Cases Of HBV Infection Research Articles

Evaluating the Effectiveness of Rapid Test for HBsAg and Anti HCV in Swabi, KPK

ABSTRACT Background: Both HBV and HCV are associated with chronicity causing irreversible damage which later may result in cirrhosis and Hepatocellular Carcinoma. Conducting sizeable epidemiological studies in order to obtain a detailed and precise data of HBV and HCV infection will enable us to be well equipped with proper awareness about the prevention both in terms of vaccines and treatment options. Objective: To highlight the importance of dire need of implementing public health measures against the increasing seroprevalence of HBV and HCV in Pakistan. Setting: This descriptive cross sectional study was conducted over a period of 17 months, starting from 7th Nov, 2022 to 31st March, 2024 at Microbiology Laboratory MTI- GKMC/BKMC, Swabi. Material and methods: A total of 459 blood samples were collected from suspected cases of HBV and HCV infection as they showed a positive result on performing the on spot screening for Hepatitis B surface antigen (HBs Ag) and Anti HCV through rapid immunochromatography (ICT). The samples which showed positive results through ICT were subjected to confirmation by polymerase chain reaction (PCR). Demographic data was also recorded. Permission from IRB was duly seeked. Results: Out of a total of 459 (ICT positive) HBV and HCV samples received at Virology section, 117 were of HBV, whereas 342 were of HCV. Out of the total 117 ICT positive HBV cases 60 were males and 57 were females. On subjection to confirmation by PCR 36 males and 18 females were confirmed positive by PCR. Similarly, out of the total 342 ICT positive HCV samples, 145 were males, whereas 197 were females, which upon subjection to confirmation by PCR, showed 104 males and 86 females confirmed positive by PCR. Conclusion: The being reported burden of HBV and HCV, stresses upon the policy makers to prioritize steps for efficient and adequate therapeutic and preventive measures for the effective reduction in the burden of HBV and HCV in Pakistan. Key words: HBV, HCV, immunochromatography, PCR

The impacts of the COVID-19 pandemic on patients with viral hepatitis B infection: follow-up, compliance with antiviral treatment, and vaccine preferences.

Elimination programs and interventions for patients with viral hepatitis B (HBV) have been disrupted during the COVID-19 pandemic. This study aimed to evaluate the effects of the COVID-19 pandemic on patients with HBV infection in terms of COVID-19 vaccine preferences, follow-up visits, and antiviral treatment compliance. In this retrospective single-center cross-sectional study, 129 patients with viral hepatitis B infection were evaluated. The patients were surveyed at the time of admission. A special form was created for patients with viral hepatitis B infection, and the form contained information about the patients at admission to collect the study data. A total of 129 participants were included in the study. Of the participants, 49.6% were males and the median age was 50 years. In total, 73 (56.6%) patients had their follow-up visits disrupted because of the COVID-19 pandemic. No newly diagnosed case of HBV infection was detected. Among the 129 patients, 46 had inactive hepatitis B, and 83 had chronic hepatitis B infection and were receiving antiviral treatment. None of the patients had trouble reaching antiviral treatments during the COVID-19 pandemic. A liver biopsy was recommended for 8 patients. Half of these 8 patients did not have follow-up visits during the COVID-19 pandemic. Most of the patients (123/129, 95.3%) received the COVID-19 vaccine and the most frequent vaccine that was used was the Pfizer-BioNTech (n: 92, 71.3%) vaccine. Serious side effects of the COVID-19 vaccines were not detected. Mild side effects were found in 41.9% (13/31) of the patients. The COVID antibody level was found to be statistically and significantly higher in the patients who received the Pfizer-BioNTech vaccine than in those that received the CoronoVac vaccine. It was reported that elimination programs and interventions for HBV infection decreased or stopped because of the COVID-19 pandemic. In the present study, no newly diagnosed case of HBV infection was detected. Most of the patients had their follow-up visits disrupted. There were no patients who could not receive antiviral treatment, the vaccination rate of the patients was high, and the vaccines were well tolerated.

Integrated genomic analyses of hepatocellular carcinoma.

Genomic alterations play important roles in the development of cancer. We explored the impact of protein-coding genes and transcriptomic changes on clinical and molecular alterations in Taiwanese hepatocellular carcinoma (HCC) patients. We analyzed 147 whole-exome sequencing and 100 RNA sequencing datasets of HCC and compared them with The Cancer Genome Atlas (TCGA)-Liver Hepatocellular Carcinoma cohort and develop a panel of 81 apoptosis-related genes for molecular classification. TERT (50%), TP53 (25%), CTNNB1 (14%), ARID1A (12%), and KMT2C (11%) were the most common genetic alterations of cancer-related genes. ALDH2 and KMT2C mutated at much higher frequencies in our cohort than in TCGA, whereas CTNNB1 was found only in 14% of our Taiwanese patients. A high germline mutation rate of ALDH2 in the APOBEC mutational signature and herb drug-related aristolochic acid-associated signature was also observed. Groups A and B of HCC were identified when we used apoptosis-related genes for molecular classification. The latter group, which had poorer survival outcomes, had significantly more aDC, CD4+ Tem, macrophages M2, NKT, plasma cells, and Th1 cells, and less CD4+ memory T cells, CD8+ Tcm, cDC, iDC, and Th2 cells, as well as more inter-chromosome fusion genes. Metatranscriptomic analysis revealed 54 cases of HBV infection. Moreover, we found that the main target gene of HBV integration is ALB. Unique genomic alterations were observed in our Taiwanese HCC patients. Molecular classification using apoptosis-related genes could lead to new therapeutic approaches for HCC.

Construction of a prediction model for chronic HBV-associated hepatocellular carcinoma based on ultrasound radiomics

ObjectiveA convolution neural network (CNN) prediction model was constructed based on contrast-enhanced ultrasonography (CEUS) images. The aim is to explore the predictive effect of the model for chronic HBV-associated hepatocellular carcinoma (HCC). MethodsA total of 80 cases of HBV infection in our hospital were selected retrospectively. All patients underwent CEUS, and the pathological results of the operation or liver puncture were used as the gold standard to identify HCC patients and Non-HCC patients. Two-dimensional (2D) and three-dimensional (3D) CNN prediction models are constructed based on CEUS images to predict HBV patients. Then, the prediction performance of the two models was compared. ResultBenign and malignant lesions were confirmed in 16 and 64 patients, respectively. Compared with the 2D-CNN prediction model, the prediction accuracy of the 3D-CNN model is improved by 11.75%. The sensitivity, specificity, accuracy, and Dice coefficient of the 3D model were higher than those of the 2D prediction model. The area under the curve (AUC) of 2D and 3D models were 0.784 (95%CI: 0.671–0.897) and 0.931 (95%CI: 0.863–0.971), respectively. ConclusionThe 3D-CNN prediction model based on CEUS is better than the 2D model in predicting HBV-associated HCC, which is worthy of further clinical application.

Residual risk of hepatitis B virus transmission through blood donations in Burkina Faso screened with rapid diagnostic tests.

Background and Aimshepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) represent the major transfusion–transmissible pathogens worldwide. The risk of transmission is relatively high in African countries, mainly due to unreliable screening methods of blood donations. In Burkina Faso, predonation screening using rapid diagnostic tests (RDTs) is widespread, raising the major question of the transfusion safety in the country. The objective of this study was to assess the risk of transmission of HBV, HCV, and HIV through blood transfusion in the context of the use of RDTs for screening of the blood donations.MethodsIn this cross‐sectional study, a total of 417 serum samples obtained from blood donors tested negative for HBsAg, anti‐HCV, and anti‐HIV using RDTs were retested for the same markers using chemiluminescent immunologic assays. Total antibodies to HBV core (anti‐HBc) were tested on randomly selected samples. HBV‐DNA and HCV‐RNA viral loads (VLs) were quantified on HBsAg and anti‐HCV positive samples, respectively. To assess possible occult hepatitis B infection (OBI), HBV‐DNA‐VL was quantified on 313 randomly selected HBsAg‐negative samples.ResultsHBsAg and anti‐HCV were found respectively in 6 (6/417; 1.4%) and 11 (11/417; 2.6%) samples. No samples were reactive for anti‐HIV. Total anti‐HBc were detected in 217 out of the 319 randomly selected samples (217/319; 68.02%). HBV‐DNA was detected in four (4/313; 1.27%) samples, including two (2/6; 33.33%) of the six HBsAg positive samples and two (2/313; 0.6%) of the HBsAg‐negative samples, suggesting two cases of occult HBV infection. All anti‐HCV antibody‐positive samples were HCV‐RNA negative.ConclusionThis study shows that RDTs are not sufficiently sensitive for the screening of blood donations. Our results highlight the urgent need to think about the extension of sensitive immunological tests in all blood transfusion centers and also the implementation of nucleic acid amplification techniques.

Deep Learning for Approaching Hepatocellular Carcinoma Ultrasound Screening Dilemma: Identification of α-Fetoprotein-Negative Hepatocellular Carcinoma From Focal Liver Lesion Found in High-Risk Patients.

BackgroundFirst-line surveillance on hepatitis B virus (HBV)-infected populations with B-mode ultrasound is relatively limited to identifying hepatocellular carcinoma (HCC) without elevated α-fetoprotein (AFP). To improve the present HCC surveillance strategy, the state of the art of artificial intelligence (AI), a deep learning (DL) approach, is proposed to assist in the diagnosis of a focal liver lesion (FLL) in HBV-infected liver background.MethodsOur proposed deep learning model was based on B-mode ultrasound images of surgery that proved 209 HCC and 198 focal nodular hyperplasia (FNH) cases with 413 lesions. The model cohort and test cohort were set at a ratio of 3:1, in which the test cohort was composed of AFP-negative HBV-infected cases. Four additional deep learning models (MobileNet, Resnet50, DenseNet121, and InceptionV3) were also constructed as comparative baselines. To evaluate the models in terms of diagnostic power, sensitivity, specificity, accuracy, confusion matrix, F1-score, and area under the receiver operating characteristic curve (AUC) were calculated in the test cohort.ResultsThe AUC of our model, Xception, achieved 93.68% in the test cohort, superior to other baselines (89.06%, 85.67%, 83.94%, and 78.13% respectively for MobileNet, Resnet50, DenseNet121, and InceptionV3). In terms of diagnostic power, our model showed sensitivity, specificity, accuracy, and F1-score of 96.08%, 76.92%, 86.41%, and 87.50%, respectively, and PPV, NPV, FPR, and FNR calculated from the confusion matrix were respectively 80.33%, 95.24%, 23.08%, and 3.92% in identifying AFP-negative HCC from HBV-infected FLL cases. Satisfactory robustness of our proposed model was shown based on 5-fold cross-validation performed among the models above.ConclusionsOur DL approach has great potential to assist B-mode ultrasound in identifying AFP-negative HCC from FLL found in surveillance of HBV-infected patients.

Epidemiological factors associated with HBV infection and uptake of testing in south west region of Cameroon: What can be done to scale up HBV testing in our setting?

Hepatitis B infection affects millions of people globally, partly due to its high degree of transmissibility and asymptomatic nature. This study was aimed at identifying prevailing epidemiological factors associated with HBV infection and testing uptake in the South West region of Cameroon. This hospital-based case-control study enrolled HBV infected participants and "healthy" controls ≥18 years old. Venous blood collected from participants was used to conduct HBV panel test (HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc). Data on demographic and behavioral risk factors as well as reasons for taking the HBV test for the first time were collected using a questionnaire. A total of 424 participants were enrolled (212 "healthy" controls and 212 HBV infected cases). Male sex (odds ratio [OR] = 2.08, p = 0.010), ≤ secondary education level (OR = 4.83, p<0.001), low-income level (OR = 3.79, p<0.001), rural settlement (OR = 2.17, p = 0.031), history of sexually transmitted infections (STI) (OR = 4.24, p<0.001) and ignorance of sexual partners HBsAg status (OR = 2.70, p = 0.003) all had an independent and significant association with HBV infection. Top 3 reasons for doing HBsAg test were free screening (40.3%), blood donation (15.0%) and administrative requirements (14.9%). HBV testing uptake and early detection can be improved if more sensitization and free/opportunistic screenings are implemented. A significant drop in the cost of HBV test could encourage more people to get tested.

A pre-existing case of HBV infection with elevated HBV DNA after COVID-19 pneumonia treatment

A pre-existing case of HBV infection with elevated HBV DNA after COVID-19 pneumonia treatment

Evolution of Hepatitis B Virus (HBV) Serologic Markers Among Antiretroviral-Naive Young People Living With Human Immunodeficiency Virus Who Had Undergone Neonatal HBV Vaccination and Initiated Antiretroviral Therapy.

With initiation of antiretroviral therapy (ART) containing nucleos(t)ide reverse-transcriptase inhibitors (NRTIs) with anti-hepatitis B virus (HBV) activity, the evolution of HBV serologic markers among people living with human immunodeficiency virus (PLWH) who were born in the era of nationwide neonatal HBV vaccination is rarely investigated. This retrospective cohort study evaluated the changes of HBV serologic markers (hepatitis B surface antigen [HBsAg], antibody to hepatitis B surface antigen [anti-HBs], and antibody to hepatitis B core antigen [anti-HBc]) of PLWH who had undergone neonatal HBV vaccination. Clinical characteristics were analyzed and the incidences of evolution of HBV serologic markers were estimated. Between 2004 and 2020, 608 PLWH (mean age, 24 years) were included and 62.0% initiated tenofovir-containing ART: 13 (2.1%) were HBsAg-positive, 312 (51.3%) tested triple-negative, 209 (34.4%) had vaccine-induced seroprotection against HBV, and 74 (12.2%) tested positive for anti-HBc with or without anti-HBs. Among 492 PLWH who received a median follow-up of 2.8 years, 4 cases of incident HBV infection occurred (0.59 per 100 person-years of follow-up [PYFU]) in PLWH testing triple-negative at baseline despite ART containing NRTIs with anti-HBV activity. Of PLWH with seroprotection against HBV at baseline, 38 subsequently lost anti-HBs (4.46 per 100 PYFU) and 4 cases of incident HBV infection occurred (0.47 per 100 PYFU). PLWH with an anti-HBs antibody titer ≥100 mIU/mL at baseline (adjusted hazard ratio [aHR], 0.10 [95% confidence interval {CI}: .02-.42]) and CD4 ≥500 cells/µL during follow-up (aHR, 0.51 [95% CI: .30-1.00]) were less likely to lose HBV seroprotection. Among young PLWH who had undergone neonatal HBV vaccination, evolution of HBV serologic markers and incident infections occurred despite ART containing NRTIs with anti-HBV activity.

Elevated LINC01232 is associated with poor prognosis and HBV infection in hepatocellular carcinoma patients and contributes to tumor progression in vitro

BackgroundHepatocellular carcinoma (HCC) had high prevalence and poor prognosis, and hepatitis B virus (HBV) infection is a major risk factor. The aim of this study is to analyze the role of long intergenic noncoding RNA 01232 (LINC01232) in the prognosis and progression of HCC, and explore the relationship between LINC01232 and HBV infection. MethodsLINC01232 expression and its prognostic value were firstly analyzed using TCGA database. Quantitative real-time PCR was used to evaluate the expression of LINC01232 in HCC patients and cell lines. Kaplan-Meier curves were used to analyze the relationship between LINC01232 expression and HCC overall survival prognosis. Function-loss in vitro experiments were performed to demonstrate the role of LINC01232 in HCC progression. A luciferase reporter assay and Pearson correlation were used to confirm the relationship between LINC01232 and microRNA (miR)-708-5p in HCC. ResultsThe expression of LINC01232 was upregulated in HCC tissues and cell lines, and high LINC01232 was associated with worse overall survival in HCC. LINC01232 reduction inhibited HCC cells proliferation, migration and invasion. LINC01232 expression was significantly correlated with HBV infection and liver cirrhosis, and showed potential to distinguish HBV-infected HCC patients. miR-708-5p, as a HBV-related miRNA, was a potential target of LINC01232, and was negatively correlated with LINC01232 in HCC. ConclusionOur findings found that highly expressed LINC01232 may be a biomarker to indicate survival prognosis in HCC patients, especially in HBV-infected cases. In addition, LINC01232 plays as an oncogene in HCC progression, and its function may exert by sponging miR-708-5p.

Analysis of risk factors for drug resistant mutations in the reverse transcriptase region in chronic hepatitis B virus-infected patients

Objective: To analyze the risk factors that may affect the mutations in the reverse transcriptase region in chronic hepatitis B virus-infected patients. Methods: 678 hospitalized cases with chronic HBV infection who underwent HBV RT testing at Tianjin Second People's Hospital from January 1, 2016 to December 31, 2016 were collected retrospectively. Among them, 417 cases were diagnosed with chronic hepatitis B, 219 cases with liver cirrhosis and 42 cases with primary liver cancer. There were 268 cases of non-use of any antiviral therapy, 138 cases of discontinuation of antiviral drugs for 6 months or more, and 272 cases of continuous antiviral therapy. HBV genotyping and RT region mutation sites were detected by direct sequencing. The risk factors that may affect the drug resistant mutation in the HBV RT mutation, including age, genotype, antiviral drug selection and medication time, hepatitis B virus infection, and biochemical markers were analyzed by univariate analysis to screen out independent risk factors. Results: Among 678 HBV-infected cases, 290 cases (42.8%) were detected with RT-region mutation. Among them, the pre-existing drug resistant rate was 6.72%, and the drug resistant mutation rate was 23.19% in treated patients. The drug resistant mutation rate of patients with continuous antiviral therapy was 66.18%. Gene mutations highest rate for 1 ~ 5 years was 27.14% in chronic HBV patients treated with antiviral therapy. Logistic regression analysis of the factors that had led to HBV mutation showed that old age, the selection of nucleoside drugs at the beginning of treatment and medication time were the main factors affecting HBV RT mutations. Conclusion: Abnormal ALT level, HBV genotype, HBV DNA quantitative level are the main factors influencing non-drug resistant mutations. Age over 60 years old, and long-term use of low-barrier nucleoside drugs are high-risk groups for HBV resistant. Therefore, HBV resistant monitoring should be strengthened.

Detection and Genetic Characterization of Hepatitis B and D Viruses: A Multi-Site Cross-Sectional Study of People Who Use Illicit Drugs in the Amazon Region.

Hepatitis B (HBV) and delta (HDV) viruses are endemic in the Amazon region, but vaccine coverage against HBV is still limited. People who use illicit drugs (PWUDs) represent a high-risk group due to common risk behavior and socioeconomic factors that facilitate the acquisition and transmission of pathogens. The present study assessed the presence of HBV and HBV-HDV co-infection, identified viral sub-genotypes, and verified the occurrence of mutations in coding regions for HBsAg and part of the polymerase in HBV-infected PWUDs in municipalities of the Brazilian states of Amapá and Pará, in the Amazon region. In total, 1074 PWUDs provided blood samples and personal data in 30 municipalities of the Brazilian Amazon. HBV and HDV were detected by enzyme-linked immunosorbent assay and polymerase chain reaction. Viral genotypes were identified by nucleotide sequencing followed by phylogenetic analysis, whereas viral mutations were analyzed by specialized software. High rates of serological (32.2%) and molecular (7.2%) markers for HBV were detected, including cases of occult HBV infection (2.5%). Sub-genotypes A1, A2, D4, and F2a were most frequently found. Escape mutations due to vaccine and antiviral resistance were identified. Among PWUDs with HBV DNA, serological (19.5%) and molecular (11.7%) HDV markers were detected, such as HDV genotypes 1 and 3. These are worrying findings, presenting clear implications for urgent prevention and treatment needs for the carriers of these viruses.

Characteristics of Hepatitis B and D Co-infection: A Descriptive Study

: About 5% of cases with chronic hepatitis B virus (HBV) are co-infected with hepatitis D virus (HDV), and this co-infection possesses a high risk for hepatocellular carcinoma (HCC) and cirrhosis. We aimed to evaluate the epidemiological and histopathological characteristics ‎and response to treatment in patients with HBV and HDV co-infection in a hepatitis clinic in Tehran, Iran. In this study, 80 patients were enrolled and evaluated for age, sex, degree of liver fibrosis, virologic status, and response rate. The incidence of co-infection of hepatitis B and D was 4.9% (80/1,631 HBV-infected cases) in our clinic. Thirty-seven (46.25%) patients had liver cirrhosis, and four (5%) patients had HCC. Besides, HDV Ribonucleic Acid (RNA) polymerase chain reaction (PCR) was positive for 31 (38.75 %) patients. Among 30 patients, 14 (46.6%) completed interferon therapy (for equal to or more than 48 weeks) and had a response with undetectable HDV RNA PCR after treatment. According to our results, for cirrhotic patients in HBV/HDV co-infection that was about 46%, it seems that the early detection of HDV antibody (Ab) plays a significant role in the prevention of progressive liver failure, and treatment with interferon can help these patients by improving the prognosis.

S2604 Acute Severe Cholestatic Hepatitis B Infection in an Immune-Competent Patient

INTRODUCTION: Acute severe cholestatic hepatitis B is uncommon and usually reported in organ transplant recipients. We report a unique case of acute HBV infection with severe cholestasis in an immune-competent patient whose symptoms were initially felt to be secondary to complications from choledocholithiasis. CASE DESCRIPTION/METHODS: A 67-year-old female presented with right upper quadrant (RUQ) pain, vomiting, fatigue & jaundice for 2 weeks. She had a new sexual partner with unknown hepatitis status. The patient had no history of alcohol, drug use or new medications. RUQ tenderness & scleral icterus were noted on exam. Labs showed AST-629u/l (Normal[N]: 10–40 u/l), ALT-497u/l (N: 12–78 u/l), ALP-294u/l (N: 33–138 u/l), T. Bili-8.4mg/dl (N: 0.0–1.5 mg/dl), D. Bili-7.5mg/dl (N: 0.0 −1.5mg/dl), INR-1. On ultrasound of the abdomen cholelithiasis with gall bladder wall thickening with normal biliary ducts was noted. Endoscopic ultrasound revealed a 2.5 mm filling defect without shadowing in distal common bile duct (CBD) & Endoscopic retrograde pancreatic duodenoscopy showed a small filling defect in mid CBD and a distal CBD stricture about 1–2 cm in length. Biopsy of CBD stricture showed inflammation. A plastic biliary stent was deployed with good drainage. Her liver tests did not improve, and additional investigations performed were positive for Hepatitis B surface antigen (HbsAg), core antibody Total (Anti HBc Total) & core IgM, Hepatitis e antigen (HBeAg). She was negative for Hepatitis B e antibody (HBeAb) and Hepatitis B surface antibody (HBsAb). HBV PCR was 765,000,000 IU/ml. She was discharged with a follow up scheduled in liver clinic, but was readmitted 2 weeks later with worsening fatigue & liver tests. A liver biopsy showed active hepatitis without evidence of bridging fibrosis or cirrhosis & positive HBV staining. Anti-viral therapy with Tenofovir was initiated with improvement in symptoms. DISCUSSION: Although several case reports describe severe cholestasis with HBV post-liver transplantation, it has rarely been described in immunocompetent patients. Our patient's presentation was initially concerning for biliary obstruction. Despite biliary drainage patient's symptoms worsened, & further investigations revealed acute HBV infection with high replication which was confirmed by biopsy. Prompt therapy with antivirals improved the clinical course. Given these findings one should have high index of suspicion to evaluate for HBV infection in unusual presentation with cholestasis.Figure 1.: Immunohistochemical stain highlights Hepatitis B surface antigen within the cytoplasm of hepatocytes (200X magnification).Figure 2.: Hepatic parenchyma with dense mixed acute and chronic inflammation throughout the hepatic lobule and intermixed ceroid-laden macrophages removing dead hepatocytes (100x magnification).Figure 3.: Hepatic parenchyma with dense mixed acute and chronic inflammation throughout the hepatic lobule and intermixed ceroid-laden macrophages removing dead hepatocytes (200 X magnification).

Effect of Policy Change to Require Laboratory Reporting With Pregnancy Indicated for Syphilis and Hepatitis B Virus Infection, New York City, January 2013-June 2018.

We evaluated the impact of a 2014 New York City health code change requiring laboratories to indicate if a patient is pregnant or probably pregnant in the electronic laboratory report (ELR) when reporting syphilis and hepatitis B virus (HBV) cases to the New York City Department of Health and Mental Hygiene (DOHMH). We calculated the number of pregnant persons with syphilis or HBV infection reported to DOHMH from January 1, 2013, through June 30, 2018. We compared the proportion in which the first report to DOHMH was an ELR with pregnancy indicated before and after the policy change. We calculated time between first ELR with pregnancy indicated and subsequent reporting by a method other than ELR and the proportion of cases in which ELR with pregnancy indicated was the only report source. A total of 552 new syphilis and 8414 HBV-infected cases were reported to DOHMH. From January 2013-June 2014 (pre-change) to January 2017-June 2018 (post-change), the proportion of cases in which ELR with pregnancy indicated was the first report to DOHMH increased significantly (14.7% [23/156] to 46.2% [80/173] for syphilis; 8.0% [200/2498] to 45.3% [851/1879] for HBV infection [P < .001]). Median time between first ELR with pregnancy indicated and subsequent reporting by a method other than ELR was 9.0 days for syphilis and 51.0 days for HBV infection. ELR with pregnancy indicated was the only report for 43.1% (238/552) of syphilis cases and 23.4% (1452/6200) of HBV cases during the study period. Including pregnancy status with ELR can increase the ability of public health departments to conduct timely interventions to prevent mother-to-child transmission.

Genetic polymorphisms of interleukin-6 influence the development of hepatitis B virus-related liver cirrhosis in the Han Chinese population

BackgroundInterleukin-6 (IL-6) plays an important role in chronic inflammation. Thus, we aimed to investigate the effects of IL-6 polymorphisms on predicting the progression of hepatitis B virus (HBV)-r elated liver cirrhosis. MethodsA cross-sectional study was conducted to analyse IL-6 polymorphisms and serum levels of IL-6 in HBV-infected patients at different clinical phases and in healthy controls. IL-6 polymorphisms were detected by the TaqMan PCR method, and plasma IL-6 levels were assessed by ELISA. ResultsOur analysis included 182 chronic hepatitis B (CHB) patients, 190 HBV-infected liver cirrhosis cases, 125 inactive HBsAg carriers, and 246 healthy controls. Seven SNPs in IL-6 including rs10499563, rs17147230, rs1800796, rs2069837, rs1524107, rs2066992, and rs2069852 were analysed. In a haplotype analysis between HBV-infected liver cirrhosis cases and CHB patients, inactive HBV carriers or healthy controls, haplotype CT in block 1 and haplotype GGCGG in block 2 were associated with liver cirrhosis (P <0.05). Moreover, the genotype or allele frequencies were significantly different in IL-6 rs10499563 and rs2069837 when HBV-infected liver cirrhosis patients were compared with CHB patients, inactive HBV carriers or healthy controls. A further study found that compared with that in the healthy controls, inactive HBV carriers or CHB patients, plasma IL-6 was elevated in HBV-infected liver cirrhosis patients. ConclusionIn conclusion, the IL-6 rs10499563 and rs2069837 polymorphisms are associated with incidence of liver cirrhosis may through their effects on IL-6 expression and these two single nucleotide polymorphisms can be used as potential prognostic markers of HBV-related liver cirrhosis.

Serological evidence of hepatitis A, B, and C virus infection in older adults in Khon Kaen, Thailand and the estimated rates of chronic hepatitis B and C virus infection in Thais, 2017.

Hepatitis A (HAV), hepatitis B (HBV), and hepatitis C (HCV) viruses are hepatotropic viruses responsible for acute/chronic hepatitis associated with liver failure, cirrhosis, and hepatocellular carcinoma. Due to the limited data on the prevalence of hepatitis in the older population in Thailand, this study aimed to evaluate the seroprevalence of these viruses in elderly Thais. Using an automated immunoassay, serum samples from individuals older than 60 years of age in Chum Phae district of Khon Kaen province in northeast Thailand were analyzed for anti-HAV (n = 93), HBV markers (n = 460, HBsAg, anti-HBs, and anti-HBc), and anti-HCV (n = 460). Samples were classified into five age groups (61–65, 66–70, 71–75, 76–80, and >80 years). The overall seroprevalence of anti-HAV, HBsAg, anti-HBc, anti-HBs, and anti-HCV was 98.9%, 4.6%, 51.5%, 32.4%, and 1.3%, respectively. When samples were stratified into three groups representing three generations (children/young adults aged 6 months-30 years and middle-aged adults between 31–60 years old from a previous survey, and older adults aged >60 years from the current study), the highest levels of anti-HAV and anti-HBc were found in older adults. Children/young adults had the lowest levels of HBsAg and anti-HCV, and the highest level of anti-HBs. These findings are consistent with the integration of HBV vaccination into the Expanded Program on Immunization (EPI) in 1992 and coincide with increased awareness of blood-borne viral transmission in Thailand. Extrapolating from our data, the estimated numbers of cases of chronic HBV and HCV infection in Thailand in 2017 were 2.2 and 0.79 million, respectively. Thus, effective treatments for viral hepatitis B and C for middle-aged and elderly Thais are needed. This seroprevalence survey could be used to help formulate policies and possible guidelines for treatment and prevention in specific age groups, which is recommended to facilitate the elimination of viral hepatitis by 2030.

Self-motivated medical care-seeking behaviors and disease progression in a community-based cohort of chronic hepatitis B virus-infected patients in China

BackgroundTo determine the treatment behaviors among a community-based cohort of chronic hepatitis B virus (HBV)-infected persons and to examine the disease progression among non-antiviral-treated HBV-infected cases after 5 years of follow-up.MethodsWe conducted a community-based prospective study on people with chronic HBV infection in mainland China from 2009 to 2014. In 2009, we recruited participants who were identified as HBV infected in 2006 in a national sero-survey. A face-to-face follow-up investigation was completed in 2014, and the personal information, the clinical diagnosis provided at the last hospital visit, the HBV antiviral treatment history, and the insurance type was collected for each patient for analysis. Multivariable logistic regression was used to identify factors that are associated with active medical care- seeking and antiviral treatments.ResultsAmong the 2422 chronic HBV-infected patients recruited in 2009, 1784 (73.7%) were followed-up to 2014, and 638 (35.8%) had sought medical care in hospitals; among them, 140 (21.9%) received antiviral treatments. The lowest medical care-seeking rate (26%) was in participants over 50-year old. We determined that the frequency of medical care-seeking was higher among those participants living in urban areas (aRR = 1.3, 95% CI:1.0–1.6), those in 0–19-year old (aRR = 1.5, 95% CI:1.1–2.1), 20–39-year old (aRR = 2.2, 95% CI:1.7–3.0) and 40–49-year old (aRR = 1.5, 95% CI:1.1–2.0), and persons with insurance of the type Urban residents’ basic medical insurance (URBMI) or Commercial health insurance (CHI) (aRR = 2.5, 95% CI:1.7–3.6) and New Rural Cooperative Medical System (NRCMS) (aRR = 1.9, 95% CI:1.4–2.6). Patients were more likely to receive antiviral treatment if they were 20–39-year old (aRR = 0.4, 95% CI:0.3–0.7), had insurance of the type URBMI or CHI (aRR = 2.6, 95% CI:1.1–6.3) or NRCMS (aRR = 3.0, 95% CI:1.3–6.9) and were treated at prefecture and above-level hospitals (aRR = 2.0, 95% CI:1.4–3.0). Among non-antiviral-treated HBV-infected cases, we found the annual rates for HBsAg sero-clearance, progress to cirrhosis and HCC were 1.0, 0.6 and 0.2%, respectively.ConclusionThe rates of medical care-seeking and antiviral treatment were low among community-based chronic HBV-infected persons, thus we recommend improving the insurance policies for HBV-infected persons to increase the antiviral treatment rate, and conducting extensive education to promote HBV-infected patients actively seeking medical care from hospitals.

Identifying Possible Hepatic Fibrosis of Hepatitis B Origin Using Non-invasive Markers: A Case-control Study in the South West Region of Cameroon

Aim: HBV infection is known to cause liver fibrosis as well as some extrahepatic manifestations. We aimed at assessing hematological changes and identifying possible hepatic fibrosis of Hepatitis B origin using non-invasive markers (NIMs).&#x0D; Study Design: A hospital-based Case-control study&#x0D; Place and Duration of Study: Conducted at the Buea Regional Hospital, South West Region of Cameroon from February 2016 to December 2017&#x0D; Methods: We enrolled HBV infected treatment naïve patients and “healthy” controls. All participants were subjected to alanine aminotransferase (ALT) and aspartate aminotransferase (AST) measurement, Full blood count (FBC), HBsAg, anti-HBc, HIV and HCV tests. Aspartate-platelet ratio index (APRI), fibrosis based on 4 factors (FIB-4), age-platelet index (API) and AST/ALT ratio (AAR) were generated from the test results. A questionnaire was administered to collect demographic data, alcohol consumption and history of liver/kidney disease or metabolic syndrome.&#x0D; Results: A total of 202 cases and 202 controls were enrolled. Hematocrit (HCT) was significantly higher (p&lt;0.001) in cases than controls. The controls had significantly higher mean values for platelet (p=0.005), neutrophil (p=0.032) and number of individuals with AST/ALT ratio (AAR) ≥1. Liver fibrosis was significantly associated with cases than controls based on APRI (OR:6.06, CI:3.59-10.24), FIB-4 (OR:5.35, CI:2.75-10.39) and API (OR:8.02, CI:1.81-35.55). Among the HBV infected cases, 69 (34.2%), 36(17.8%) and 8(4.0%) had results indicative of fibrosis from at least 2, at least 3 and all 4 NIMs respectively. AAR detected possible fibrosis in 136 HBV infected cases of which up to 77 (56.6%) were not detected as fibrosis by the other NIMs.&#x0D; Conclusion: HBV infection affects neutrophil percentage, HCT, PLT, APRI, FIB-4 and API in our study population. AAR did not prove to be a reliable NIM. Using at least 3 NIMs for HBV infected patients can significantly scale up their reliability for determining liver fibrosis in clinical practice.

Seroprevalence of Hepatitis B&C in coronary artery disease patients in Urmia, Northwest of Iran

BackgroundCoronary artery disease (CAD) is one of the main causes of death all over the world. Predisposing factors comprise some infectious etiologies with systemic effects such as the hepatitis C virus and HBV-infection might be related to CAD from chronic inflammation process. The relationships between hepatitis B&C virus (HBV&HCV) infections and CAD considered a noticeable health problem. In the present study, we evaluated the seropositivity of HCV&HCB in CAD patients from the Iranian population.Materials and MethodsWe conducted a cohort study including 192 CAD subjects. To identify HCV&HCB -infected subjects, a serologic examination comprising Hepatitis B surface antigen (HBsAg) and anti-HCV antibodies (HCV-Ab) tests performed by ELISA method. Also, we examined the biochemical blood parameters such as lipid profile, glycemic parameters, and blood inflammatory factor (C-reactive protein).ResultsWe identified a very low percent of HBV-infected cases (1.04%). All examined CAD patients indicate the HCV Ab-negative results. The HBV-infected subject had not, hyperlipidemia, and diabetes. HBV infection was not related to the increased risk of CAD. Also, CAD risk factors were not associated with the prevalence of HBV&HCV.ConclusionAccording to the results, HCV&HCB infections had very low prevalence in examined subjects and there was not any association between CAD and prevalence of HCV&HCB infections.