High Prevalence Of HBV Infection Research Articles

HBV prevalence in Sub-continental countries: A systematic review and meta-analysis

Background Hepatitis B virus (HBV) is a major source of disease burden worldwide, with an estimated 296 million individuals living with infections worldwide. Although vaccine programs exist to control infections, certain sub-populations around the world continue to have very high prevalence of HBV infection. Methods A systematic search of studies of HBV published after 2010 was conducted for India, Pakistan, Bangladesh, Nepal, Sri Lanka and Bhutan. Each paper was independently screened for risk of bias and inclusion. Data were extracted from included studies before being analysed to estimate pooled prevalence, and to conduct sub-group analyses. Random-effects models were used for estimating summary prevalence due to a high level of heterogeneity between studies, and funnel plots were combined with Egger’s test to assess publication bias. Meta-regression was conducted to investigate sources of between-study heterogeneity. Results The pooled prevalence of HBV across all studies was 3% (95% CI 0.02, 0.05). For countries with multiple studies, the pooled prevalence in India was 3% (95% CI 0.02, 0.04), in Pakistan 6% (95% CI 0.03, 0.09), in Bangladesh 5% (95% CI of 0.02, 0.12), and in Nepal 1% (95% CI 0.00, 0.08). There was some evidence of publication bias, and a high level of heterogeneity across studies. Risk of bias analysis found most studies to be of fair or moderate quality. Conclusions The prevalence of HBV among countries in the sub-continent was higher than the global average, but was not as high as some other regions. Countries with greater numbers of displaced persons had higher prevalence of HBV, with a wide range of prevalence between subpopulations likely reflecting differential uptake, and implementation, of vaccination programs.

Seropositivity to viral hepatitis in blood donors in north Darfur state-Sudan

Objective: The aim of this research is to investigate the sero-prevalence of hepatitis B (HBV) and hepatitis C (HCV) infection among apparently healthy volunteer blood donors, as well as the relationship between serological evidence of viral hepatitis and age and demographic characteristics. Methods: A retrospective study of sequential blood donation findings from January to December 2017 was performed in North Darfur, Western Sudan. The descriptive quantities were calculated using Chi-square test. Results: A total of 4527 respondents showed an interest in donating blood. All of them were between the ages of 17 and 49 years. A total of 247 (5.5%) and 19 (0.4%) donors tested positive for HBV and HCV, respectively, while 4280 (94.5%) and 4508 (99.6%) donors tested negative for HBV and HCV, respectively. On both HBV and HCV, there was a strong association between serological evidence of viral hepatitis and age (P =0.000). In comparison to the other age categories, the prevalence of HBV and HCV was higher in age group (35-39) and (40 or more) years, (76/247) 30.8 % and (171/247) 69.2 % for HBV and (7/19) 36.8% and (12/19) 62.2 % for HCV. Conclusions: Blood donors in North Darfur have been shown to have a high prevalence of HBV infection and a low frequency of HCV. There was a statistically significant relationship between viral hepatitis and age, but a negative statistically significant relationship between occupancy and age.

The impact of ethnicity on chronic hepatitis B infection course and outcome: big data analysis from Israel

ABSTRACT Objectives: The effect of ethnicity on chronic hepatitis B virus (CHB) infection’s course and outcome has attracted little research. We aimed to compare different aspects of ethnic disparities in CHB patients, including prevalence, phenotypes, management, and outcome between two major ethnic groups in Israel. Design: We conducted a large retrospective cohort study utilizing the Leumit-Health-Service database. Electronic reports of almost 700,000 members from different ethnicities and districts throughout Israel from 2000 to 2019 were reviewed. Patients’ ethnicity was categorized based on the classification of the Israeli Central Bureau of Statistics into two main groups, Arabs and Jews. CHB diagnosis was based on ICD-9-CM codes and supportive serology results. Prevalence, clinical backgrounds, disease course, and patients’ outcomes were compared between both groups. Results: The prevalence of CHB in the Arab minority group was almost twice and a half-higher when compared to their Jewish counterparts (4.3% vs. 1.8%), but they had a lower rate of referral for HBsAg testing (7% vs. 7.9%). The Arab CHB patients were significantly younger at the time of diagnosis (37.6± 13.5 vs. 45.3± 15; P < 0.001). Male predominance was noted in both groups. The Arab patients had a higher rate of active hepatitis (HBeAg-positive and/or negative hepatitis) phase (36.4% vs. 29.8%; P = 0.01), as well as a significantly higher rate of HBeAg seroconversion (45.2% vs. 35.4%; P = 0.033). Nucleos/tide analogue treatment figures were similar, with most patients in both groups receiving a high barrier to resistance treatment. Patients’ outcome was similar in both groups as the rate of hepatocellular carcinoma, cirrhosis, and advanced fibrosis (after stratification analysis) were comparable between both groups. Conclusion: Marked by a prominently higher prevalence of HBV infection, patients in the Arab ethnic group had a lower rate of referral for HBsAg testing but received comparable management and had a similar outcome compared to their Jewish counterparts.

Sero-Prevalence of HBV and its Associated Factors Among Healthcare Providers in Public Health Facilities in Eastern Ethiopia.

Background:Healthcare providers are in high occupational risk of Hepatitis B virus infection than that of the general population because of the high risk of occupational exposure to patients’ body fluids and accidental sharp injuries. There are no large facility-based studies conducted on the prevalence of HBV infection and its associated factors among health care providers in eastern Ethiopia.Objective:This study aimed at investigating the seroprevalence of Hepatitis B Virus and its associated factors among the healthcare providers in public health facilities in eastern Ethiopia.Methods:A facility-based cross-sectional study was conducted among 438 randomly selected healthcare providers in eastern Ethiopia from March to June 2018. Pretested structured questionnaire was used to collect data on socio-demographic characteristics and other risk factors. In addition, a 2.5 ml blood was collected and the serum was analyzed for Hepatitis B surface antigen using the Instant Hepatitis B surface antigen kit. Data were entered using Epidata version 3.1 and analyzed using SPSS statistical packages version 22. Descriptive summary measures were used. Bivariate and multivariable logistic regression was conducted at 95% CI. An association at P-value <.05 was considered statistically significant.Results:A total of 438 (92.02% response rate) health care providers have participated in this study. The prevalence of hepatitis B virus infection was 9.6%. There were no significant differences in the HBV infection rates among healthcare providers with respect to socio-demographic characteristics (P-value >.05). After adjusting for some variables, the following variables remained statistically significantly associated with HBsAg positive result in the multivariable analysis: exposure to body fluids (AOR = 3.0; 95% CI [1.25, 7.05]), history of needle stick injury (AOR = 4.70; 95% CI [2.10, 10.55]), history of operation/surgery (AOR = 4.88, 95% CI [1.43, 16.62]), history of multiple sexual partner (AOR = 7.48; 95% CI [2.08, 26.96]), and being unvaccinated (AOR = 6.09; 95% CI [2.75, 13.51]).Conclusion:This study showed a high prevalence of HBV infection among health care providers in eastern Ethiopia. This is significant because health professionals may be at increased risk of chronic complications and may also be source of infection for their clients and general population during their healthcare practice. Management commitment that should focus on occupational safety and health promotions is necessary.

“ASSOCIATION OF ABO & RH BLOOD GROUPS WITH HEPATITIS, HIV AND SYPHILIS INFECTIONS IN HEALTHY BLOOD DONORS AT TERTIARY CARE CENTRE”.

Background: People from certain blood groups are more prone to develop infections transmitted by blood transfusion. In order to improve the management of such infections some hypothesis suggests that genetic predispositions like ABO and Rh blood groups would inuence the occurrence of such infections. Hence the present study aims to assess any possible associations of ABO &amp; Rh blood groups with Hepatitis, HIV &amp; syphilis infections in healthy blood donors. This was a retrospective study in heal Methods: thy blood donors of tertiary care hospital enrolled during years 2016 to 2020. Blood samples from total 34015 donors were screened for blood grouping &amp; serology of HIV, Hepatitis &amp; Syphilis. Result: Out of total donors only 171 donors were found positive for transfusion transmitted infections. Hepatitis B virus was found more prevalent compared to other infections. In ABO blood group type “B” and in Rh blood group type “Positive” was found more prevalent in donors. But it did not show any signicant association with transfusion transmitted infections. Conclusion: High prevalence of HBV infections in blood donors in present study point towards need of public health measures in general population. Undertaking further research to determine the special blood groups as increased risk for categorized donors is recommended.

Prevalence of hepatitis B markers seropositivity in sickle cell (SCA) children in ABUTH Shika, Kaduna State

Background: The study was carried out to determine the scope and pattern of hepatitis B infection among patient with sickle cell disease presenting at ABUTH Shika. Aims and objectives. This research work was conducted to determine the seropositivity of HBV infection amongst SCA patients and also to determine the associated potential risk in the acquisition of the infection.Patients and method: In order to determine the pattern of HBV infection among children with SCA aged 6 months to 12 years and associated risk factors; a random selection of 146 children was made at the paediatric haematology clinic of Ahmadu Bello University Teaching Hospital, Shika. For each SCA patient, an age-and sex- matched control with genotype AA presenting with minor ailments were selected from the paediatric outpatient of the hospital. The children were screened for various markers of hepatitis B virus using a spot test and ELISA test.Results: The prevalence rates of hepatitis B infection documented in the SCA and control groups were 24.66% and 28.77% respectively. The prevalence was highest in 9 - 12 year age group for both SCA patients and controls with prevalence of 42.86% and 42.11% respectively. None of the risk factors studied which included blood transfusions, parenteral injections, hospitalization, ulcers, tattooing, traditional circumcision, ear piercing, traditional scarification and contact with known hepatitis case were significantly associated with HBV infection in either the SCA or control group. There was also no association between frequency of hospitalizations, transfusions and people sleeping in the same room with HBV infection in either SCA patients or the control groups. The most frequent marker found among both the SCA and control group was anti-HBc.Conclusion: High prevalence of HBV infection was detected in both the subjects and controls. Children with SCA were not found to be at increased risk of contracting hepatitis B infection. It is recommended that all children should benefit from early vaccination.

Hepatocellular Carcinoma in India

Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world. The incidence of HCC is rising in India and is one of the leading GI cancers. The prevalence of HCC in India varies from 0.2 to 1.6%. The age adjusted incidence rate of HCC in India for men ranges from 0.7 to 7.5 per 100,000 populations, and for women 0.2 to 2.2 per 100,000 populations. The male to female ratio for HCC in India is 4:1. The incidence of HCC in cirrhotic in India is 1.6% per year. The age standardized mortality rate for HCC in India for men is 6.8/100,000 and for women is 5.1/100,000. HBV is the main etiological factor associated with HCC in India. Due to high prevalence of HBV infection in India, the surveillance is poor and there has been no comprehensively analyzed data for HCC. Despite recent advances in the treatment of HCC, many patients cannot be cured due to the advanced stage of HCC at the time of diagnosis in India. Optimal application of multidisciplinary team approach and active involvement in clinical studies with new agents in HCC patients are critically important.

Hepatitis B virus serological screen in a general hospital in Beijing from 2008 to 2018, and challenges to our vaccination policy

ObjectiveHepatitis B virus (HBV) has a worldwide distribution and remains a leading public health problem in China. MethodAutomated chemiluminescence microparticle immunoassay was used to test all five markers of HBV serology in serum samples among 696,048 patients, pregnant women, and normal subjects in Beijing from 2008 to 2018. ResultsThe overall prevalence of subjects categorized as previous/ occult HBV infection, inactive HBsAg carrier, active HBV infection, HBsAg, HBV susceptible, and immune via vaccination was 29.4%, 4.8%, 1.4%, 6.4%, 33.9% and 30.3%, respectively; men had a significantly higher prevalence of HBV infection than women. The prevalence of HBsAg was around 0.5% in subjects ≤ 10 years of age, increased dramatically to 3.7% in subjects between 11 and 20 years of age, reached the highest level of 7.9% in subjects between 41 and 50 years of age, and finally decreased to 2.8% in subjects ≥ 81 years of age. During the 10 years from 2008 to 2018, the prevalence of HBsAg was stabilized at about 6.0%, and indicators of HBV susceptibility, previous/ occult HBV infection, and immunity via vaccination were not further improved, despite the constant implementation of HBV vaccination since 1992. All four age groups (21 − 30y, 31 − 40y, 41 − 50y and 51 − 60y) of the normal adult population were found to have a significantly lower prevalence of HBsAg and HBV susceptibility but significantly higher prevalence of immunity via vaccination compared with corresponding age groups of the sub-total population. ConclusionsAlthough high coverage has been established among infants and young children, their vaccination alone could not reduce HBV infection in the adult Chinese population quickly. Adult populations with more vaccinated individuals are found to have fewer individuals with HBsAg. Vaccination in adults or at least in high-risk adults is an urgent need to decrease horizontal HBV transmission in China.

The association between low glucose-6-phosphate dehydrogenase activity level and hepatitis B virus infection among pre-pregnant reproductive-age Chinese females

The relationship between females with low glucose-6-phosphate dehydrogenase activity level (LG6PD) and HBV infection is unclear. We conducted a cross sectional study of 124 406 reproductive-age Chinese females who participated in the National Free Pre-conception Check-up Projects to investigate the risk of HBV infection among females with LG6PD and its effect on liver enzyme. Based on HBV serological test results, the participants were divided into the susceptible, immunized, and HBV infected groups. The multivariable-adjusted odds ratios (ORs) for HBV infection in LG6PD participants were 1.71 (95% confidence interval (CI): 1.45–2.01) and 1.41 (95% CI: 1.23–1.62), respectively with the susceptible and immunized participants as references, compared to those without LG6PD. Participants with HBV infection only and combined with HBV infection and LG6PD had 184% and 249% significantly higher risks of elevated alanine transaminase (ALT) (susceptible participants as reference). If the immunized participants were used as reference, significant higher odds of elevated ALT occurred (3.48 (95% CI: 3.18–3.80), 4.28 (95% CI: 2.92–6.28)). Thus, reproductive-age females with LG6PD had a higher prevalence of HBV infection, and LG6PD might exacerbate ALT elevation in HBV infected females. Our findings underscore the need to explore collaborative management approaches for these two diseases among reproductive-age females for maternal and child health.

World hepatitis day in Burkina Faso, 2017: seroprevalence and vaccination against hepatitis B virus to achieve the 2030 elimination goal

BackgroundBurkina Faso is a high endemicity country for HBV infection. However, there are few data on vaccine coverage against HBV. The aim of this study was to contribute to the improvement of HBV vaccine coverage in Ouagadougou through HBV screening.MethodsAwareness campaigns and voluntary hepatitis B screening were organized in the twelve districts of Ouagadougou by the “SOS Hepatitis Burkina” association. A rapid HBsAg detection test (Abon Biopharma Guangzhou, Co., Ltd. Chine) was performed on 2216 individuals, who voluntarily answered a series of questions. Vaccination against hepatitis B was proposed to HBV negative participants.ResultsIn a sample of 2216 participants, aged 1 to 78 years (mean age 29.7 ± 14.7 years); a prevalence of 10.4% (230/2216) of HBsAg was obtained. This prevalence was high in the age groups 31 to 40 years (14.5%) and 41 to 50 years (15.0%). The prevalence of HBV was higher in the sixth district (14.3%) of Ouagadougou. At the end of the screening, 1202/1986 HBV negative participants were vaccinated, resulting in a vaccination rate of 60.5%. Vaccination coverage ranged from 44.5 to 73.7% all twelve districts.ConclusionsThis study still reports a high prevalence of HBV infection among young people with a peak in the sixth district of Ouagadougou. The study achieved high vaccination coverage in all age groups and districts of Ouagadougou.Trial registrationThe present study has been approved by the Ethics Committee for Health Research of Burkina Faso. CERS201501006 Registered 14 January 2015.

Hepatitis C virus infection among illicit drug users in an archipelago of the Amazon.

Hepatitis C virus (HCV) infection causes acute and chronic liver disease and may lead to cirrhosis, liver failure or hepatocellular carcinoma. The behavior of illicit drug users (DUs) typically exposes them to risks of viral infection. In the Brazilian Amazon region, a number of studies have identified high rates of drug use among adolescents, and a high prevalence of HBV infection in DUs, disseminated by sexual and parenteral activities. However, the epidemiological scenario of HCV infection in the region is still poorly understood. This study determined the prevalence, genotypes, and risk factors for HCV infection among DUs of the Marajó Archipelago. This cross-sectional study collected samples and epidemiological information from DUs in 11 municipalities. The diagnosis was established by EIA and real-time PCR, and the samples were genotyped by multiplex real time PCR. The data were analyzed by simple and multiple logistical regression. In 466 DUs, 28.3% had anti-HCV antibodies, and 25.5% had HCV-RNA. In 92 injecting drug users, 88.0% had anti-HCV antibodies, and 80.4% had HCV-RNA. Genotypes 1 and 3 were detected, with three cases of mixed infections. The multivariate analysis indicated associations of HCV infection with age (≥ 35 years), tattoos, intravenous drug use, shared use of injection equipment, and the daily and long-term (> 3 years) use of illicit drugs. These findings will contribute to the development of effective measures for the prevention of HCV infection among Brazilian DUs, as well as its general population.

Seroprevalence of hepatitis B Surface antigen among apparently healthy primary school pupils in Batagarawa Local Government area of Katsina State, Nigeria

Introduction : Hepatitis B virus infection is a major public health problem worldwide. It is more infectious and more in Nigeria than the Human Immunodeficiency Virus (HIV). It is a major risk factor for the development of liver cirrhosis and hepatocellular cancer in hyperendemic areas. This study was carried out between 8th January and 7th March, 2012, to assess the prevalence of Hepatitis B virus infection among apparently healthy primary school pupils in Batagarawa Local Government, Katsina state. Methods : Hepatitis B surface antigen was tested for in 240 apparently healthy primary school pupils in Batagarawa Local Government, Katsina state in North- Western Nigeria using commercial recombinant enzyme-based HBsAg test strip. Results : Of the 240 samples screened, 56 (23.3%) were seropositive. HBsAg seroprevalence was higher among children aged 7 – 9 years (7.9%), and among male (15.8%) than female (7.8%) subjects. Of the predisposing factors for HBV infection studied, traditional circumcision among the male subjects recorded the highest prevalence of 30%. Conclusion : The high prevalence of HBV infection amongst the subjects studied strongly suggests that urgent preventive measures, particularly health education of the general public on HBV infection and provision of universal HBV vaccination should be given urgent priority. Keywords : Children, HBsAg, Primary school, Seroprevalence

The effect of occult HBV infection on carcinogenesis of cryptogenic hepatocellular carcinoma

Objective To investigate the effect of occult HBV infection (OBI) on carcinogenesis of cryptogenic hepatocellular carcinoma. Methods Samples of hepatocellular carcinoma (HCC) and pericarcinomatous tissues obtained after hepatectomy from January 2011 to November 2013 at the Third Affiliated Hospital of Sun Yat-Sen University were collected. They were divided into two groups: the cryptogenic HCC group (the CH group, n=26) and the HBV related HCC group (the HH group, n=40). These samples were compared with the normal liver tissues obtained in 30 patients. HBV DNA was identified by the nested polymerase chain reaction and the immunohistochemical method was taken to examine the hepatitis B virus X protein (HBx) and Yes-associated protein (YAP) expressions. Results OBI was identified in 20 (77.8%) cryptogenic HCC patients and 8 (26.7%) in the control group. There was a significant difference between the two groups (χ2=14.072, P 0.05), but the YAP expression in the tumor tissues was significantly higher than that in the nontumorous tissues (P 0.05). However, their expressions in the cancerous tissue of the HH group and the CH group were significantly higher than in the normal liver tissues (P<0.05). Conclusion A high prevalence of HBV infection was observed in HBsAg-negative HCC and the high expressions of HBx and YAP might be involved in the process of cryptogenic hepatocellular carcinoma. Key words: Hepatocellular carcinoma, cryptogenic; Occult infection; Hepatitis B virus; Hepatitis B virus X protein; Yes-associated protein (YAP)

Assessment of hepatitis B virus antibody titers in childhood cancer survivors.

Childhood cancer survivors have high seronegative rates for HBV and the majority of the patients achieved HBsAb titer >10mIU/ml with a single booster dose of HBV vaccine, which is worth further investigation and research. This study suggests revaccination against HBV post-chemotherapy treatment, as the recommended advice, especially in countries with a high prevalence of HBV infection. What is Known: • There is a variable prevalence of low HBsAb titers measured after the end of chemotherapy in childhood cancer survivors. • There are no universal guidelines for revaccination of these patients. What is New: • This research identified that 86% of childhood cancer survivors treated with standard chemotherapy were seronegative for HBV infection. • A single booster dose HBV vaccine was successful for the majority of patients (90%) to achieve HBsAb titers >10mIU/ml.

HBV Infection Trend in Iranian Disabled Children; Is It really Worrying?

We read with a great interest the article written by Davoodbeglou and colleagues entitled “Evaluation of Hepatitis B Infection Prevalence in Institutionalized Intellectually Disabled Children” which is recently published in your prestigious journal 1 . The authors concluded that HBV infection is more prevalent among institutionalized disabled children and that we should change our health policies for HBV infection management in this population. They have conducted a valuable study with an important subject in a high risk population for hepatitis. Despite our interest to the findings of Davoodbeglou et al. study there are some challenging points about their work; so we think that some comments may be of benefit. The first, authors have claimed a higher prevalence of HBV infection among vaccinated children in comparison with those with no or undetermined vaccination history. While there are studies in which the efficacy of neonatal HBV immunization has been proven 2 . How the authors justify this finding? In addition the authors have not mentioned the sampling method of their study which is the crucial factor of prevalence studies. This may seriously affect the results of study. Also the time period in which the study was conducted has not been determined by the authors. Was it after or before distribution of national vaccination program for hepatitis B? In this regard we should be aware of the maximum age of disabled individuals included in the study. In conclusion we appreciate the valuable effort of the authors; however we were wondering if we could kindly ask them to interpret better our concerns.

Hepatitis B in Ghana: a systematic review & meta-analysis of prevalence studies (1995-2015).

BackgroundAlthough, chronic hepatitis B (HBV) is considered to be of significant public health importance in Ghana, not many reviews detailing the burden (prevalence) of the disease have been conducted. This study was aimed at summarizing the available information and to make an accurate estimate of HBV infection prevalence in Ghana over the last two decades (1995–2015).MethodsA systematic search was conducted in PubMed, ScienceDirect, Google Scholar and Africa Journals Online (AJOL) databases to retrieve primary studies published between 1st January 1995 and 4th October 2015, assessing the prevalence of HBV among populations in Ghana. This was supplemented by a manual search of retrieved references.ResultsThirty (30) studies across all the ten (10) regions of Ghana and involving an overall population size of 105,435 were analyzed. The national prevalence of HBV as determined by HBsAg seropositivity was 12.3 %. HBV prevalence among voluntary blood donors (VBDs), replacement blood donors (RBDs) and pregnant women were 10.8, 12.7 and 13.1 % respectively. HBV infection prevalence was highest among studies published within the period 1995–2002 (17.3 %), followed by those published within 2003–2009 (14.7 %) and the lowest prevalence rate being recorded across studies published in the period 2010–2015 (10.2 %). Regional prevalence were determined for Ashanti, Greater Accra, Eastern, Northern, central and Brong-Ahafo regions as 13.1, 10.6, 13.6, 13.1, 11.5 and 13.7 % respectively. No aggregate data were derived for Volta, Western, Upper East and Upper West regions. Higher prevalence of HBV infection was attained for rural (13.3 %) compared to urban settings (12.2 %). Across the country, highest HBV infection prevalence rates were recorded in persons within the age group 16–39 years.ConclusionHepatitis B infection is clearly an important public health problem in Ghana. The burden of the disease as dictated by a high prevalence rate calls for urgent public health interventions and strategic policy directions to controlling the disease to avert any potential future explosion.

Regional and Ethnic Aspects of Viral Hepatitis B among Pregnant Women

The aim of this study was to determine the prevalence of HBV infection among pregnant women in districts of Eastern Slovakia with a diverse prevalence of Roma population. Overall 59,279 serum samples from 9 regional departments of clinical microbiology from Eastern Slovakia were collected in the period from January 2008 till December 2009 and analysed. The number of HBsAg positive samples overall and during pregnancy was 1.74% and 2.12%, respectively. Comparing districts with higher (> 5%) and lower (< 5%) Roma population, there was no significant difference in the prevalence of HBsAg positive samples overall (1.95% vs.1.62%). However, in the subgroup of pregnant women the prevalence of HBsAg positive samples (2.72% vs. 0.95%) differs significantly (p < 0.01). The prevalence of HBV infection among pregnant women in Eastern Slovakia did not rapidly exceed the estimated nationwide prevalence. However, in districts with higher Roma population the expected higher prevalence of HBV infection was confirmed. This indicates the need to pay special attention to the prevention of hepatitis B in these districts.

A Multicentre Molecular Analysis of Hepatitis B and Blood-Borne Virus Coinfections in Viet Nam

Hepatitis B (HBV) infection is endemic in Viet Nam, with up to 8.4 million individuals estimated to be chronically infected. We describe results of a large, multicentre seroepidemiological and molecular study of the prevalence of HBV infection and blood-borne viral coinfections in Viet Nam. Individuals with varying risk factors for infection (n = 8654) were recruited from five centres; Ha Noi, Hai Phong, Da Nang, Khanh Hoa and Can Tho. A mean prevalence rate of 10.7% was observed and levels of HBsAg were significantly higher in injecting drug users (IDUs) (17.4%, n = 174/1000) and dialysis patients (14.3%, n = 82/575) than in lower-risk groups (9.4%; p<0.001). Coinfection with HIV was seen in 28% of HBV-infected IDUs (n = 49/174) and 15.2% of commercial sex workers (CSWs; n = 15/99). HCV infection was present in 89.8% of the HBV-HIV coinfected IDUs (n = 44/49) and 40% of HBV-HIV coinfected CSWs (n = 16/40). Anti-HDV was detected in 10.7% (n = 34/318) of HBsAg positive individuals. Phylogenetic analysis of HBV S gene (n = 187) showed a predominance of genotype B4 (82.6%); genotypes C1 (14.6%), B2 (2.7%) and C5 (0.5%) were also identified. The precore mutation G1896A was identified in 35% of all specimens, and was more frequently observed in genotype B (41%) than genotype C (3%; p<0.0001). In the immunodominant ‘a’ region of the surface gene, point mutations were identified in 31% (n = 58/187) of sequences, and 2.2% (n = 4/187) and 5.3% (n = 10/187) specimens contained the major vaccine escape mutations G145A/R and P120L/Q/S/T, respectively. 368 HBsAg positive individuals were genotyped for the IL28B SNP rs12979860 and no significant association between the IL28B SNP and clearance of HBsAg, HBV viral load or HBeAg was observed. This study confirms the high prevalence of HBV infection in Viet Nam and also highlights the significant levels of blood-borne virus coinfections, which have important implications for hepatitis-related morbidity and development of effective management strategies.

Faisabilité du dépistage ciblé VIH, VHB, VHC dans une structure de soins ambulatoires avec un système de permanence d’accès aux soins de santé intégré

In France, patients coming from sub-Saharan Africa, French Indies and French Guiana are frequently missed HIV, HBV and HCV diagnosis, despite high prevalence of these infections. Targeted proposal of HIV, HBV and HCV screening, using sensitive enzyme immunoassays, to any adult patient originating of the above mentioned areas, with/without medical insurance, consulting for a medical issue in outpatients' department. Monocentric prospective study in a hospital in Paris during 28 consecutive days in 2010. Among the 272 eligible patients, 166 were tested (patients' acceptance: 61%). 180/272 (66%) alleged being tested previously for HIV, women (66/87, 76%) more frequently than men (114/185, 62%), P=0.02. Patients' acceptance seemed higher in patients mentioning no previous test than in patients reporting previous test. Among the patients who refused being tested, reporting a previous negative HIV test, more than a quarter has been tested more than 1 year ago. Among the 166 tested patients, 120 (72%) came back to get their results, men (89/113, 79%) more frequently than women (31/53, 58.5%), P=0.009; recently metropolitan patients more frequently than longer metropolitan patients, P=0.01; patients without any job more frequently than patients with a job, P=0.01. Three (1.8%) HIV tests returned positive; HBsAg was positive in 13 (7.8%) patients; 54 patients (32.7%) had a negative hepatitis B screening (anti-HBcAb+HBsAg+anti-HBsAb), attesting to sensitivity to this infection, only 18 patients (10.9%) showed isolated anti-HBsAb at protective levels. Eighty-one patients (49.1%) exhibited anti-HBcAb, confirming the high prevalence of HBV infection in the areas the patients came from. Six patients (3.6%) had anti-HCVAb. There was no co-infection. Targeted HIV, HBV and HCV screening to patients coming from high prevalence areas in outpatients' department appears a very cost-effective strategy.

OC8 SCREENING FOR HBV IN IMMIGRANTS: PILOT PHASE OF EPIDEMIOLOGICAL STUDY IN HEALTY POPULATION

Results: We evaluated 118 subjects (55 M, 63 F), 71 (60.1%) 25–45 years old, 28 (23.7%) >45 years old, 16 (13.5%) 15–24 years old and 3 (82.5%) 20,000 in 4 (33.3%). Conclusions: The data of this pilot phase suggest a high prevalence of HBV infection in the immigrant population. The prevalence appears similar to that of country of birth. HBV-DNA quantification indicate that 50% of carriers have to be evaluated for treatment. On the basis of these data we confirm the utility of a screening programme for HBV in the immigrants.