/ml). The average anti-HBs titer of female (n=90) employee is 713(10- &gt;2000 mIU/ml) and average anti-HBs titer of male (n=390) employee is 587.77(0 - &gt;2000 m IU/ml). Female employee developed higher immunity (73.33%) than male employee (56.41%). So it is presumptive that vaccine is safe and effective and we can continue vaccination without prior screening test.J Dhaka Medical College, Vol. 25, No.1, April, 2016, Page 16-25

World Hepatitis Day in Burkina Faso, 2016: Awareness, Screening, Identification of HBV Markers, HBV/HCV Coinfection, and Vaccination

Background: Hepatitis B virus (HBV) can cause chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Coinfection with hepatitis C virus (HCV)/HBV leads to a higher risk of liver damage. Development of HBV awareness campaigns could reduce the prevalence of this disease and limit the consequences. Objectives: The aim of this study was to sensitize, detect, and identify HBV markers and propose vaccination for people not infected with HBV. Methods: With the support of “SOS Hepatitis Burkina” association, an HBV screening program, available for all volunteers, was implemented in several localities of Ouagadougou and the surroundings. A rapid HBsAg detection test was performed on 2207 subjects, who voluntarily answered a series of questions. A rapid detection test of HCV antibodies was performed in HBsAg-positive cases. HBV markers were also determined in HBsAg-positive cases. Results: In a sample of 2207 individuals, aged 1 - 85 years (mean age, 31.4 ± 15.7 years), the prevalence of HBsAg was 9.8% (217/2207) after screening. Before screening, 6.8% (150/2207) of the participants claimed that they were vaccinated against HBV. Also, multivariate analysis revealed that HBV infection was significantly associated with age (21 - 30 years) and vaccination status (P = 0.03; OR, 1.67; 95% CI, 1.04 to 2.69 and P = 0.003; OR, 5.69; 95% CI, 1.80 to 18.00, respectively). Among 217 HBsAg-positive cases, the prevalence of HBV markers was reported as follows: AbHBs (0.9%), HBeAg (6.0%), AbHBe (87.6%), and AbHBc (100.0%). Based on the findings, HCV was detected in 0.9% (2/217) of HBsAg-positive subjects. In this study, 628 out of 1990 HBsAg-negative subjects were vaccinated for three doses, resulting in a vaccination rate of 31.6%. Conclusions: The present study reported an HBsAg prevalence of 9.8% in the study population. This intervention could contribute to major vaccination coverage against HBV after screening. Therefore, raising awareness and development of screening campaigns on HBV can increase the vaccination coverage of the population. The findings also showed that absence of vaccination against HBV constitutes a high-risk factor for HBV infection.

Investigation of HBV DNA in HBsAg positive patients

Hepatitis B virus is an important health problem which about 400 million people are infected chronically and 500,000 to 1,200,000 people die every year due to HBV-related diseases. In the study we aimed to investigate the HBV DNA results in HBsAg positive patients. HBsAg positivity was detected by ELISA method in patients who were admitted to our hospital with suspicion of hepatitis. HBV DNA was performed by real time PCR. In this context, the presence of HBV DNA in serum sample results of 2437 HBsAg-positive patients which were sent to our Microbiology laboratory between August 2014 and August 2015 was retrospectively examined. HBV DNA was positive in 1037 (42.5%) and 1400 (57.5%) of the HBsAg positive cases. 42.2% of male patientsÂ’ and 43% of female patientsÂ’ HBV DNA was positive. HBV DNA positivity was detected in 42% of adult patients and 55% of children in child age group. As a result; we suggest that viral replication should be demonstrated in HBsAg-positive cases and HBV DNA level should be determined for follow-up the antiviral therapy.

Prevalence of hepatitis B in pregnant women and management of babies born to Hepatitis B positive mother: a criterion based clinical audit

Introductions: This study aims at identifying the prevalence of Hepatitis B virus infection in pregnant women and adherence to the management of the newborns of these women as per the international guidelines.Methods: This was a cross sectional study conducted at Patan Hospital from January 1, 2008 to December 30, 2014. Prevalence of HBsAg in pregnant women in Patan Hospital and management of babies born to these women, the immunization status, breast feeding status and follow up advice for the babies were studied. These data were analyzed to see whether we were following international guidelines for preventing mother to child transmission of hepatitis B infection.Results: There were total of 58,917 deliveries and 59,438 births during the seven-year study period. During this period, total 148 cases of pregnant ladies with HBsAg positive status were recorded. The prevalence of HBsAg positive case was 0.25% or 1 in every 398 deliveries. Fifty-four babies (87%) received hepatitis B vaccine (HBV) and hepatitis B immunoglobulin (HBIG) within 12 hours of birth. Eight babies (22%) failed to receive HBV and HBIG within 12 hours of birth. Fifty-eight (96%) babies were breastfed after birth. Mother’s HBsAg positive status was not the reason for formula feeding in any of the babies. Follow up HBsAg status was not advised in any of the babies.Conclusions: Patan Hospital seems to be following most of the guidelines in the management of HBV infection in pregnant women, except for checking the HBsAg status of their babies at 9-18 months of age.Journal of Patan Academy of Health Sciences. 2016 Dec;3(2):23-27

SY-2-7 - Effectiveness of hepatitis alert system implementation on regimen adaptation for electronic medical record

Purpose: There are some cases to become fulminant hepatitis and reached to death from fulminant hepatitis by Hepatitis B virus (HBV) reactivation after administration of the strong immunosuppressive agent or anticancer agents for the blood malignancy or malignant cancer disease patients. So it is necessary to check the HBV-DNA and liver function test for patients with Hepatitis B surface (HBs) antigen(Ag)-positive or HBsAg-negative but HBs antibody(Ab) or Hepatitis B core(HBc)Ab positive cases with regimen adaptation. We examined the number of HBV markers checked patients at adapted regimen of anticancer agent past five years in our hospital. In addition, we evaluated change of HBV markers checked ratio at the time of regimen application after hepatitis alert system implementation of electronic medical record system May 2015.Results: There are 1,726 chemotherapy patients adapted regimen in our outpatients chemotherapy room from January 1 2010 to December 31 2015.The HBsAg checked cases were 1611/1726 (93.3%) and HBsAg-positive cases were 22/1611 (1.3%). Among HBsAg-negative patients, HBsAb, HBcAb checked ratio drastically rose to 84%, 83% at after May 2015 when hepatitis alert system implementation from 18%, 10% at 2010, 21%, 16% at 2012, 29%, 28% at 2014, 58%, 56% at 2015. HBsAb and HBcAb positive rate were 100/528 (19%) and 100/472 (21.8%)before alert system, 29/156(19%) and 33/155 (21%) after. The HBV-DNA checked ratio of patients with positive HBsAb or positive HBcAb was 106/128 (83%) before, 34/38 (89%) after.Conclusion: Hepatitis alert system implementation for EMR are drastically effective for increasing checked ratio of the HBV-related marker for the chemotherapy patients at the time of the regimen adaptation on EMR system. Purpose: There are some cases to become fulminant hepatitis and reached to death from fulminant hepatitis by Hepatitis B virus (HBV) reactivation after administration of the strong immunosuppressive agent or anticancer agents for the blood malignancy or malignant cancer disease patients. So it is necessary to check the HBV-DNA and liver function test for patients with Hepatitis B surface (HBs) antigen(Ag)-positive or HBsAg-negative but HBs antibody(Ab) or Hepatitis B core(HBc)Ab positive cases with regimen adaptation. We examined the number of HBV markers checked patients at adapted regimen of anticancer agent past five years in our hospital. In addition, we evaluated change of HBV markers checked ratio at the time of regimen application after hepatitis alert system implementation of electronic medical record system May 2015. Results: There are 1,726 chemotherapy patients adapted regimen in our outpatients chemotherapy room from January 1 2010 to December 31 2015. The HBsAg checked cases were 1611/1726 (93.3%) and HBsAg-positive cases were 22/1611 (1.3%). Among HBsAg-negative patients, HBsAb, HBcAb checked ratio drastically rose to 84%, 83% at after May 2015 when hepatitis alert system implementation from 18%, 10% at 2010, 21%, 16% at 2012, 29%, 28% at 2014, 58%, 56% at 2015. HBsAb and HBcAb positive rate were 100/528 (19%) and 100/472 (21.8%)before alert system, 29/156(19%) and 33/155 (21%) after. The HBV-DNA checked ratio of patients with positive HBsAb or positive HBcAb was 106/128 (83%) before, 34/38 (89%) after. Conclusion: Hepatitis alert system implementation for EMR are drastically effective for increasing checked ratio of the HBV-related marker for the chemotherapy patients at the time of the regimen adaptation on EMR system.

Screening, characterisation and prevention of Hepatitis B virus (HBV) co-infection in HIV-positive children in South Africa

BackgroundIn South Africa, the first HBV vaccine dose is administered at age 6 weeks, leaving a potential window for vertical transmission. Insights into HBV seroprevalence in the vulnerable HIV-infected group are important to drive improvements in surveillance, treatment and prevention. ObjectivesWe set out to implement a screening program for HBV among HIV-infected children and adolescents in Kimberley, South Africa. Our aims were to demonstrate that screening is feasible and sustainable, to establish the prevalence of HBV, to characterise the HBV cases we identified, and to inform discussion about the infant vaccination schedule. Study designWe tested all HIV positive children (age 0–16) for Hepatitis B surface antigen (HBsAg), delivering this testing as part of routine state-funded care. We followed up HBsAg-positive cases with an extended panel of HBV serology tests, and HBV DNA viral load quantification. ResultsOur screening campaign was successfully incorporated into routine out-patient care. Among 625 patients tested, we found five positive for HBsAg (0.8%), of whom three were Hepatitis B e-antigen positive. Two additional children initially tested HBsAg-positive but were negative on repeat testing. Antiviral therapy in the HBsAg children was reviewed and adjusted if required. ConclusionsThe results testify to the overall success of the HBV vaccine campaign. However, we have demonstrated that ongoing vigilance is required to detect cases and prevent transmission events. Further evaluation of the optimum timing of the first vaccine HBV vaccine dose is required; a vaccine dose at birth could reduce prevalence further.

The prevalence of hepatitis B infection in central China: An adult population-based serological survey of a large sample size.

The objective of this study was to determine the prevalence of serum HBsAg among adults in Henan province, China. A provincial serosurvey of people aged 18-74 years was conducted and individuals for analysis were selected using a multistage stratified random cluster sampling method. A 5-ml serum sample from each person was collected and the serum was tested for the presence of HBsAg, HBcAb, HBsAb, HBeAg, and HBeAb by ELISA. Multivariate analysis was used to identify factors associated with the prevalence of HBsAg. A total of 16,685 residents, aged 18-74 years who resided in 60 communities or villages in Henan, China were surveyed. Among the eligible study population, 642 HBsAg positive cases (3.7%) were found. The prevalence increased steadily from 3.1% among population aged 18-35 years old, to 5.1% among population aged 55-74 years. Accordingly, HBsAb declined steadily from 53.4% to 24.7%. Six hundred and forty-two positive HBsAg blood samples were screened for the HBeAg and HBeAb. HBeAg prevalence declined steadily from 27.7% among population age 18-35 years old to 6.8% among population age 55-74 years old. The single factor analysis was used for 16 possible risk factors and multivariate analysis showed that five risk factors were significantly related to HBV infection. HBV infection is a serious public health problem among adult population in Henan. Strengthening administrative regulations of medical practices, especially in rural areas, and providing health education propaganda to the public of HBV infection should be given more attention on public health policy. J. Med. Virol. 89:450-457, 2017. © 2016 Wiley Periodicals, Inc.

Prevalence of hepatitis B and C infections in hemodialysis patients

Introduction: Infections with hepatitis B and C viruses (HBV and HCV) are a major global health problem. Patients with chronic renal failure (CRF) on hemodialysis constitute a population at risk of HBV and HCV infections. Objective: Determining prevalence of the surface antigen of hepatitis B virus (HBsAg) and antibodies to hepatitis C virus (anti-HCV) in patients who attended dialysis units in the city of Posadas (Argentina). Materials and methods: The studied population comprised 172 patients with CRF in hemodialysis. HBsAg and anti-HCV antibodies were evaluated by enzyme-linked immunosorbent assay (ELISA). Results: On a total of 172 hemodialysis patients included in the study, 98 were males (57%) and 74 were females (43%), aged between 12 and 85 years (mean 53.4). 8.7% (15/172) of the patients were positive for HBsAg and 9.9% (17/172) were positive for anti-HCV reagents. 72.1% of patients had a hemodialysis treatment time of less than 5 years. A history of having received previous transfusions was observed in both HBsAg positive cases (7/15) and the anti-HCV positive cases (5/17). Elevated transaminase levels were observed in patients with positive and negative serology. Conclusion: The results of this study demonstrate a high prevalence of serological markers for HBV and HCV in patients with CRF on hemodialysis in city of Posadas (Argentina), as compared to cities in developed countries.

Detection of Hepatitis -B virus Genotypes among Chronic Carriers in Duhok - Iraq

Background: Hepatitis B virus (HBV) is one of the major etiological agents causing acute and chronic liver disease worldwide with significant morbidity and mortality. The high genetic variability of HBV is reflected by eight genotypes (A to H), each with a particular geographical prevalence.Objectives: The study was conducted to find out HBV genotypes in chronic hepatitis B- (CHB) carriers in association with serological markers of HBV.Methods: This work was carried on from March to, December 2012 in Duhok/Iraq and enrolled 134 HBsAg positive carrier cases. recruited to Central Public Health Lab. Specific primers PCR technique was used to detect HBV genotypes. The carrier cases were screened for markers of HBV infection by Enzyme Linked Immunosorbent Assay (ELISA). Automated machine for quantitative determination of ALT was used.Results: The carrier cases were 91 males (67.9 %), 43 females (32.1 %), and their age range was 10-87 year old (mean=31.4 SD± 13.3). Among the studied patients 133(99.2%) were found to have genotypes D including 91(67.9%) males and 42(31.3%) females and only one female patient carried genotype B (0.8%). Anti-HBc(total), IgM anti-HBc, HBeAg and Anti HBeAb were detected in rates of 100%,0%,50%and 46.9 % respectively. The patient with genotype B had positive HBe Ag, negative HBeAb and normal ALT level.Conclusion: This study revealed that hepatitis B virus genotype D is the main genotype in Duhok/ Iraq followed by genotype B. High percentage of CHB patients with genotype D are HBeAg positive. Most of CHB patients with high ALT level had positive HBeAg rather than negative HBeAg.

HBsAg and anti-HCV screening in elderly hospitalized patients of a German tertiary referral centre.

Elderly patients are under-represented in hepatitis B and C screening approaches, but may be at increased risk for advanced liver disease. We therefore screened a hospitalized elderly population. 6011 admissions to the department of internal medicine and neurology within one year were screened for HBsAg and anti-HCV (Elecsys(®)-HBsAg and -anti-HCV). Positive anti-HCV results were confirmed with the INNO-LIA™ assay. HCV-RNA was analyzed by real-time PCR in the case of confirmed positive anti-HCV results, HBV-DNA in the confirmed HBsAg positive individuals. Patient´s mean age (62.4 years) was 19 years above that of the average German population. The confirmed HBsAg prevalence was 0.6 %. 34 % (n = 12/35) of HBsAg positive cases were newly diagnosed, three of them presented with HBV-DNA levels > 2000 IU/mL. The confirmed anti-HCV prevalence was 0.9 %. 14 % (n = 8/56) of anti-HCV positive patients were previously undiagnosed. HCV-RNA was positive in three of them. In newly diagnosed individuals cirrhosis was present in 1/12 of the HBsAg and in 3/8 of the anti-HCV positive individuals. Compared to non-infected controls, the following risk factors were significantly more frequent in infected patients: (i) HBsAg: sexual exposure (20 % vs. 2 %), blood transfusion before 1992 (13 % vs. 6 %), referrals from nursing homes (10 % vs. 1 %). (ii) Anti-HCV: blood transfusion before 1992 (41 % vs. 6 %), IVDU (25 % vs. 0.5 %), organ transplantation (20 % vs. 5 %), hemodialysis (11 % vs. 3 %). HBsAg and anti-HCV were underdiagnosed in a senescent population, however, only few cases presented with advanced liver disease. Referrals from nursing homes were at increased risk for HBV infection.

Characterization of Occult Hepatitis B Infection Among Injecting Drug Users in Tehran, Iran.

BackgroundHepatitis B virus (HBV) infection is a major health problem worldwide.ObjectivesThe aim of this study was to investigate the frequency of occult hepatitis B infection (OBI) and its associated risk factors, together with the molecular characterization of the virus in injecting drug users of Tehran.Patients and MethodsThe study consisted of 229 injecting drug users. Serum samples were collected and tested for the presence of hepatitis B core antibody (HBcAb) and hepatitis B surface antigen (HBsAg) by an enzyme-linked immunosorbent assay (ELISA). HBV B virus DNA was extracted from the serum samples, and a fragment of the S gene was amplified using the nested polymerase chain reaction. The genotype, subgenotypes, subtype, and S gene mutation of HBV were determined by direct sequencing. A phylogenetic tree was constructed using the neighbor-joining method.ResultsSixty-four (28%) participants were HBcAb positive, 59 cases were HBcAb positive and HBsAg negative, and 5 cases were HBsAg positive. Hepatitis B DNA was found in three HBsAg-positive cases. Thirteen of 59 (22%) individuals were hepatitis B DNA positive. The phylogenetic tree of hepatitis B DNA showed the existence of genotype D. The only significant correlation was between sharing a syringe and OBI.ConclusionsIn comparison with the rate of HBcAb positivity reported in other Iranian studies, the rate was higher in the present study. There were a few variations, genotypes, and subtypes among the infected injecting drug users. Further investigations are needed to unravel the molecular characterization of OBI.