HBsAg Positive Rate Research Articles

Frequency of brucellosis and hepatitis b virus seropositivity in patients with chronic lymphocytic leukemia

Objective: Patients with chronic lymphocytic leukemia (CLL) show defective cellular and humoral immune responses. Although such immune failure is known to be associated with an increase in the frequency of particularly gram–positive and –negative bacterial infections, data on the increase in the frequency of zoonoses such as brucellosis and viral infections such as the hepatitis B virus (HBV) are inconclusive. This study aims to investigate the frequency of brucellosis and HBV seropositivity in patients diagnosed with CLL. Methods: Patients followed–up for CLL between 2005 and 2019 were evaluated. Results of patients who were tested for HBsAg and anti–HBs serology using the ELISA assay and for brucellosis using the serum agglutination (Wright) test were recorded. Demographic data and laboratory results of all patients included in the study were evaluated. Results: This study included 188 patients diagnosed with CLL, of whom 56 (29.8%) were female and 132 (70.2%) were male. Median age was 62 (33–92) years. Complete blood count parameters at diagnosis were as follows: median leukocyte count, 54.4×109/L (5.1–312.3×109/L); median lymphocyte count, 42.3×109/L (2.8–296.8×109/L); median platelet count, 148×109/L (86.3–342.3×109/L); median hemoglobin level, 13.4 g/dL (8.5-16.9 g/dL). HBsAg and anti–HBs were tested in 142 patients. A total of 16 (11.27%) patients were HBsAg–positive; with 5 (3.52%) positive cases in females and 11 (7.75%) in males. A total of 105 (73.95%) patients were anti–HBs–positive; with 32 (22.54%) positive cases in females and 73 (51.41%) in males. Wright agglutination test was performed on 82 patients. A total of 4 (4.88%) patients reacted positively to the Wright test; with 3 (3.66%) positive cases in females and 1 (1.22%) in males. Conclusion: Compared with the epidemiological studies conducted in the same region; the rate of positive reactions to the Wright agglutination test was consistent with the literature data; however, a higher rate of HBsAg positivity was determined. This may be linked to the increase in the risk of HBV transmission due to the immune defect caused by CLL or the immunosuppressive picture induced by the medication used in the treatment, or viral reactivation.

Frequency of Brucellosis and Hepatitis B Virus Seropositivity in Patients with Chronic Lymphocytic Leukemia

Objective: Patients with chronic lymphocytic leukemia (CLL) show defective cellular and humoral immune responses. Although such immune failure is known to be associated with an increase in the frequency of particularly gram–positive and –negative bacterial infections, data on the increase in the frequency of zoonoses such as brucellosis and viral infections such as the hepatitis B virus (HBV) are inconclusive. This study aims to investigate the frequency of brucellosis and HBV seropositivity in patients diagnosed with CLL.
 Methods: Patients followed–up for CLL between 2005 and 2019 were evaluated. Results of patients who were tested for HBsAg and anti–HBs serology using the ELISA assay and for brucellosis using the serum agglutination (Wright) test were recorded. Demographic data and laboratory results of all patients included in the study were evaluated.
 Results: This study included 188 patients diagnosed with CLL, of whom 56 (29.8%) were female and 132 (70.2%) were male. Median age was 62 (33–92) years. Complete blood count parameters at diagnosis were as follows: median leukocyte count, 54.4×109/L (5.1–312.3×109/L); median lymphocyte count, 42.3×109/L (2.8–296.8×109/L); median platelet count, 148×109/L (86.3–342.3×109/L); median hemoglobin level, 13.4 g/dL (8.5-16.9 g/dL). HBsAg and anti–HBs were tested in 142 patients. A total of 16 (11.27%) patients were HBsAg–positive; with 5 (3.52%) positive cases in females and 11 (7.75%) in males. A total of 105 (73.95%) patients were anti–HBs–positive; with 32 (22.54%) positive cases in females and 73 (51.41%) in males. Wright agglutination test was performed on 82 patients. A total of 4 (4.88%) patients reacted positively to the Wright test; with 3 (3.66%) positive cases in females and 1 (1.22%) in males.
 Conclusion: Compared with the epidemiological studies conducted in the same region; the rate of positive reactions to the Wright agglutination test was consistent with the literature data; however, a higher rate of HBsAg positivity was determined. This may be linked to the increase in the risk of HBV transmission due to the immune defect caused by CLL or the immunosuppressive picture induced by the medication used in the treatment, or viral reactivation.

Seroconversion of hepatitis B surface antigen among those with previously successful immune response in Southern China

ABSTRACT Recommendations promoted worldwide have suggested a period of protection lasting more than 20 years against hepatitis B (HB) following primary immunization. Starting in 1987, universal HB vaccinations were carried out in Long An County, Guangxi Province, one of the earliest counties in which plasma-derived HB vaccine was delivered to newborns across China. Data collection targeted toward understanding the long term (26–33 years since primary immunization) immune effects of the plasma-derived HB vaccine was conducted in 2015; a second data collection was carried out in 2019 to assess seroconversion in the same cohort. This study qualitatively compared positive vs negative results and quantitatively assessed HB biomarkers – HB surface antigen (HBsAg), antibody to HBsAg (anti-HBs), HB e-antigen (HBeAg), antibody to HBeAg (anti-HBe), and antibody to HB core antigen (anti-HBc) – in serum 26–33 years after the full initial course of HB vaccination, then analyzed anti-HBs seroconversion using the two-phase sampling method in the same cohort and calculated the anti-HBs seroconversion rate from 2015 to 2019. The protective sero-conversion rate (anti-HBs ≥10mIU/mL) was 37.6% (192/511); the HBsAg-positive rate was 5.3% (27/511); the anti-HBs mean geometric titer (GMT) was 11.1 mIU/mL. Among the 143 participants involved in both 2015 and 2019 data collections, the seroconversion rate was 3.5% (5/143); two individuals had protective anti-HBs levels in 2015. These findings indicate that anti-HBs status can be seroconverted to a protective concentration level 4 years earlier in a high HBV epidemic region. The role of genomic mutations and the disappearance of immune memory and seroconversion should be investigated.

Analysis of HBsAg screening among rural childbearing age people in Yunnan province during 2013-2017

Objective: To explore the current status of HBV infection before pregnancy among rural childbearing age people in Yunnan province, find out the population at high risk and areas with high incidence and provide evidence for promoting pre-pregnancy aristogenesis and medical interventions for prevention of HBV infection. Methods: The subjects in the study were rural childbearing age people aged 18-49 who received the national free pre pregnancy eugenic health examination in Yunnan province during 2013-2017. Descriptive analysis was conducted for HBsAg positive rate and its difference among various characteristics. The SPSS 22.0 software was used for statistical analysis. Results: A total of 2 180 841 rural childbearing age people were surveyed, the HBsAg positive rate before pregnancy was 3.13%(68 314/2 180 841) in Yunnan. And the HBsAg positive rate was 3.56% (37 694/1 057 376) in men, higher than that in women (2.73%, 30 620/1 123 465). The HBsAg positive rate was highest in age group 41-49 years (3.77%, 3 126/82 931). The HBsAg positive rate was higher in minority ethnic group (3.77%, 27 974/742 518) than in Han ethnicity group (2.81%, 40 024/1 425 870). Moreover, the highest HBsAg positive rate of was 8.20%(851/10 378) in Yao ethnic group. The people with education level of primary education had the highest HBsAg positive rate (3.97%, 17 294/435 219). The HBsAg positive rate was highest in Xishuangbanna Dai autonomous prefecture (6.65%, 3 875/58 232) in Yunnan. Moreover, the HBsAg positive population in severe poor area (3.32%, 19 755/595 665) was higher than those in less poor area (3.17%, 29 750/939 101) or normal areas (2.91%, 18 809/646 075). There was significant difference in HBsAg positive rate among populations in different age groups, ethnic groups, education level groups, areas and economic level groups (P<0.001). Conclusions: The HBsAg positive rate in rural childbearing age people in Yunnan was related to multi factors, including sex, age, ethnic group, education level, area and economic development level. The HBsAg positive rate was higher in men, older age and lower education level, minority ethnic group (especially in Yao ethnic group), from Xishuangbanna prefecture and the poor living conditions in childbearing age population.

Dawn of the clinical cure for chronic hepatitis B

The discovery of hepatitis B virus (HBV) has provided a scientific basis for the diagnosis, prevention and treatment of chronic hepatitis B (CHB). The universalization of neonatal hepatitis B vaccine has greatly reduced the HBsAg positive load rate of the Chinese population. Antiviral therapy based on interferon and / or nucleos(t)ide analogues had effectively inhibited HBV replication, improved liver inflammation, liver fibrosis, and reduced the incidence of liver cirrhosis and hepatocellular carcinoma. However, the existing treatment methods can achieve the clinical cure goal of negative HBsAg. In recent years, direct antiviral drugs for HBV life cycle and immunomodulatory drugs for antiviral response have entered an active stage of research and development. Clinical trials that are well-designed, standardized, analyzed, and interpreted are the key to the success of the research and development of a clinical cure for hepatitis B. It is hoped that the experts in hepatology, clinical pharmacology and methodology will work together to promote the research and development process of new drugs for clinical cure of hepatitis B by adopting new clinical trial design, new endpoint indicators, new data management and quality control technology.

Efficacy and safety of telbivudine treatment for the prevention of HBV perinatal transmission.

To observe the efficacy of telbivudine in chronic hepatitis B (CHB) women with high viral load during pregnancy and the long-term effects on intelligence, growth, and development of the newborns.A total of 87 patients were included. Forty-two patients received telbivudine orally 600 mg per day and treatment initiated from 12 weeks after gestation until the 12th postpartum week. Forty-five patients were untreated according to principle of informed consent. All infants received injection of hepatitis B immune globulin (HBIG; 200 IU) and were vaccinated with recombinant HBV vaccine. Wechsler preschool intelligence scale was used to assess mental and neuropsychological developments of these children till they were 6 years old. Data including serum HBV DNA viral load, Apgar score, and scores of Wechsler preschool intelligence scale were analyzed and compared.Levels of both serum HBV DNA and ALT in patients who received telbivudine were significantly decreased at the 12th week after delivery, compared with baseline levels (P < .01). No significant changes were observed in patients not receiving telbivudine (P > .05). Serum HBV DNA and ALT levels at the 12th week after delivery in the telbivudine group were significantly lower than those of patients without telbivudine (P < .01). The serum HBsAg-positive rate in neonates 7 months of age was 0%, which was significantly lower than that in control group (11.11%) (P < .05). No statistical differences were observed between the 2 groups regarding maternal cesarean section rate, adverse pregnancy rate, postpartum bleeding rate, neonatal body mass, Apgar score, neonatal malformation incidence, or intelligence development of newborn.Telbivudine is effective to reduce the viral load in CHB mothers with high viral load and could lower the perinatal transmission rate. Both mental and physical development in neonates with exposure to telbivudine during perinatal period were similar to those without telbivudine exposure.

Hepatitis Serology in Patients Receiving Immunosuppressive Treatment

Amaç: İmmünsupresif ilaç kullananlarda, hepatit B reaktivasyon riskine yönelik tarama yapılması önerilmektedir. Bu çalışmada immünsüpresif tedavi öncesi, Enfeksiyon hastalıkları kliniğine yönlendirilen hastalarda hepatit B virüsü (HBV), hepatit C virüsü (HCV) ve hepatit A virüsü (HAV) sonuçları retrospektif olarak irdelenmesi amaçlandı.Materyal ve Metod: Çalışmamızda Ocak 2018 - Aralık 2018 tarihleri arasında immünsüpresif tedavi öncesi, Enfeksiyon hastalıkları kliniğine yönlendirilen 148 hastanın hepatit B yüzey antijeni (HBsAg), hepatit B yüzey antikoru (Anti-HBs), hepatit B core protein antikoru (Anti-HBc IgG), anti hepatit C virüs antikoru (Anti-HCV) ve anti hepatit A virüs antikoru (Anti-HAV) hasta dosyalarından ve hastane otomasyon sisteminden retrospektif olarak incelendi.Bulgular: HBsAg pozitiflik oranı %4.1, Anti-HBs pozitiflik oranı %31.8, İzole Anti-HBc IgG pozitiflik oranı %1.4 ve iki hastada ise Anti-HBs bakılmamıştı. Anti-HCV pozitifliği %1.4 tespit edildi. Hastaların %79.7 Anti-HAV bakılmamış, Anti-HAV pozitifliği %12.2 ve Anti-HAV negatifliği %8.1 olarak saptandı. Sonuç: İmmünsüpresif tedavi öncesi tarama yapılmasına rağmen bazı taramaların eksik yapıldığı tespit edildi. Bu nedenle bu hastaları takip eden hekimlere eğitim verilmesi ve özellikle HBV enfeksiyonu konusunda farkındalık oluşturulmasını önermekteyiz.

Characteristics of methadone maintenance treatment clinic patients and influencing factors for HBsAg positivity based on Bayesian network model

Objective: To understand the characteristics and explore the influencing factors of HBsAg positivity in methadone maintenance treatment (MMT) clinic patients. Methods: A face to face interview and medical record review were conducted in 1 040 patients at three MMT clinics in Guangxi from September to November in 2014. The questionnaire information included general demographic characteristics, drug use history, MMT status, sexual behaviors, and health status, etc. Blood samples were collected from the patients at the same time for the detections of the level of HBsAg, anti-HBs and anti-HCV. By using χ(2) test, unconditional logistic regression model and Bayesian network model the influencing factors for HBsAg positivity in MMT clinic patients and the complex network relationship among these factors were explored. Results: A total of 1 031 MMT clinic patients were surveyed, the HBsAg positive rate was 11.35% (117/1 031). The anti-HCV positive rate was 71.77% (740/1 031), among the anti-HCV positive patients, the HBsAg positive rate was 10.27% (76/740). After adjusting for the confounding factors, anti-HBs positive persons might not be HBsAg positive (OR=0.05, 95%CI: 0.03-0.09), and anti-HCV positive persons might not be HBsAg positive too (OR=0.30, 95%CI: 0.17-0.52) compared with anti-HBs negative and anti-HCV negative persons, respectively. The persons with family history of hepatitis B virus infection were more likely to be HBsAg positive compared those with no such family history (OR=5.30, 95%CI: 2.68-10.52). Bayesian network model analysis results showed that family history of hepatitis B virus infection and anti-HBs were directly related with HBsAg positivity. Anti-HCV, intravenous drug use in the past three months and other drug using during treatment were indirectly related with HBsAg positivity. Conclusions: Anti-HBs, family history of hepatitis B virus infection, anti-HCV, intravenous drug use in past three months and other drug use during treatment were related with the HBsAg positivity in MMT clinic patients. So, it is necessary to enhance health education, improve health awareness and decrease high risk behaviors to reduce the rate of HBV infection.

Serological hepatitis B virus (HBV) activity in patients with HBV infection and B-cell non-Hodgkin's lymphoma.

Previous epidemiological studies suggest an association between hepatitis B virus (HBV) infection and B-cell non-Hodgkin lymphoma (B-NHL). The aim of our study was to evaluate clinical characteristics and serological indicators of HBV activity in patients who were diagnosed with both HBV infection and indolent or aggressive B-NHL. Seventy-two patients with current or resolved HBV infection and B-NHL were identified between 2000 and 2017 at our institution. Forty-five (63%) and 27 (37%) patients were identified with aggressive and indolent B-NHL, respectively. In indolent B-NHL, the proportion of HBsAg-positive patients was significantly higher compared with aggressive B-NHL (59% vs 38%, P=.03). HBV-DNA levels were significantly higher in patients with indolent compared to aggressive B-NHL (P=.01). In the subgroup analyzes of follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL), the rate of HBsAg positivity in FL is significantly higher than that in DLBCL (83% vs 44%, P=.04), and HBV-DNA levels were significantly higher in FL compared with DLBCL (P=.007). Our results suggest that serological HBV activity is higher in patients with both HBV infection and indolent B-NHL compared to those with aggressive B-NHL.

Blood-borne chronic viral infections in a large cohort of immigrants in southern Italy: A seven-centre, prospective, screening study.

Aim of this study was to evaluate the prevalence of blood-borne chronic viral infections in immigrants living in southern Italy and identify factors associated to viral infections. A prospective screening program was performed in seven clinical centers operating in Campania, Apulia and Calabria regions in southern Italy, in order to identify immigrants with HBV, HCV or HIV infections. Of 4,125 immigrants observed in the study period, 3,839 (93.0%) agreed to be screened: 381 (9.9%) resulted HBsAg-positive, 136 (3.5%) anti-HCV, 62 (1.6%) anti-HIV and 1,448 (37.7%) HBsAg-negative and anti-HBc-positive. Ongoing or previous HBV infection was observed more frequently in males (p=0.02 and p<0.001, respectively), whereas HIV infection in females (p=0.01). Immigrants from western Africa showed a higher rate of HBsAg positivity (p<0.0001), HBsAg negativity/anti-HBc positivity (p<0.0001) and anti-HIV positivity (p=0.004) compared with those from other geographical areas. At multivariate analysis, ongoing HBV infection was associated with male sex (OR 1.49, 95% CI: 1.04-2.14) and origin from western Africa (OR 4.67, 95% CI: 1.70-12.80) and eastern Europe (OR 3.44, 95% CI: 1.17-10.08). HCV infection showed the tendency to be more frequent among males (OR 1.84, 95% CI: 0.99-3.42). HIV infection was associated with an older age (OR 1.04, 95% CI: 1.01-1.06), origin from western Africa (OR 4.09, 95% CI: 1.26-13.29) and female sex (OR 2.38, 95% CI: 1.29-4,39; p=0.006). The high prevalence of HBV, HCV and HIV infections in our large cohort of immigrants should definitively prompt Italian Healthcare Authorities to develop adequate cost-effective screening policies.

HBS Ag seroclearance and seroconversion time in Patients with chronic hepatitis B Infection.

Background:Hepatitis B Surface antigen (HBsAg) seroclearance and seroconversion (development of antibodies against HBsAg) can increases the survival of Chronic hepatitis B (CHB) patients. The aim of this study was to determine the percentage and timing of HBsAg seroclearance and seroconversion in patients with chronic hepatitis B infection.Methods:1026 patients with CHB infection who referred to a private clinic were included. These patients had been followed-up for an average of 15 years. The patients whose HBs Ag was cleared from the blood and remained negative until the end of follow-up were designated as HBs Ag serocleared and the patients whose HBs Ab was positive during follow-upwas designated as HBs Ag seroconverted. The time of seroclearance and seroconversion of patients was recorded. Liver function tests, alpha-fetoprotein (AFP) and Hepatitis B early antigen (HBe Ag) status were extracted from the patients’ medical records. Data were analysis with SPSS 17.Results:The duration of follow-up was from 2 to 410 months and most patients were males (58.2%).The survival rate of HBs Ag positivity after 5, 10 and 15 years were 95.6, 89.4 and 80.7%, and 98, 93.5 and 84.9% of patients had not yet developed anti-HBs antibodies after 5, 10 and 15 years, respectively. Age, gender and taking medication had no effect on HBs Ag clearance from the blood or anti-HBs productionConclusion:The HBs Ag seroconversion is a rare occurrence, but the incidence of this may increase with time, age and drug consumption. Though there was no relationship in our patients

The Prevalence of HBV Infection: A Retrospective Study of 13 Years in a Public Hospital of Northeast China.

The prevalence of hepatitis B virus (HBV) infection was an imbalance in different provinces of China. This study aimed to investigate the prevalence of HBV infection and evaluate the prophylactic measures in a public hospital of northeast China over the preceding 13 years. A total of 13,948 patients in 2004 and 15,256 patients in 2017 of Shengjing Hospital of China Medical University were tested of serum HBsAg, HBeAg, HBsAb, HBeAb, and HBcAb levels with Abbott MEIA Kits. In people born before 1992, HBsAg-positive rate was 5.45% and 6.47%; isolated HBsAb positive rate was 14.62% and 21.24%; HBV marker negative rate was 54.27% and 42.77% in 2004 and 2017 survey, respectively. The males had a significant higher HBsAg-positive rate than the females. In people born during 1992-2004, HBsAg positive rate was 0.58% and 0.57%, isolated HBsAb positive rate was 41.47% and 46.57%; and HBV marker negative rate was 51.97% and 46.86% in 2004 and 2017 survey, respectively. Males and females had no difference of HBsAg-positive rate. In children born after 2005, HBsAg positive rate was 0.11%, isolated HBsAb positive rate was 76.68%, and HBV marker negative rate was 18.51% in 2017 survey. No difference of HBsAg-positive rate was found between the genders. A dramatic decrease of HBsAg positive rate and a progressive increase of HBsAb-positive rate were found among people born after 1992 and progressed further in those born after 2005. Immunization of infants and timely birth dose was the key method for prevention of HBV infection. Expanded HB vaccination would be needed for people born before 2005, especially those born between 1992 and 2004.

Seroepidemiology of Hepatitis B Virus Infection in Native and Immigrant Pregnant Women: A 20-Year Retrospective Study in Taiwan.

Universal immunoprophylaxis against hepatitis B virus (HBV) is regarded as a key element to prevent perinatal HBV infection. The aim of the present study was to investigate the changes in the hepatitis B surface antigen (HBsAg)- and hepatitis B envelope antigen (HBeAg)-positive rates in native and immigrant pregnant women, to realize the impact of immigrants, and to identify any weaknesses 30 years after the implementation of hepatitis B vaccination in Taiwan. A total of 20,020 test results of HBsAg and HBeAg in pregnant women-2,915 (14.6%) immigrant women and 17,105 native Taiwanese-from 1996 to 2015 were analyzed for changes during this 20-year retrospective cohort study. Native Taiwanese have a higher HBsAg-positive rate than immigrant women (P < 0.001). However, the HBsAg-positive rates decreased by 0.6% per year among native women, but did not decrease significantly (only by 0.18% per year) among immigrant women. The overall HBsAg-positive rate remained at high levels, 4.8% in the year 2015. The HBeAg-positive rate decreased significantly, by 0.22% per year, in the total women as well as by 0.23% per year in the native women (all P < 0.001); by contrast, the HBeAg-positive rate in immigrants decreased at a slower rate (0.10% per year), without a significant decreasing trend (P = 0.300). Higher HBeAg (+)/HBsAg (+) rate was found for the immigrants than for the native women (P < 0.001). To quickly and effectively lower the risk of vertical transmission, new approaches combined with vaccination may be needed in the post-immunization era.

Research progress and challenges for hepatitis B prevention and treatment in China

Viral hepatitis B is still one of the serious infectious diseases threatening the broad masses of people in China. However, since hepatitis B vaccine was brought into the immunization program in 1992, HBV infection prevalence has decreased significantly, especially the HBsAg positive rate of children under 5 years old has decreased to less than 1% . Hepatitis B vaccine vaccination among susceptible adults is also more and more widespread. HBV DNA test entered the era of high sensitivity, its detection limit has been reached to 10-20 IU/mL, so it provides more accurate decision points for clinical treatment and prognosis judgement. New nuclear nucleoside drugs, and the development of equential or joint treatment such as Peg interferon make hepatitis B patients see a new hope of functional cure. Through standardized antiviral therapy, which can effectively inhibit HBV DNA viral replication, it significantly reduces the risk of adverse outcomes, such as decompensated liver cirrhosis and cancer. This HBV control and prevention column of China Tropical Medicine published 5 papers about the latest research results of the early diagnosis of hepatitis B related diseases, mother-to-child transmission mechanism, clinical treatment and prognosis in China. We believe that through the joint efforts of everyone, it will not take long time to eliminate hepatitis B infection in our country. 摘要： 乙型病毒性肝炎目前仍然是威胁我国广大人民群众的严重传染病之一, 但自1992年乙肝疫苗纳入计划免疫 规划以来, 乙肝病毒感染流行率已明显下降, 尤其是5岁以下儿童的HBsAg阳性率已降到1%以下。成人易感者乙肝疫 苗接种也越来越广泛。HBV DNA的检测进入了高灵敏度时代, 检测下限已低至10~20 IU/mL, 因此为临床治疗决策点 提供了更准确的依据和预后判断支持。新型核苷类等药物的研制和序贯或联合聚乙二醇干扰素等治疗方案使人们看 到了实现乙肝“功能性治愈”新希望。乙肝患者通过规范化抗病毒治疗, 可有效抑制其体内HBV DNA病毒复制, 显著 降低失代偿肝硬化和肝癌等不良转归风险。《中国热带医学》这期乙肝防治专栏重点刊登了5篇针对我国乙肝相关疾病 的早期诊断、母婴传播的发生机制、临床患者的治疗和转归等方面的最新研究成果。相信通过大家的共同努力, 在我 国消除乙肝的夙愿已为期不远。

Real-world efficacy of immunoprophylaxis against mother-to-infant transmission of hepatitis B virus based on puerperant population

Objective To assess the efficacy of immunoprophylaxis against mother-to-infant transmission of hepatitis B virus (HBV) in a real-world setting since the implementation of charge-free hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine in China. Methods The screening rate and the prevalence of hepatitis B surface antigen (HBsAg) in 61 790 puerperants, and the administration of combined immunoprophylaxis in infants of HBsAg-positive mothers in Rugao City of Jiangsu Province from July 1, 2011 to June 30, 2016 were retrospectively analyzed. HBV infection status of infants born to HBV infected mothers was followed up after 7 months of age. HBsAg-positive infants and their mothers were followed up again for HBV markers in April 2018. Fisher's exact test and Cochran-Armitage trend test were used to statistically analyze the differences between groups and various years, respectively. Results All 61 790 puerperants were screened for HBsAg and the prenatal screen rate was 98.6% (60 937/61 790) with an increasing trend over time (χ2trend=750.908, P<0.001). HBsAg-positive puerperants accounted for 5.5% (3 397/61 790) with a decreasing trend over time (χ2trend=32.667, P<0.001). In total, 778 offspring (399 boys and 379 girls) of 759 HBsAg-positive mothers were followed up at (13.7±6.9) months of age, among which 751 (96.5%) were administered and 25 (3.2%) were probably administered standard combined immunoprophylaxis after birth, and the rest two (0.3%) were not. Fourteen infants (1.8%) were HBsAg positive and all born to mothers with positive hepatitis B e antigen (HBeAg). None of the 538 infants born to HBeAg-negative mothers was HBsAg-positive. HBsAg-positive rate in infants born since 2013 was lower than those in 2011 and 2012 (χ2trend=13.352, P=0.000 3). Eleven HBsAg-positive mothers and their children were followed up again 4–5 years later in April 2018. HBV DNA levels of all mothers were within the range of (7.34–28.2)×107 IU/ml except one case of spontaneous HBeAg seroconversion. One out of the 11 infected children also had HBeAg seroconversion. Phylogenetic analysis of HBV S gene showed that the 11 pairs of mothers and children were all infected with HBV of genotype C. Conclusions The implementation of charge-free HBIG and hepatitis B vaccine for newborns achieves fruitful results in Rugao city as the mother-to-infant transmission of HBV in the real-world had been further reduced to a similar level reported in literature survey. Key words: Hepatitis B virus; Hepatitis B; Infectious disease transmission, vertical; Immunoglobulins; Communicable disease control

Risk factors of hepatitis B virus infection between vaccinated and unvaccinated groups among spouses in 2006 and 2014: a cross-sectional study in Beijing

ABSTRACTObjectives: To assess the prevalence of hepatitis B virus (HBV) infection among married individuals and to analyze the associated risk factors of HBV infection in vaccinated and unvaccinated groups in 2006 and 2014.Methods: Information of married individuals aged over 16 y with a clear HBV vaccination status was extracted from the database constructed by the Beijing Center for Disease Prevention and Control from population-based investigation.A structured questionnaire was employed to collect demographic information, vaccinated history, and other related influence information of HBV of participants. Pearson chi-square test, Fisher's test, and logistic regression were used to explore the risk factors of HBV infection.Results: A total of 2874 individuals in 2006 and 1622 individuals in 2014 were enrolled in our study. The mean age of individuals was 49.30 and 46.68 y in 2006 and 2014, respectively. The overall positive rates of HBsAg, anti-HBc, and single anti-HBs were 4.80%, 43.01%, and 5.78% in 2006, which were 4.69%, 38.22%, and 14.18% in 2014, respectively. For vaccinated individuals, age was significantly correlated with anti-HBc in 2014 (40 < age ≤50 versus age ≤30, relative risk (RR) = 3.03, 95% confidence interval (95%CI) = 1.04–8.84). Gender [male versus female, RR = 0.60, 95%CI = 0.36–1.00 (2006); RR = 0.71, 95%CI = 0.52–0.97 (2014)] and age (in 2006) were found to be significantly associated with single anti-HBs.For unvaccinated individuals, HBsAg positivity was statistically significant correlated with gender [RR = 1.47, 95%CI = 1.04–2.06, in 2006], residence (urban versus rural, RR = 0.40, 95%CI = 0.24–0.67, in 2006; RR = 0.58, 95%CI = 0.34–0.99, in 2014), sharing syringes [RR = 3.75, 95%CI = 1.33–10.63 (in 2006); RR = 2.07, 95%CI = 1.26–3.41 (in 2014)], infected wives (RR = 1.97, 95%CI = 1.28–3.05, in 2006), and infected husbands (RR = 2.19, 95%CI = 1.25–3.82, in 2006). Anti-HBc positivity was significantly associated with gender [RR = 1.19, 95%CI = 1.10–1.30 (in 2006); RR = 1.24, 95%CI = 1.09–1.40 (in 2014)], age (in 2006 and 2014), endoscopic medicine treatment [RR = 1.16, 95%CI = 1.03–1.32 (in 2006), RR = 1.21, 95%CI = 1.01–1.45 (in 2014)], sharing syringes (RR = 1.43, 95%CI = 1.25–1.64, in 2014), body piercing (RR = 0.84, 95%CI = 0.75–0.93, in 2006), infected wives (RR = 1.32, 95%CI = 1.18–1.47, in 2006), and infected husbands (RR = 1.39, 95%CI = 1.22–1.59, in 2006). Anti-HBs positivity was associated with age (in 2006 and 2014).Conclusions: Prevalence of HBV infection was lower in 2014 than in 2006 according to HBsAg and anti-HBc positivity. Unvaccinated individuals faced much more risk of HBV infection than those of vaccinated.

Establishment and development of national community-based collaborative innovation demonstration areas to achieve the control target of hepatitis B in China

BackgroundThe major infectious diseases of hepatitis B has constituted an acute public health challenge in China. An effective and affordable HBV control model is urgently needed. A national project of Community-based Collaborative Innovation HBV (CCI-HBV) demonstration areas has optimized the existing community healthcare resources and obtained initial results in HBV control.MethodsBased on the existing community healthcare network, CCI-HBV project combined the community health management and health contract signing service for long-staying residents in hepatitis B screening. Moreover, HBV field research strategy was popularized in CCI-HBV areas. After screening, patients with seropositive results were enrolled in corresponding cohorts and received treatment at an early stage. And the uninfected people received medical supports including health education through new media, behavior intervention and HBV vaccinations. In this process, a cloud-based National Information Platform (NIP) was established to collect and store residents’ epidemiological data. In addition, a special quality control team was set up for CCI project.ResultsAfter two rounds of screening, HBsAg positive rate dropped from 5.05% (with 5,173,003 people screened) to 4.57% (with 3,819,675 people screened), while the rate of new HBV infections was 0.28 per 100 person-years in the fixed cohorts of 2,584,322 people. The quality control team completed PPS sampling simultaneously and established the serum sample database with 2,800,000 serum samples for unified testing.ConclusionsCCI-HBV project has established a large-scale field research to conduct whole-population screening and intervention. We analyzed the HBsAg prevalence and new infection rate of HBV in the fixed population for the epidemic trend and intervention effect. The purpose of CCI-HBV project is to establish and evaluate a practical model of grid management and field strategy, to realize the new goal to control hepatitis B in China. To provide policymakers with a feasible model, our results are directly applicable.Trial registrationThe project was funded by the Major Projects of Science Research for the 11th and 12th five-year plans of China, entitled “The prevention and control of AIDS, viral hepatitis and other major infectious diseases”, Grant Nos. 2009ZX10004901, 2011ZX10004901, 2013ZX10004904, 2014ZX10004007 and 2014ZX10004008.

Progress in research of effect of pregnancy complicated with hepatitis B virus infection on maternal and infant safety

Hepatitis B virus (HBV) infection is one of the important public health problems. In order to eliminate the threat of viral hepatitis to public health, World Health Organization has proposed to achieve the goal of reducing the HBsAg positive rate in children to 0.1% by 2030. There are regional differences in HBsAg positive rates among pregnant women worldwide, from 0.6% in areas with low prevalence to 20% in areas with high prevalence. The positive rate of HBsAg in pregnant women in China is higher than global average. In recent years, several studies have found that HBV infection in pregnancy not only increase the risk of mother-to-child transmission, but also adversely affect the health of pregnant women and their children. Therefore, this paper summarizes the progress in research both at home and abroad in terms of HBsAg positive rate in pregnant women and the influence of pregnancy complicated with HBV infection on pregnant women and perinatal infants in order to explore the effect of pregnancy complicated with HBV infection on maternal and infant safety.

Üçüncü basamak bir hastaneye başvuran hastalarda HBsAg ve anti-HCV seroprevalansı: Altı yıllık retrospektif veriler

Aim: We aimed to investigate the alteration and distribution of seroprevalence of hepatitis B and hepatitis C within the years according to age groups in patients who applied to our hospital. Materials and Methods: The patients have been evaluated for six years retrospectively who were admitted to third step hospital in Istanbul. The duplicate results of patients who submitted more than one application within the same year were excluded from this study. Male and female patients were divided into four age groups as 0-14, 14-25, 25- 49 and over 49 years old. Electrochemiluminescence method (Roche Cobas 6000, Germany) was used for HBsAg and anti-HCV assays. Results: HBsAg positivity was 2.97% and anti-HCV positivity was 1.35%. HBsAg positivity was higher in males, and anti-HCV positivity was higher in females. No significant increase in seroprevalences of anti-HCV and HBsAg was observed during the six years observation period. HBsAg seroprevalences decreased in years especially in 0-14 and 14-25 year-old male groups. HBsAg seroprevalence was not decreased in the other age groups over the years. There was no significant difference in anti-HCV seroprevalence over the years. HBsAg positivity was higher in males and anti-HCV positivity was higher in females. Anti-HCV and HBsAg seroprevalence were not significantly differed over the years. Conclusion: It was remarkable that HBsAg positivity rate had decreased over the years especially in 0-14 and 14-25 year-old males. Seroprevalence of HBsAg did not decrease in years in other age groups. There was no significant difference in the seroprevalence of anti-HCV during the measurement period.

Blood-Borne Chronic Viral Infections in a Large Cohort of Immigrants in Southern Italy

Background: The aim of this study was to evaluate the prevalence of blood-borne chronic viral infections in immigrants in Italy, and identify factors associated. Methods: A prospective screening program was performed in seven clinical centers operating in Campania, Apulia and Calabria in southern Italy, to identify immigrants with HBV, HCV or HIV infections. Findings: Of 4·125 immigrants observed in the study period, 3·839 (93·0%) agreed to be screened: 381 (9·9%) resulted HBsAg, 136 (3·5%) anti-HCV, 62 (1·6%) anti-HIV-positive and 1·448 (37·7%) HBsAg-negative and anti-HBc positive. Ongoing or previous HBV infection was observed more frequently in males (p=0·02 and p<0·001, respectively), whereas HIV infection in females (p=0·01). Immigrants from western Africa showed a higher rate of HBsAg positivity (p<0·0001), of HBsAg negativity/anti-HBc positivity (p<0·0001) and anti-HIV positivity (p=0·004) compared with those from other geographical areas. At multivariate analysis, ongoing HBV infection was associated with male gender (OR:1·49, 95% CI: 1·04-2·14) and origin from western Africa (OR: 4·67, 95% CI: 1·70-12·80) and eastern Europe (OR 3·44, 95% CI: 1·17-10·08). HCV infection was independently associated with male sex (OR 1·84, 95% CI: 0·99-3·42); HIV infection was associated with an older age (OR 1·04, 95% CI: 1·01-1·06) and origin from western Africa (OR 4·09, 95% CI: 1·26-13·29), while male gender was a protective factor (OR 0·45, 95% CI: 0·24-0·85). Interpretation: The high prevalence of HBV, HCV and HIV infections in our large cohort of immigrants should constitute a warning to Italian Healthcare Authorities to develop adequate cost-effective screening policies. Funding Statement: This work was financially supported by Gilead for the study “Evaluation of an innovative model to eliminate HCV infection in a high-risk population of undocumented migrants and low income refugees” (EUDRACT: 2017-001024-21). Declaration of Interests: All the authors of the manuscript declare that they have no conflict of interest in connection with this paper. Ethics Approval Statement: The study was approved by the Ethics Committee of the Azienda Ospedaliera Universitaria of the University of Campania Luigi Vanvitelli (214/2012; 481/2018).