Hepatitis B Surface Antigen Positivity Research Articles

Impact of hepatitis B virus infection on the risk of gallbladder polyps: a cohort study.

We aimed to determine whether hepatitis B virus (HBV) or hepatitis C virus (HCV) infection remains an important risk factor for gallbladder polyps (GBPs) in the current context of reduced prevalence of these infections. The cohort included 392,913 asymptomatic adults who underwent abdominal ultrasonography (US). The prevalence of GBP sized ≥ 5 mm, ≥ 10 mm, and overall (< 5, 5-9 and ≥ 10 mm) was 2.9%, 0.1%, and 12.8%, respectively. The prevalence of hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), and hepatitis C antibody (anti-HCV) positivity was 3.2%, 26.7%, and 0.1%, respectively. The GBP risk was significantly increased in HBsAg-positive individuals, with an adjusted odds ratio of 1.66 (95% confidence interval, 1.49-1.85) for GBP ≥ 5 mm, 2.39 (1.53-3.75) for GBP ≥ 10 mm, and 1.49 (1.41-1.59) for overall, whereas there was no significant association between anti-HCV positivity and GBP risk. The GBP risk did not increase significantly in individuals who tested negative for HBsAg but positive for HBcAb. The presence of HBsAg may be an independent risk factor for GBP development in the current context of a indecreasing prevalence of HBsAg positivity. A more comprehensive evaluation of GBP during abdominal US surveillance of HBsAg-positive individuals may be necessary.

Association between the Expression Patterns of Hepatitis B Surface Antigen and Hepatitis B Core Antigen with Clinicopathological Parameters and Antiviral Therapy in Liver Biopsies Obtained from Chronically Infected Hepatitis B Positive Omani Patients

Background: Hepatitis B virus (HBV) infection is considered a major global health problem. The main objectives of the current study is to determine the patterns of expression of the hepatitis B surface antigen (HBsAg) and HBV core antigen (HBcAg) in liver tissue samples obtained from hepatitis B virus-infected Omani patients and to associate between the pattern of the expression of HBsAg and HBcAg with the other clinical parameters and anti-viral therapy. Methods : The expression patterns of HBsAg and HBV core antigen HBcAg were determined by immunohistochemistry (IHC), in 58 formalin-fixed paraffin-embedded liver tissue biopsies obtained from chronic hepatitis B Omani patients. The association between positivity for HBV antigens with gender, age group, histological appearances, and antiviral therapy was determined. Results: IHC-positive staining of HBsAg was demonstrated in 28 patients (48.3%) patients, of whom 4 (6.9%) also showed HBcAg expression. The expression pattern of HBsAg was predominantly cytoplasmic and was seen in 25 (89.3%) of patients, whereas expression of HBcAg was nuclear in 3 (75%) of patients. HBsAg and HBcAg IHC positivity were more common among males than females and among those aged 39–58 years (P = 0.130 and 0.569, respectively). The presence of lymphocytic infiltration in the majority of liver biopsies examined in the present study indicates that the liver damage could be attributed to immunologically mediated events, especially because HBV is a non-cytopathogenic virus. No significant statistical association was found between positivity for HBsAg/HBcAg by IHC and antiviral treatment. Conclusions: Determination of the expression patterns of HBV antigens in liver biopsies obtained from chronic hepatitis B Omani patients and the association between these expression patterns with other clinical histopathological parameters and anti-viral therapy, will contribute greatly to a better understanding of the pathogenesis of HBV in this unique cohort group of infected individuals.

Lower end of treatment HBsAg and HBcrAg were associated with HBsAg loss after nucleos(t)ide analog cessation

BackgroundSince hepatitis B surface antigen (HBsAg) loss is rarely achieved with nucleos(t)ide analog (NA) treatment, most patients require life-long NA treatment. Previous studies have shown that some patients remain virologically responsive even after NA cessation. However, there is still controversy surrounding whether NA discontinuation increases the HBsAg loss rate. Therefore, this study aimed to assess the cumulative rate of HBsAg loss and identify the predictors of HBsAg loss after NA discontinuation.MethodsThis multicenter prospective study included HBV e antigen (HBeAg)-positive patients without cirrhosis from 12 hospitals in China who met the inclusion criteria. The enrolled patients stopped NA and were followed up with clinical and laboratory assessments every 3 months for 24 months after NA cessation or until clinical relapse (CR) occurred.ResultsOverall, 158 patients were classified into two groups. Group A included patients with HBsAg positivity at NA cessation (n = 139), and Group B included patients with HBsAg negativity at NA cessation (n = 19). In Group A, the 12-month and 24-month cumulative rates of HBsAg loss were4.3%and 9.4%, respectively. End of treatment (EOT) HBsAg (hazard ratio (HR) = 0.152, P < 0.001) and EOT hepatitis B core-related antigen (HBcrAg) (HR = 0.257, P = 0.001) were associated with HBsAg loss. The areas under the receiver operating characteristic curves for EOT HBsAg and HBcrAg levels were 0.952 (P < 0.001) and 0.765 (P < 0.001), respectively. Patients with EOT HBsAg ≤ 135 IU/mL (59.2% vs. 1.3%, P < 0.001) or HBcrAg ≤ 3.6 logU/mL (17% vs. 5.4%, P = 0.027) had a higher 24-month cumulative HBsAg loss rate. In Group B, none of the patients experienced virological relapse after NA cessation. Only 1 (5.3%) patient had HBsAg reversion.ConclusionsEOT HBsAg ≤ 135 IU/mL or HBcrAg ≤ 3.6 logU/mL can be used to identify patients with a higher likelihood of HBsAg loss after NA cessation. Patients with HBsAg negativity after NA cessation have favorable clinical outcomes, and HBsAg loss was durable in most cases.

Knowledge, attitude, practices, seroprevalence and vaccination status concerning hepatitis B, hepatitis C, human immunodeficiency virus among health care students

Aim: Students of all departments that serve patients during their education are in the risk group in terms of parenterally transmitted microorganisms. This study aims to evaluate the knowledge level and serologic status of healthcare students about viral hepatitis and Human Immunodeficiency Virus (HIV) infection.&#x0D; &#x0D; Methods: A sociodemographic questionnaire consisting of 29 questions was applied to 262 students who presented to the medico-social outpatient clinic between January 2015 and December 2020. Additionally, hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (Anti HBs), hepatitis B core antibody (Anti HBc total), hepatitis C virus antibody (Anti HCV), HIV antibody (Anti-HIV) serum levels were investigated. The obtained information was evaluated with descriptive statistics and chi-square test in statistical package for the social sciences package program version 20. Results were given as frequency and percentage.&#x0D; &#x0D; Results: The mean age of the study group (230 female and 32 male) was 21.29 ± 2.2 years. According to the questionnaire, 43.9% of students stated that they had HBV vaccination, while 56.1% of the students stated that they were not vaccinated. The rate of the student who checked antibodies after vaccination was 14.1%. While 74% of students stated that they took lessons about hepatitis risk factors, 26% of students did not take any lessons. According to the laboratory results, Anti HBs positivity was found in 235 students (89.7%). Anti-HBc total positivity was found in 5 students (1.9%). HBsAg positivity was found in 2 students (0.8%). Anti-HCV and Anti-HIV were negative in all our students.&#x0D; &#x0D; Conclusion: Our results indicate that high prevalence of Anti HBs seropositivity among healthcare students. This result can be explained by our successful vaccination program in Turkey. As a preventive medicine perspective, it should be ensured that students studying at these schools should be trained, screened, and guided to become immune.

Hepatitis B Virus Immunity Gap: A Six-Year Laboratory Data Review of Hepatitis B Serological Profiles in Gauteng Province, South Africa.

In 1995, the hepatitis B vaccine in South Africa was incorporated into the childhood expanded programme of immunization. We report on immunity gaps of laboratory-based hepatitis B virus (HBV) among patients in public facilities in Gauteng Province from 1st January 2014 to 31st December 2019. Methodology. We analyzed HBV serological data extracted from the National Health Laboratory Services Central Data Warehouse (NHLS CDW). A descriptive analysis was performed for hepatitis B surface antigen (HBsAg), antibodies to HBV core (anti-HBc) total, anti-HBc IgM, and antibodies to HBV surface antigen (anti-HBs) according to annual distribution, age groups, and sex. The HBsAg positivity rate was 7.0% (75,596/1,095,561; p=0.001): 7.4% (96,532/944,077) in the 25 years and over age group and 4.0% (358/9,268 and 325/10,864) in the under 5 and 13-24 year age groups. The positivity rates of the other HBV serological markers were as follows: anti-HBc total was 37.0% (34,377/93,711; p < 0.001), anti-HBc IgM was 2.4% (5,661/239,237; p=0.05), and anti-HBs was 37.0% (76,302/206,138; p ≤ 0.001). Naturally acquired HBV immunity was detected in 25.7% (11,188/43,536) of patients in the 25 years and over age group, and 9.7% and 8.2% (113/1,158 and 541/6,522) among those under 5 years and 13-24 year age group, respectively (p < 0.001). Vaccine-induced immunity was 56.6% (656/1,158) in children under 5 years and 10.2% (4,425/43,536) among those 25 years and above (p < 0.001). Fifty-six percent (29,404/52,581) of patients were HBV seronegative; predominantly among patients in the 13-24 year age group (60.6%; (3,952/6,522)) and 25 years and over (56.3% (24,524/43,536)) (p=<0.001). The HBV infection seroprevalence remains high in South Africa, with Gauteng province having high intermediate endemicity. However, the HBV immunity gap has shifted from younger children to older children and adults.

Hepatitis B prevention and treatment needs in women in Senegal (ANRS 12356 AmBASS survey)

BackgroundAlthough mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is prevalent in West Africa, epidemiological data on HBV infection in women remain scarce. We studied i) hepatitis B surface antigen (HBsAg) prevalence and its correlates, ii) HBV screening history and serological status awareness, iii) MTCT risk and treatment needs in Senegalese women.MethodsA cross-sectional population-based serosurvey for HBsAg positivity was conducted in 2018–2019 in the rural area of Niakhar (Fatick region, Senegal). Participants were offered home-based HBV screening and answered face-to-face questionnaires. HBsAg-positive participants underwent clinical and biological assessments. Data were weighted and calibrated to be representative of the area’s population. Logistic regression models helped identify factors associated with HBsAg-positivity in adult women (> 15 years old).ResultsHBsAg prevalence in adult women was 9.2% [95% confidence interval: 7.0–11.4]. Factors associated with HBsAg-positivity were being 15–49 years old (ref: ≥ 50), living in a household with > 2 other HBsAg-positive members, and knowing someone with liver disease. Only 1.6% of women had already been tested for HBV; no one who tested HBsAg positive was already aware of their serological status. In women 15–49 years old, 5% risked MTCT and none were eligible for long-term antiviral treatment.ConclusionsAdult women have a high HBsAg prevalence but a low MTCT risk. Low rates of HBV screening and serological status awareness argue for the adoption of systematic screening during pregnancy using free and rapid diagnostic tests. Additionally, screening household members of HBsAg-positive women may greatly improve the cascade of care in rural Senegal.Trial registrationClinicalTrials.gov identifier (NCT number): NCT03215732.

Detection and prevalence of HBsAg and HBV DNA among visiting patients attending health facilities in Nigeria

Hyper-endemicity of the Hepatitis B virus (HBV) has for long been retained in parts of Sub-Saharan Africa, including Nigeria with a prevalence rate above 8%. Despite the implementation of vaccination programs, factors such as inadequate diagnostic protocols, the prevalence of occult infections, and population group-specific susceptibility to infection remain overlooked in control strategies. This study, therefore, aims at investigating the prevalence of hepatitis B viral infection, the presence of mutant strains, and establishing a link between age, blood parameters and susceptibility to infection. A total of 451 blood samples from participants aged 1–50 years were tested for the presence of hepatitis B surface antigen (HBsAg) and HBV DNA using rapid diagnostic testing and PCR molecular-based assay. Age, blood group and hemoglobin (Hb) genotype were used to evaluate associated risk of infection. Statistical analysis was done using Python3. A prevalence of 5.8% and 18.2% were recorded using rapid diagnostic testing and PCR molecular-based assay respectively. Correlation between age and, HBV DNA and HBsAg positivity gave a p-value of 1.672. Error rates of 4.4% and 16.9% were recorded for false positives and false negatives respectively, with a rapid test kit sensitivity of 7.32% and specificity of 94.58%. Blood group O rhesus D positive (O⁺) showed a statistically significant higher risk of infection (P < 0.001, odd ratio (OR) = 0.38, 95% CI = 0.23–0.63) compared to non-O blood types. Age groups 21- 30 years and 31–40 years, both showed high relative risk and odd ratios. The low sensitivity found for the available RDT kits negatively influenced the ability to screen for Hepatitis B strains, hence, the high rate of false negatives. The Hb genotype may also play some role or have some association with the viral infection. This study highlights areas to specifically look into in implementing HBV eradication strategies.

Efficacy and Long-term Safety of Telbivudine Usage During Second or Third Trimester in Hepatitis B Surface Antigen Positive Mothers With High Viral Load: A 10-year Prospective Study.

The study is to evaluate the efficacy and long-term safety of telbivudine (LdT) usage for hepatitis B surface antigen (HBsAg) positive pregnant women with high viral load. The efficacy and safety of LdT during pregnancy were not assessed from a long-term perspective. HBsAg-positive pregnant women were enrolled and grouped according to antiviral initiation time. Group A (n=100) and group B (n=100) were treated with LdT initiated in the second or third trimester. Group C (n=90) received no antiviral treatment. The efficacy and safety of LdT treatment were compared and infants were followed-up at 1, 5, and 10 years. Denver developmental screening test was conducted at 5 years. Viral loads before delivery in LdT-treated groups were lower than that in group C and group A was lower than that in group B ( P <0.001). No infants in LdT-treated groups were infected whereas 8.8% (8/90) infants in group C had positive HBsAg (χ 2 =23.20, P <0.001). All LdT-treated mothers were well tolerated and no LdT-related adverse events in infants were reported. Part of the physical growth index of infants was higher than Chinese standard values (SV) and showed significant differences. In groups A and B, the developmental screening test qualified rate of 100% (48/48) and 97.96% (48/49) showed no significant difference compared with 92% in normal Chinese children (χ 2 =5.72, P =0.06). Treatment initiated during the second trimester could strengthen the success of mother-to-child transmission blockage. LdT treatment during pregnancy is safe for both mothers and infants in the long term.

Treat-all: challenges of partial response and low-level viremia

The recently updated "Guidelines for the Prevention and Treatment of Chronic Hepatitis B" in China have brought about significant changes. The new treatment indications almost mandate the implementation of a Treat-all strategy for the chronically HBV-infected population in China. While simultaneous negativity for hepatitis B surface antigen (HBsAg) and hepatitis B virus (HBV) DNA has long been an accepted criterion for treatment discontinuation, there has been controversies over the initiation of treatment criteria starting with HBsAg and HBV DNA positivity. Despite the inconsistent treatment criteria, the academic community has started supporting treat-all strategies in recent years due to the decreasing cost of treatment, prolonged management duration, and growing evidence of poor outcomes in untreated populations. Therefore, this update to the Chinese HBV guidelines represents a new direction that suggests "The greatest truths are the simplest." However, in the process of rolling out the Treat-all strategy, we must remain cautious of possible issues arising from the new strategy. Among them, the problem of partial response or low-level viremia following treatment may become more prominent due to the inclusion of a significant number of patients with normal or low levels of alanine transaminase. As existing evidence suggests that low-level viremia increases the risk of HCC in patients, it is essential to monitor and explore optimal therapeutic options for these patients.

Evaluation of HBsAg Seroclearance in Patients with Hepatitis B.

Hepatitis B surface antigen (HBsAg) seroclearance/seroconversion is regarded as an indicator of the ultimate immune control of hepatitis B virus (HBV) infections. HBsAg loss is the most important endpoint, as it shows deep suppression of HBV replication and viral protein expression. This study was aimed to retrospectively evaluate the HBsAg seroclearance/seroconversion status in patients with acute or chronic hepatitis B (CHB) diagnosis. Patients diagnosed with acute or CHB at the Harran University Faculty of Medicine Department of Gastroenterology between January 2012 and December 2020 were included in this study. This study was designed as a retrospective historical cohort. Experimental analysis of the data was done with the help of the SPSS version 22.0 package program. Of 1,053 patients with positive HBsAg, 854 patients with sufficient data in their files were included in this study. There were 494 (57.8%) males and 360 (42.2%) females; the mean age was 42.71 ± 14.31 (range 18-88). The mean duration of illness was 86.13 ± 72.92 months. In the 9-year follow-up of 854 patients, 65 (7.9%) of the last HBsAg test were negative and seroclearance had developed. The last anti-HBs test was positive in 49 (75.4%) of 65 patients who developed seroclearance, and it was found that seroconversion had developed. Twenty-seven of 30 (90%) of the patients who developed seroclearance had liver transplantation. Sixteen of 19 (84.2%) of them had acute hepatitis B, 14 of 477 (2.9%) were hepatitis carriers, 5 of 201 (2.5%) had e-negative CHB, 2 of 36 (5.6%) had cirrhosis, and 1 of 43 (2.3%) of them were delta hepatitis who developed seroclearance disease; none of the 38 e-positive CHB patients developed seroclearance. In the 9-year follow-up of patients who were positive for HBsAg at their first admission, approximately one-tenth (7.9%) developed seroclearance, and two-thirds also developed seroconversion. After liver transplantation and acute hepatitis B, almost all patients developed seroclearance, whereas, in approximately 3% of carriers (e-negative CHB and cirrhotic patients) seroclearance developed. Taşkın MC, Uyanikoglu A, Cindoglu C. Evaluation of HBsAg Seroclearance in Patients with Hepatitis B. Euroasian J Hepato-Gastroenterol 2022;12(2):65-68.

Epidemiology of Chronic Hepatitis B Infection in the Cohort of College Students with Vaccination in Taiwan.

After the mass vaccination project in Taiwan, the prevalence of the hepatitis B virus (HBV) infection for the college-aged population of 18 to 21 years is uncertain. We aimed to investigate the prevalence of hepatitis B markers in different birth cohorts. A total of 38,075 students in universities in Kaohsiung area undergoing entrance examinations between July 2006 to September 2020 were included. Seroprevalence of the hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs) status and laboratory data were collected. The seropositive rate of HBsAg was less than 1% for students born after 1991. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST), were significantly higher, and body mass index (BMI) was significantly lower in HBV carriers compared to those who were not carriers (all p < 0.001). Multivariate logistic regression showed that age, male, higher BMI, and positive HBsAg were risk factors of abnormal ALT value. A decrease in the positive rate of anti-HBs which was significantly higher in the cohort of plasma-derived vaccines than recombinant vaccines was found. We concluded that there were decreasing trends in seropositive rates of HBsAg and anti-HBs for students of the college-aged population in the Kaohsiung area. The status of HBsAg was a predictive factor of abnormal ALT levels. The period effect on anti-HBs seropositivity for DNA recombinant vaccine somehow existed.

Positive status of Hepatis B Virus seroprevalence in local people and immigrants

Background In our study, we aimed to examine the seroprevalence of hepatitis B virus (HBV) infection and whether there is a sociodemographic difference between the two groups according to the hepatitis B surface antigen (HBsAg) results obtained in the blood samples given by the Turkish population and Syrian immigrants living in Bursa in their primary, secondary, and tertiary care applications. &#x0D; Material and Methods All patients with HBsAg serology who applied to family health centers, migrant health centers, 2nd and 3rd level hospitals in Bursa province during the 5-year period from January 2017 to the end of December 2021 were included in our study.&#x0D; Results During our study, HBsAg tests were taken from 955,528 people until the end of 2017-2021. The rate of Turkish citizens was 96.1% (n: 918,140), and the rate of Syrian origin was 3.9% (n: 37,388). Of all patients, 39.4% (n: 376,388) were male, and 60.6% (n: 579,140) were female. The HBsAg test was negative in 96.4% (n: 921,582) and positive in 3.6% (n: 33,946) of the patients. HBsAg positivity was found to be 3.6% in Turks and 2.4% in Syrians. HBsAg positivity was found to be 4.6% in men and 2.9% in women. The highest HBsAg positivity rate was 7.4% in the 50-59 age group. &#x0D; Conclusions The dissemination of the hepatitis B vaccine, which is currently in use, seems to be the most crucial weapon in the hands of humanity to prevent this infection and the diseases it will cause.

Prevalence of hepatitis B virus infection among pregnant women in the mountainous regions of southern China: A retrospective single‐center study

Hepatitis B virus (HBV) infection remains a major public health issue worldwide. Moreover, its prevalence varies significantly in different geographic areas of China. The current study aimed to assess the prevalence of HBV infection among Hakka pregnant women in Meizhou, a remote mountainous region in southern China. This research was performed between January 2015 and December 2020. In total, 16,727 pregnant women receiving antenatal care at Meizhou People's Hospital were included in the analysis. All pregnant women were screened for serum HBV markers. The prevalence rates of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody positivity among the participants were 11.74% (n=1964) and 48.00% (n=8029), respectively. The overall prevalence rates of susceptibility to infection, HBV immunity, previous/occult infection, inactive HBsAg carrier, and active infection were 36.16%, 33.61%, 16.94%, 8.11%, and 2.30%, respectively. According to age distribution, the prevalence rate of HBsAg positivity elevated concomitantly with increasing age (p < 0.001). From 2015 to 2020, the prevalence rate of HBsAg positivity decreased from 14.50% to 8.19% and that of hepatitis B pre-core antigen positivity from 4.42% to 2.31%. In addition, pregnant women with HBsAg-positive status were more likely to present with gestational diabetes, thrombocytopenia, and anemia than those with HBsAg-negative status. The HBV infection rate remains high among pregnant women in the indigenous Hakka population in southern China. To prevent vertical transmission, cautious surveillance of maternal HBV infection status should be considered in Hakka pregnant women in Meizhou.

Use of serum Golgi protein 73 for screening chronic hepatitis B virus infection patients needing antiviral therapy in the community.

Use of serum Golgi protein 73 for screening chronic hepatitis B virus infection patients needing antiviral therapy in the community.

A booster hepatitis B vaccine for children with maternal HBsAg positivity before 2 years of age could effectively prevent vaccine breakthrough infections

BackgroundThe long-term protective effect of hepatitis B vaccine (HepB), the incidence of hepatitis B virus (HBV) vaccine breakthrough infections (VBIs), and whether a booster HepB is necessary remain to be clarified in children born to mothers with chronic HBV infection.MethodsBased on a long-term follow-up prospective cohort of 1177 hepatitis B surface antigen (HBsAg)-positive mothers and their paired infants which was established from 2009 to 2011, total 454 children with immunoprophylaxis success as determined by postvaccination serologic testing (PVST) at 7 months old were included in this study. Among the 454 children, 246 never had a booster HepB, and 208 children received a booster HepB from 1 to 5 years of age. Multivariate logistic regression analysis was used to analyse the risk factors for HBV VBIs.ResultsThe hepatitis B surface antibody (anti-HBs) levels declined sharply from 7 months to 2 years old, and the anti-HBs seronegative rate in the children increased significantly from 2 years old. A total of 31 (6.83%) of the 454 children experienced VBIs, of which 7 had overt and 7 had occult HBV infections. Notably, 14 (45.16%) of the 31 children with VBIs were diagnosed at 2 years old, and all of them had anti-HBs positivity (> 10 mIU/mL) at 1 year old. Maternal hepatitis B e antigen (HBeAg) positivity, higher HBV DNA and HBsAg levels, lower initial infant anti-HBs levels and not receiving a booster HepB were independent risk factors for VBIs. The incidence of VBIs was significantly lower in children with a booster HepB than in nonboosted children (0.50 vs. 11.90%, P < 0.001), and none of the boosted children developed overt or occult HBV infection. The anti-HBs levels of 76.67% for the children with VBIs in the nonboosted group indicated positivity before VBIs was detected.ConclusionsAfter the primary full immunization with HepB, children born to mothers with chronic HBV infection, especially the children with maternal HBeAg positivity, high HBV DNA levels, high HBsAg levels and/or low initial infant anti-HBs levels, were at a high risk of VBIs, and a booster HepB for these children before 2 years old, instead of when their anti-HBs level is < 10 mIU/mL, could reduce the incidence of VBIs.

S3276 A Rare Case of Non-Small Cell Lung Cancer Causing False Positive Hepatitis B Surface Antigen

Introduction: Hepatitis B surface antigen (HBsAg) is a protein on the surface of HBV which can be a distinctive serological marker of acute or chronic hepatitis B infection. We present a case of 74-year-old male with a false positive HBsAg test. Case Description/Methods: A 74-year-old African American male with medical comorbidities of stage IV non-small cell lung cancer (NSCLC) and HTN presented to the hospital for an acute kidney injury with proteinuria. Hepatitis B virus (HBV) panel was obtained and revealed positive HBsAg. HBsAg was previously negative two years prior. Patient had multiple risk factors for hepatitis B infection including prior use of IV cocaine and multiple sexual partners. The patient denied any recent vaccinations. Liver function tests were normal. Physical examination did not reveal chronic liver disease manifestations. HBs Antibody (HBsAb) was positive with a quantitative value of 0.53. Hepatitis B core immunoglobulin M (HBc IgM), HBcAb total, HBeAg, HBeAb were all negative with undetectable serum HBV DNA. The HBsAg was not confirmed as a true positive after repeat testing with an antibody neutralizing procedure involving a human antibody to HbsAg. Discussion: Accurate interpretation of laboratory tests is imperative in diagnosing hepatitis B. There was high suspicion that patient had false positive HBsAg. The patient’s serological profile did not fit acute or chronic hepatitis B. The patient had no evidence of acute hepatitis B with negative HBc IgM, HBV DNA and no evidence of chronic hepatitis B with HBcAb total being negative. Furthermore, a positive HBsAb is not seen in acute and chronic hepatitis B. Transient HBsAg has been seen in patients for up to 2 weeks after HBV vaccination, however, our patient had not been vaccinated recently. The most common cause is the presence of heterophile antibodies. These naturally occurring human antibodies can bind to a variety of chemical structures including animal antibodies seen in immunochemistry assays. They can be neutralized by specific inactivating binders. Other viral infections such as Epstein-Barr Virus (EBV), transfusions, or systemic disease can cause false positives. A likely suspect was the patient’s NSCLC causing a paraneoplastic syndrome which would be the first instance of such in the literature. There have been cases of parathyroid adenoma and basal cell carcinoma causing false positivity. Patients with false-positive HBsAg need further workup to prevent misdiagnosis and potentially harmful management.

Hepatit B Yüzey Antijeni (HBsAg) Pozitif Hastalarda Hepatit A ve Hepatit E Virüsü Seropozitifliği

Introduction: In this study, we aimed to determine the anti-HAV IgG and anti-HEV IgG seroprevalence in patients admitted to our clinic with Hepatitis B surface antigen (HBsAg) positivity. &#x0D; Material and Method: Data of 1827 patients followed up on for HBsAg positivity between 2010 and 2019 were obtained retrospectively. &#x0D; Results: The mean age of 1827 HBsAg positive patients was 42.71±14.84; there were 730 (39.96%) female patients and 1097 (60.04%)male. Of the 923 HBsAg positive patients whose anti-HAV IgG was measured, 830(%89,9) were detected to be positive, and 93 (10.1%) negative. Anti-HAV IgG negative patients were most often in the 21-30 age range (38.7%). Age medians were significantly different between the groups (p=0.001). HBsAg positive patients who were also positive for anti-HAV IgG tended to be older than anti-HAV IgG negative patients. In contrast, there was no significant difference in gender between anti-HAV IgG negative and positive patients (p=0.674). Of 143 HBsAg positive patients who were tested for anti-HEV-IgG, five were positive (3.5%).&#x0D; Conclusion: It is of interest that we found a lower rate of anti-HAV IgG positivity in young Chronic Hepatitis B patients. When hepatitis B virus is detected, a test for anti-HAV IgG should be requested from patients and if the test result is negative, the patient should be vaccinated. Our study data analysis also revealed a low anti-HEV IgG positivity.

Seroprevalence of Hepatitis B Virus Among Pregnant Women in India: A Systematic Review and Meta-Analysis

Hepatitis B virus (HBV) infection during pregnancy is associated with perinatal transmission contributing to the pool of HBV infection in the population. There is a wide variation in the reported data on the seroprevalence of HBV in pregnant patients from various parts of India. Hence, a systematic review and meta-analysis was conducted to determine the pooled seroprevalence of HBV and its associated demographic factors. A comprehensive literature search of Medline, Scopus, and Google Scholar was conducted from January 2000 to April 2022 for studies evaluating the prevalence of HBV in pregnant patients from India. A total of 44 studies with data on 272,595 patients were included in the meta-analysis. The pooled prevalence of hepatitis B surface antigen (HBsAg) in pregnant women was 1.6% [95% confidence interval (CI), 1.4-1.8]. Among patients with HBsAg positivity, the pooled prevalence of hepatitis B e antigen was 26.0% (95%CI 17.4-34.7). There was no significant difference in the odds of HBV seroprevalence based on the age (<25 years vs.>25 years) [odds ratio (OR) 1.07, 95%CI 0.74-1.55], parity (primipara vs. multipara) (OR 1.09, 95%CI 0.70-1.70) or area of residence (urban vs. rural) (OR 0.88, 95%CI 0.56-1.39). However, the odds of HBV seroprevalence in those with no or primary education was higher than in those with secondary level education or higher (OR 2.29, 95%CI 1.24-4.23). Prior history of risk factors was present in 13.5-22.7% of patients indicating a vertical mode of acquisition. There is a low endemicity of HBV among pregnant women in India. Risk factors are seen in less than 25% of the cases, indicating vertical transmission as the predominant mode of acquisition, which can be reduced by improving vaccination coverage.

Hepatitis B virus infection and HBeAg positivity among pregnant women in South West Uganda.

BackgroundHepatitis B virus is a public health burden in Uganda, yet little is known about its epidemiology in pregnancy.ObjectiveThis study aimed at determining the prevalence and associated risk factors of hepatitis B virus infection among pregnant women attending antenatal care at the Kyazanga Health Centre IV in Lwengo District, Uganda.MethodsThis cross-sectional study was conducted from April 2021 to June 2021 and analysed qualitative data that were collected using a structured in-person questionnaire. Aseptically collected blood specimens were screened for hepatitis B virus infection using an immunochromatographic rapid diagnostic test kit. Participants who were positive for the hepatitis B surface antigen (HBsAg) were further screened for hepatitis B envelope antigen (HBeAg) using commercial rapid diagnostic test kits.ResultsOut of 384 pregnant women studied, eight tested positive for HBsAg. This gave a prevalence of 2.1% (95% confidence interval: 1.0% – 4.1%); 5/8 (62.5%) were positive for HBeAg. None of the variables studied were significantly associated with HBsAg positivity among pregnant women.ConclusionHepatitis B viral infection is still a public health challenge in pregnant women with possible risk for vertical transmission to their babies in the study area. We recommend routine screening for hepatitis B virus in pregnancy in addition to strengthening current strategies aimed at controlling and preventing hepatitis B infection spread and transmission.

Occult hepatitis B virus infections and risk factors among school-going adolescent voluntary blood donors in Kwale County Kenya, January 2020-June 2021: Cross sectional study.

Occult hepatitis B virus (HBV) infections remain a safety concern worldwide. The prevalence in Kenya ranges from 2.6% to 4.4% among secondary school-going voluntary blood donors. This study estimated the prevalence of occult HBV infections among school-going voluntary blood donors through donations made to Kwale Satellite Blood Transfusion Center (KSBTC). This was a retrospective cross-sectional study on data collected by the KSBTC between January 2020 and June 2021 among secondary school-going voluntary blood donors. Data were collected in MS Excel 2013 and analyzed in Epi Info 7. Descriptive statistics were calculated and we compared donors with positive Hepatitis B surface antigen (HBsAg) to those with negative HBsAg. Crude Prevalence Odds Ratios (cPOR) at 95% confidence intervals (CI) were calculated to identify factors associated with positive HBsAg. A total of 613 records were analyzed. The mean age of the donors was 19.1 years (± 1.8 years), there were 457 males (74.5%), 502 individuals were in the age group 18-25 years (82.3%), and the mean hemoglobin level was 14.1 g/dl (±1.6 g/dl). First-time blood donors made up 84.8% of all donors (513/605) and the mean inter-donation period was 20 months (±5.8 months) for repeat donors. The sero-positivity for HBsAg was 8.8% (54/613). Age category 16-17 years with positive HBsAg were 10.2% (11/108), femaleswere10.9% (17/156), and first-time donors were 9.4% (48/513). On bivariate analyses, first-time blood donors were 1.5 times more likely to test positive for HBsAg compared to repeat donors (cPOR = 1.5, 95% CI 0.61-3.57). Females were 1.4 times more likely to test positive for HBsAg compared to male donors (cPOR = 1.4, 95% CI 0.76-2.54). The majority of the voluntary blood donors were males and the majority of occult HBV infections came in the first-time blood donor group. We recommend increasing targeted recruitment of repeat donors by encouraging healthy first-timer donors to be regular donors, and suggest this population should be vaccinated against HBV infections.