Incidence Of Hepatitis B Virus Research Articles

Influence of socio-cultural factors on hepatitis B infection in Mombasa County, Kenya

Background: The hepatitis B virus (HBV) is responsible for causing a communicable liver disease that can be prevented through vaccination. Although the HBV vaccine was introduced in Kenya’s expanded immunization program in 2003, the incidence of HBV remains high in the country, especially among IDUs. Objective was to investigate the influence of socio-cultural factors on HBV infection in Mombasa County, Kenya. Methods: The study utilized a cross-sectional analytical design. The study was purposely conducted in Mombasa County because the area is highly prevalent with drug users and people with hepatitis B. There are eight treatment centers in the county, 4 public and 4 privates where stratified random sampling was used. The sample size was proportionately distributed across the selected treatment centers. The study employed a mixed method of data collection, involved; self-administered questionnaire to the IDU’s, key informant interviews and focused group discussion with treatment care managers. Results: The prevalence of hepatitis B was 22%; with male (77.1%) most affected than women (22.9%). Bivariate analysis show that a history of drug abuse was significantly associated with prevalence of hepatitis B (χ2=2.485, df=1, p=0.046). Conclusions: The prevalence of hepatitis B is on the increase among injecting drug users. Having a history of drug abuse was a significant predictor to the prevalence of hepatitis B among injecting drug users in this study. Cultural practices such as piercing and tattooing were observed among study participants were established as a risk factor to hepatitis B infection among injecting drug users.

Estimating the epidemiology of chronic Hepatitis B Virus (HBV) infection in the UK: what do we know and what are we missing?

Background: HBV is the leading global cause of cirrhosis and primary liver cancer. However, the UK HBV population has not been well characterised, and estimates of UK HBV prevalence and/or incidence vary widely between sources. We aimed to i) extract and summarise existing national HBV prevalence estimates, ii) add a new estimate based on primary care data, and; iii) critique data sources from which estimates were derived. Methods: We undertook a narrative review, searching for national estimates of CHB case numbers in the UK (incorporating incidence, prevalence and/or test positivity data) across a range of overlapping sources, including governmental body reports, publications from independent bodies (including medical charities and non-governmental organisations) and articles in peer-reviewed scientific journals. An alternative proxy for population prevalence was obtained via the UK antenatal screening programme which achieves over 95% coverage of pregnant women. We also searched for diagnoses of HBV in the QResearch primary care database based on laboratory tests and standardised coding. Results: We identified six CHB case number estimates, of which three reported information concerning population subgroups, including number of infected individuals across age, sex and ethnicity categories. Estimates among sources reporting prevalence varied from 0.27% to 0.73%, congruent with an estimated antenatal CHB prevalence of <0.5%.Our estimate, based on QResearch data, suggests a population prevalence of ~0.05%, reflecting a substantial underestimation based on primary care records. Discussion: Estimates varied by sources of error, bias and missingness, data linkage, and "blind spots" in HBV diagnoses testing/registration. The UK HBV burden is likely to be concentrated in vulnerable populations who may not be well represented in existing datasets including those experiencing socioeconomic deprivation and/or homelessness, ethnic minorities and people born in high-prevalence countries. This could lead to under- or over-estimation of population prevalence estimation.Multi-agency collaboration is required to fill evidence gaps.

Strategic information to guide elimination of viral hepatitis

WHO has placed the world on the path towards the elimination of hepatitis B virus (HBV) and hepatitis C virus (HCV). The 2016 adoption of the Global Health Sector Strategy (GHSS) set goals for a 90% reduction in incidence and a 65% reduction in mortality for HBV and HCV by 2030, along with targets for improvements in testing, treatment, and hepatitis B vaccination. 1 WHOGlobal Health Sector Strategy on viral hepatitis, 2016–2021—towards ending viral hepatitis. June 2016.. http://apps.who.int/iris/bitstream/10665/246177/1/WHO-HIV-2016.06-engDate accessed: December 13, 2022 Google Scholar The collection of reliable data for elimination of viral hepatitis is a particular challenge, requiring monitoring of trends in HBV and HCV incidence and mortality. Even when data are available, the development of HBV and HCV sequalae, including severe liver damage and liver cancer, usually occurs decades after infection, making the interpretation of elimination effects complex. Furthermore, given low screening rates and fragile national surveillance systems, new infections and mortality are often under-reported. Global reporting of progress towards elimination of hepatitis B and hepatitis CThere has been notable global progress towards hepatitis elimination. In 2019, 30·4 million (10·3%) people living with hepatitis B knew their infection status, which was slightly higher than in 2015 (22·0 million; 9·0%), and 6·6 million (22·7%) of those diagnosed with hepatitis B received treatment, compared with 1·7 million (8·0%) in 2015. Mortality from hepatitis C has declined since 2019, driven by an increase in HCV treatment ten times that of the strategy baseline. However, an estimated 89·7% of HBV infections and 78·6% of HCV infections remain undiagnosed. Full-Text PDF

Efficacy of Accelerated Vaccination against Hbv to Achieve Antibody formation in Multiple Sclerosis Patients Receiving Anti-Cd20 Therapy.

Ocrelizumab is a monoclonal antibody that has been approved for use in both relapsing-remitting multiple sclerosis (RRMS) and primary progressive multiple sclerosis (PPMS). Since ocrelizumab acts on B cells, it also affects humoral immunity, thus reducing the vaccine response. In this study, we aimed to elucidate the relationship between the antibody response following rapid vaccination against hepatitis B virus (HBV) in multiple sclerosis (MS) patients receiving ocrelizumab treatment, and the time of vaccination. A total of 220 MS patients were included in this retrospective analysis. The patients' baseline HBV serostatuses (HbsAg, Anti-HbsAb, Anti-HbcAb), previous drug history for MS, whether they were vaccinated against HBV in the past, vaccination status before or after ocrelizumab treatment, and protective antibody titers according to vaccination times, occult HBV incidence and initiation of antiviral treatment were evaluated. Forty-nine percent of MS patients using ocrelizumab were not vaccinated against HBV. The patients were divided into three groups according to their vaccination status as: individuals vaccinated in the past (7.3%, n = 16), vaccinated before treatment (4.5%, n = 10), and vaccinated after treatment (22.3%, n = 49). The antibody titers of the patients in the 6th month after ocrelizumab treatment were measured as 78 mIU/ml, 193 mIU/ml, and 0, respectively. The number of patients with occult HBV infection was 38. In patients with a suspected diagnosis of MS, HBV serostatus should be evaluated at the beginning and if necessary, patients should be vaccinated in the early period. Vaccinating patients at least 1 month before initiating multiple sclerosis treatment is more effective in terms of protective antibody formation.

1243. Hepatitis D Virus and Hepatitis B Virus Epidemiology in Utah

Abstract Background Hepatitis Delta Virus (HDV) is a rare infectious disease that requires a helper virus (ex. Hepatitis B Virus (HBV)) for transmission. Worldwide, it is estimated that 12-72 million individuals are infected with HDV. Within the United States, an accurate measure of HDV prevalence is attenuated by limited testing and variable notifiable disease status. Recent reports have noted a significant shift in the international HDV epidemiology. This retrospective study was designed to further evaluate the prevalence and clinical features of HDV and HBV within the Utahn patient population. Methods Within University of Utah Health, patient demographics, diagnostic codes (ICD9, ICD10) for HBV and HDV, CPT test codes and lab results were evaluated from 2000-2020. Univariate and multivariate analyses were performed. Timeseries analyses, including Mann-Kendall (MK) trend test, Bayesian Information Criterion (BIC) and Autoregressive Integrated Moving Average (ARIMA) were performed to characterize trends in HDV and HBV prevalence. Results Between 2000-2020, 2878 HBV and 180 HDV patients were identified within the University of Utah Health system. The median age of the HBV and HDV patients was 45 years with 56% males and 42 years with 60% males, respectively. 10% of all HBV-tested patients were tested for HDV. The positivity rate of patients tested for HDV was 7%. Statistical analysis of race and ethnicity showed a significant difference in incidence and testing rates among the Utahn Asian population when compared against non-Asian populations. A significant increasing trend in the incidence of both HBV (MK=156, p=2.8e-6) and HDV (MK=83, p=0.01) was observed between 2000-2020. Within the timeframe analyzed, two structural breaks were observed for HDV/HBV incidence ratio. Conclusion Together, our analysis suggests a significant change in the incidence of HDV and, due to the global temporal trend observed, may be suggestive of a change in HDV transmission pattern. Active surveillance of HDV in the United States and worldwide is warranted to further define these observed changes in HDV incidence. Disclosures All Authors: No reported disclosures.

Evaluating the cost-effectiveness of hepatitis B vaccination strategies in high-impact settings for adults.

Adults at increased risk for hepatitis B virus (HBV) infection are recommended to receive vaccination. We conducted a cost utility analysis to evaluate approaches for implementing that recommendation in selected high-risk settings: community outreach events with a large proportion of immigrants, syringe service programs, substance use treatment centres, sexually transmitted infection (STI) clinics, tuberculosis (TB) clinics and jails. We utilized a decision tree framework with a Markov disease progression model to compare quality adjusted life-years and cost in 2021 United States dollars from four strategies: a 3-dose vaccination regimen with prevaccination screening and testing (PVST; baseline comparison); PVST at the initial encounter followed by a 2-dose series (Intervention 1); PVST with the first dose of a 2-dose vaccination series at the initial encounter (Intervention 2); and a 2-dose vaccination series without PVST (Intervention 3). In all settings, Intervention 1 resulted in worse health outcomes compared with the baseline strategy. Intervention 2 averted incident chronic HBV infections in all settings (range -9.4% in TB clinics, -14.8% in syringe service programs) and was a cost-saving approach in settings with higher risk of infection (i.e. jails, -$266 per person; syringe service programs, -$597; substance use treatment centres, -$130). Providing a 2-dose vaccination series without any screening (Intervention 3) averted incident HBV infections and was cost-saving in all settings but resulted in more HBV-related deaths in settings with higher HBV prevalence. These results demonstrate a 2-dose vaccine series is a cost-effective approach in these high-impact settings, even if prevaccination testing is not possible.

Liver Inflammation Is Common and Linked to Metabolic Derangements in Persons With Treated Human Immunodeficiency Virus (HIV).

We sought to characterize in people with human immunodeficiency virus (PWH) the potential etiologies of elevated alanine aminotransferase (ALT) levels, which are common and often unexplained. Participants from the longitudinal observational AIDS Clinical Trials Group HAILO cohort without a history of hepatitis C virus (HCV) or hepatitis B virus (HBV) infection nor reported heavy alcohol use were included. Clinical and demographic characteristics, including medication use, the hepatic steatosis index (HSI), and metabolic syndrome (MetS) were compared between participants with and without ALT elevation. Six hundred sixty-two participants were included; 444 (67%) had ≥1 and 229 (35%) ≥2 consecutive ALT elevations during a median of 4.0 years of follow-up. HSI and Hispanic or other (non-White or Black) race/ethnicity were consistently associated with higher odds of abnormal ALT (odds ratio [OR] 1.1 for HSI as a continuous variable, OR 1.9-2.8 for Hispanic/other race/ethnicity for ≥1 or ≥2 ALT elevations); older age and current smoking were associated with lower odds of abnormal ALT. Associations with metabolic disease, as well as with incident HBV and HCV infection, were strengthened by restricting outcomes to persistent and higher degrees of ALT elevation. ALT elevation was common in this cohort of PWH and associated with metabolic disease and hepatic steatosis markers. Nonalcoholic fatty liver disease is likely a common cause of liver inflammation in PWH receiving suppressive antiretrovirals, deserving targeted diagnosis and intervention.

Estimating the epidemiology of chronic Hepatitis B Virus (HBV) infection in the UK: what do we know and what are we missing?

Background: HBV is the leading global cause of cirrhosis and primary liver cancer. However, the UK HBV population has not been well characterised, and estimates of UK HBV prevalence and/or incidence vary widely between sources. We summarised datasets that are available to represent UK CHB epidemiology, considering differences between sources, and discussing deficiencies in current estimates. Methods: We searched for estimates of CHB case numbers in the UK (incorporating incidence and/or prevalence-like data) across a range of available sources, including UK-wide reports from government bodies, publications from independent bodies (including medical charities and non-governmental organisations) and articles in peer-reviewed scientific journals to collate estimated positivity rates. An alternative proxy for population prevalence was obtained via the UK antenatal screening programme which achieves over 95% coverage of pregnant women. Results: We identified six CHB case number estimates, of which three reported information concerning population subgroups, including number of infected individuals across age, sex and ethnicity categories. Estimates among sources reporting prevalence varied from 0.27% to 0.73%, congruent with an estimated antenatal CHB prevalence of <0.5%. Discussion: Estimates varied by sources of error, bias and missingness, data linkage, and substantial "blind spots" in consistent testing and registration of HBV diagnoses. The HBV burden in the UK is likely to be concentrated in vulnerable populations who may not be well represented in existing datasets including those experiencing socioeconomic deprivation, ethnic minorities, people experiencing homelessness and people born in high-prevalence countries. Together, these factors could lead to either under- or over-estimation of overall prevalence, and additional efforts are required to provide estimates that best reflect the whole population. Multi-parameter evidence synthesis and back-calculation model methods similar to those used to generate estimates of HCV ad HIV population-wide prevalence may be applicable to HBV.

The impact of the COVID-19 pandemic on hepatitis B virus vaccination and transmission among men who have sex with men: A mathematical modelling study

BackgroundDuring the COVID-19 pandemic, the number of hepatitis B virus (HBV) vaccinations among men who have sex with men (MSM) has been considerably lower than before the pandemic. Moreover, less frequent HBV testing and a reduction in numbers of sex partners have been reported. We assessed the impact of these COVID-19-related changes on HBV transmission among MSM in the Netherlands. MethodsWe estimated the changes in sexual activity, HBV testing, and HBV vaccination among MSM during the pandemic from Dutch data. We used a deterministic compartmental model and investigated scenarios with small or large declines in sexual activity, testing, and vaccination for the current phase of the pandemic (without available data). We examined the increase in HBV vaccinations needed to prevent further increase in HBV incidence. ResultsWith a decrease in numbers of sex partners of 15–25% during the first lockdown and 5% during the second lockdown, we found a decline of 6.6% in HBV incidence in 2020, despite a >70% reduction in HBV testing and vaccination during the first lockdown. With numbers of sex partners rebounding close to pre-pandemic level in 2021, and a reduction of 15% in testing and 30% in vaccination in 2021, we found an increase of 1.4% in incidence in 2021 and 3.1% in 2026. With these changes, an increase of ≥60% in HBV vaccinations in 2022 would be needed to bring the HBV incidence in 2023 back to the level that it would have had if the COVID-19-related changes had not occurred. ConclusionsDespite reductions in sexual activity during the COVID-19 pandemic, the decrease in HBV vaccinations may result in a small increase in HBV incidence after 2021, which may persist for years. It is important to restore the vaccination level and limit further increase in HBV transmission among MSM.

Preventing mother-to-child transmission of HBV

Hepatitis B virus (HBV) infection is a global public health threat with about 296 million chronic infections worldwide and 1·5 million new infections each year. 1 WHOGlobal progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Accountability for the global health sector strategies 2016–2021: actions for impact. World Health Organization, Geneva2021 Google Scholar In 2016, WHO developed a global strategy to eliminate hepatitis as a public health threat by 2030, with a goal to reduce incidence by 90% and mortality by 65%. 2 WHOGlobal health sector strategy on viral hepatitis 2016–2021. https://www.who.int/hepatitis/strategy2016-2021/ghss-hep/en/Date: 2016 Date accessed: March 13, 2022 Google Scholar Mother-to-child transmission (MTCT) remains a key contributor to HBV incidence globally, 3 Bierhoff M Nelson KE Guo N Jia Y Thio CL Prevention of mother-to-child transmission of hepatitis B virus: protocol for a one-arm, open-label intervention study to estimate the optimal timing of tenofovir in pregnancy. BMJ Open. 2020; 10e038123 Crossref PubMed Scopus (7) Google Scholar and extra interventions beyond the hepatitis B vaccination for children to decrease MTCT are needed. On that basis, the birth dose of hepatitis B vaccine (HepB-BD) combined with hepatitis B immunoglobulin (HBIg) or tenofovir disoproxil fumarate, or both during pregnancy have been proved to effectively prevent MTCT. 4 Funk AL Lu Y Yoshida K et al. Efficacy and safety of antiviral prophylaxis during pregnancy to prevent mother-to-child transmission of hepatitis B virus: a systematic review and meta-analysis. Lancet Infect Dis. 2021; 21: 70-84 Summary Full Text Full Text PDF PubMed Scopus (63) Google Scholar However, access to HBIg is an issue in many low-income and middle-income countries (LMICs). Immunoglobulin-free strategy to prevent HBV mother-to-child transmission in Cambodia (TA-PROHM): a single-arm, multicentre, phase 4 trialAn immunoglobulin-free strategy using an HBeAg rapid diagnosis test and alanine aminotransferase-based algorithm to assess eligibility for tenofovir, is effective at preventing MTCT of HBV when tenofovir was initiated at least 4 weeks before birth. Full-Text PDF

Global incidence and mortality of hepatitis B and hepatitis C acute infections, cirrhosis and hepatocellular carcinoma from 2010 to 2019.

Hepatitis B virus (HBV) and hepatitis C virus (HCV) contribute to significant healthcare burden globally. We aim to provide an updated and comprehensive analysis of global trends in the incidence and mortality of HBV and HCV related acute infections, cirrhosis and hepatocellular carcinoma (HCC). Estimates of annual cause-specific disease incidence and mortality for HBV and HCV were analysed using the 2010-2019 Global Burden of Diseases, Injuries and Risk Factors Study database. Three distinct disease states were evaluated: acute infections, cirrhosis and HCC. Age-standardized disease incidence and mortality were presented per 100,000 population and stratified by age, sex, year and 21 world regions. From 2010 to 2019, overall incidence of acute HBV declined by 19.3% (95% CI 4.1-32.0, p<.05) and HBV cirrhosis declined by 15.0% (95% CI 9.8-20.7, p<.05). Incidence of HCV cirrhosis increased by 5.6% (95% CI 0.3-10.2, p<.05) and HCV HCC remained stable. Incidence of acute HCV declined until 2015, after which it began increasing. From 2010 to 2019, overall mortality for HBV cirrhosis and HCV cirrhosis declined, whereas mortality for acute infections and HCC remained stable. Major differences in HBV and HCV incidence and mortality trends were observed when stratified by world regions. In conclusion, while our analyses of global trends in HBV and HCV incidence and mortality demonstrate encouraging trends, disparities in disease epidemiology were observed across world regions. These observations will identify regions and populations where greater focus and resources are needed to continue progressing towards viral hepatitis elimination.

Assessing the Cost-Utility of Universal Hepatitis B Vaccination Among Adults.

Although effective against hepatitis B virus (HBV) infection, hepatitis B (HepB) vaccination is only recommended for infants, children, and adults at higher risk. We conducted an economic evaluation of universal HepB vaccination among US adults. Using a decision analytic model with Markov disease progression, we compared current vaccination recommendations (baseline) with either 3-dose or 2-dose universal HepB vaccination (intervention strategies). In simulated modeling of 1 million adults distributed by age and risk groups, we quantified health benefits (quality-adjusted life years, QALYs) and costs for each strategy. Multivariable probabilistic sensitivity analyses identified key inputs. All costs reported in 2019 US dollars. With incremental base-case vaccination coverage up to 50% among persons at lower risk and 0% increment among persons at higher risk, each of 2 intervention strategies averted nearly one-quarter of acute HBV infections (3-dose strategy, 24.8%; 2-dose strategy, 24.6%). Societal incremental cost per QALY gained of $152722 (interquartile range, $119113-$235086) and $155429 (interquartile range, $120302-$242226) were estimated for 3-dose and 2-dose strategies, respectively. Risk of acute HBV infection showed the strongest influence. Universal adult vaccination against HBV may be an appropriate strategy for reducing HBV incidence and improving resulting health outcomes.

Prevention of mother-to-child transmission of hepatitis B: birth-dose vaccination is not enough

Hepatitis B virus (HBV) infection is an important contributor to the global burden of disease. Globally, 296 million people are living with chronic HBV infection, including 6 million children younger than 5 years, and about 1·5 million people newly infected with HBV annually.1 Furthermore, cirrhosis and hepatocellular carcinoma resulting from chronic HBV infection cause about 820 000 deaths per year.1 In 2016, WHO adopted the Global Health Sector Strategy on viral hepatitis, which called for a reduction of HBV incidence by 90% and mortality by 65% by 2030.

Effectiveness of Hepatitis B Vaccination Campaign in Italy: Towards the Control of HBV Infection for the First Time in a European Country.

Background: In 1991, a mass immunization campaign against the hepatitis B virus (HBV) for children and teenagers was introduced in Italy. This study evaluated the impact of the immunization campaign on the incidence and modes of HBV transmission. Method: Acute HBV cases of viral hepatitis were reported to the National Surveillance System (SEIEVA). Hepatitis A cases reported to the same system were used as controls to calculate the adjusted odds ratios and the population attributable risk for potential risk factors. Results: The incidence of acute HBV declined from 5.0 in 1990 to 0.4 in 2019 per 100,000 population. The fall was almost total in people targeted by the campaign: in 2019, zero cases (100% reduction) in the age-group 0–14 years and 0.1 cases per 100,000 population (99.4% reduction) in the age-group 15–24 years were reported. In the decade 2010–2019, nearly one-fifth (19.3%) of cases occurred in foreigners. Intravenous drug use is no longer a risk factor (OR = 0.7; 95% CI = 0.5–1.02). Beauty treatments, risky sexual exposure, and household contact with an HBsAg carrier were found to be independent predictors of acute hepatitis B. Conclusions: The HB vaccination campaign proved effective in minimising acute HBV in Italy. Control of the infection is close to being reached for the first time in Europe.

Progress on global hepatitis elimination targets.

In 2016, the World Health Assembly adopted a Global Health Sector Strategy on viral hepatitis, with targets set for the years 2020 and 2030 to achieve hepatitis elimination. The main target of hepatitis elimination strategy is to reduce the incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) by 90% and mortality by 65% in 2030. In last 5 years, the number of people receiving HCV treatment has increased from 1 million to 9.4 million; however, this number is far from the 2030 target of 40 million people receiving HCV treatment. HBV and HCV incidence rates are down from 1.4 million to 1.1 million annual deaths but this is far from the 2030 target of < 0.5 million deaths. The coronavirus disease 2019 pandemic has severely affected the efforts in the fight against hepatitis. No major donor has committed to investing in the fight against hepatitis. Time is running out. There is a need to speed up efforts in the fight against hepatitis to achieve hepatitis elimination by 2030.

The frequency of detection of anti-HBc in blood donors from four regions of Russia

Introduction. Occult hepatitis B virus (HBV) revelation in HBV nuclear antigen testing is of particular importance to prevent transfusion infection.Aim — the identification of factors affecting the anti-HBc detection rate in donated transfusable blood components from different regions of Russia.Materials and methods. A cohort screening single-stage epidemiological study was conducted with 2,000 donor blood samples, 500 samples per each of four regions of the country, the Republics of Crimea (Simferopol) and Sakha (Yakutia), the cities of Saransk and Orenburg. Data on 968 blood samples from the National Research Center for Hematology’s donor bank were used as reference. The testing targeted HBV nuclear antigen antibodies. Positive donated blood samples were additionally tested for IgM and virus surface antigen antibodies using Abbott and Vector-Best commercial reagent kits.Results. Donor demographic profiles differed insignificantly across members of the Russian Federation. Males predominated among the donors (69.6 %). Anti-HBc was detected in 219 of 2,000 samples examined (10.9 %). The donor blood sample anti-HBc detection rate ranged from 6.0 to 21.6 %, depending on the region. Anti-HBc-positive proportions in Orenburg, Crimea, Mordovia and Sakha comprised 8.2, 8.0, 6.0 and 21.6 %, respectively (p &lt; 0.01). First-time donors had anti-HBc in 8.06, regular donors — in 11.29 % cases. The anti-HBc detection rate varied with donor’s age, being zero or near 1 % in 20-yo or younger people. Acute HBV antibodies had zero rate in Orenburg at zero or low-titre (&lt; 100 mIU/mL) protective antibodies; 31 total samples, 15 low-titre and 16 negative for protective antibodies. In Simferopol, acute phase antibodies were negative in 7 blood samples containing high-titre protective antibodies (&gt; 100 mIU/mL) and in 5.0 % samples with their low or zero levels. In Yakutian donors, acute phase antibodies were revealed only at protective antibodies negative. In Saransk, this marker was equal-proportion at zero and high-titre protective antibodies (3.3 % each).Conclusion. Transfusion component procurement from younger donors should be prioritised as enhancing haemotransfusion viral safety. Positive occult HBV tests were less common in regions with low HBV incidence.

Past and Future Perspectives for Hepatitis B and C in Pakistan.

BackgroundHepatitis B and C are viral infections of the liver transmitted by blood contamination. These infections are endemic in Pakistan and put a tremendous burden on its healthcare system. We conducted this study to assess the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in Gujranwala, Pakistan, from 2010 to 2015 and determine the trend of future infections for a prediction of the disease burden by 2030 so policymakers can make informed decisions.MethodsWe conducted a retrospective cross-sectional study of 66,308 healthy blood donor samples at District Headquarters Teaching Hospital in Gujranwala from January 2010 to December 2015. Samples were screened for HBV and HCV using the kit method, and data were analyzed using IBM SPSS Statistics for Windows, version 20.0 (IBM Corp., Armonk, NY). We applied a least squares regression to our results to predict HBV and HCV incidence in 2030.ResultsA total of 715 samples (1.08%) were positive for HBV and 1,846 samples (2.78%) were positive for HCV. Our projections indicate that 3.25% of patients in Pakistan will be positive for HBV, and 6.36% will be positive for HBC by 2030.ConclusionWe found an unexpectedly greater burden of HBV and HCV in the recent past than at current levels. The predicted percentages of future burden over the next decade were alarmingly high. These data necessitate implementing preventive and therapeutic measures by policymakers to reduce the disease burden and mortality in Pakistan.

An assessment of hepatitis B virus prevalence in South African young blood donors born after the implementation of the infant hepatitis B virus immunization program: Implications for transfusion safety.

The prevalence of hepatitis B surface antigen is estimated to be 6.7% in the South African population and in April 1995 the nation introduced universal hepatitis B virus (HBV) vaccination for newborns and infants. We studied the temporal association of this program with HBV prevalence in young blood donors and the contemporary HBV incidence and residual risk of transfusion-transmitted HBV infection (TT-HBV). We used blood donation data from January 2011 to December 2019. Estimation of HBV prevalence donations made by first-time blood donors were analyzed by birth cohort and covariates. To estimate the incidence and residual risk of TT-HBV, mathematical models used data from both first time and repeat donors. HBV prevalence in first-time donors decreased from 0.84% (95% confidence interval [CI] 0.78-0.90) in 2011 to 0.66% (95% CI 0.61-0.70) in 2019. The post-1995 birth cohort had a significantly lower HBV prevalence of 0.14% (95% CI 0.13-0.15) than the pre-1985 birth cohort of 1.29% (95% CI 1.25-1.33) and the odds of HBV infection were reduced in a multivariable model (odds ratio [OR]=0.28, 95% CI 0.24-0.34). The residual risk of TT-HBV occurring from window-period, occult, and possible vaccine breakthrough infections were estimated at 36.9, 5.8, and 2.2 per million red blood cell transfusions, respectively. Donors born after the start of routine HBV immunization had significantly lower prevalence of HBV infection, supporting the effectiveness of the vaccination program. The contemporary residual risk of TT-HBV has decreased and should decline further as more vaccinated young people join the donor pool.

Serum hepatitis B virus ribonucleic acid and its influencing factors in chronic hepatitis B.

Hepatitis B virus (HBV) remains one of the most serious and prevalent health problems in the world. To determine the serum hepatitis B virus (HBV) RNA levels in patients with chronic hepatitis B (CHB) with low HBV DNA levels and analyze the influencing factors. Seventy-two CHB patients with low HBV DNA levels were enrolled and divided into 2 groups according to hepatitis B e antigen (HBeAg) status; their age, sex, the incidence of HBV RNA level < lower limit of detection (LLD), and serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), quantitative determination of HBsAg (qHBsAg), HBV DNA, and HBV RNA levels were compared. The factors influencing serum HBV RNA levels < LLD and the correlation between serum HBV RNA levels, and serum ALT, AST, qHBsAg and HBV DNA levels were analyzed. In HBeAg-positive patients, serum AST, qHBsAg and HBV RNA levels were higher, and serum HBV DNA levels and incidence of HBV RNA < LLD were lower than those in HBeAg-negative patients (p < 0.05). Multivariate linear regression analysis revealed that HBeAg is a factor that significantly influences serum HBV RNA levels in patients with CHB (p < 0.05). Multivariate logistic regression analysis indicated that HBeAg and qHBsAg are factors that influence serum HBV RNA levels < LLD in patients with CHB. In HBeAg-positive patients, serum HBV RNA levels were positively correlated with qHBsAg and HBeAg. The serum HBV RNA levels in CHB patients with low HBV DNA levels varied according to HBeAg status. The HBeAg is a factor that significantly influences serum HBV RNA levels in patients with CHB, while HBeAg and qHBsAg are factors that significantly influence serum HBV RNA levels < LLD in patients with CHB.

Distribution and Incidence of Blood-Borne Infection among Blood Donors from Regional Transfusion Centers in Burkina Faso: A Comprehensive Study.

ABSTRACTThere is a high prevalence of blood-borne infections in West Africa. This study sought to determine the seroprevalence of blood-borne infections, including hepatitis B virus (HBV), hepatitis C virus (HCV), HIV, and syphilis, in blood donors in Burkina Faso. Blood donors were recruited from 2009 to 2013 in four major cities in Burkina Faso of urban area (Ouagadougou) and rural area (Bobo Dioulasso, Fada N’Gourma, and Ouahigouya). Serology tests including hepatitis B surface antigen, anti-HCV, anti-HIV, and rapid plasma reagin test were used for screening and were confirmed with ELISA. Disease prevalence was calculated among first-time donors. Incidence and residual risk were calculated from repeat donors. There were 166,681 donors; 43,084 had ≥ 2 donations. The overall seroprevalence of HBV, HCV, HIV, and syphilis were 13.4%, 6.9%, 2.1%, and 2.4%, respectively. The incidence rates (IRs) of HBV, HCV, HIV, and syphilis infection were 2,433, 3,056, 1,121, and 1,287 per 100,000 person-years. There was lower seroprevalence of HBV and HCV in urban area than in rural area (12.9% versus 14.0%, P < 0.001; and 5.9% versus 8.0%, P < 0.001), and no difference in HIV (2.1% versus 2.1%, P = 0.25). The IRs of new HBV, HCV, HIV, and syphilis were 2.43, 3.06, 1.12, and 1.29 per 100,000 person-years, respectively. The residual risk was one per 268 donations for HBV, one per 181 donations for HCV, and one per 1,480 donations for HIV, respectively. In conclusion, this comprehensive study from four blood donation sites in Burkina Faso showed high HBV and HCV seroprevalence and incidence with high residual risk from blood donation.