High Risk Of Hepatitis B Virus Infection Research Articles

The impact of donor hepatitis B virus infection on transplant outcomes in deceased donor kidney transplantation recipients.

The use of hepatitis B virus (HBV)-positive donor kidneys to expand the donor pool has been implemented, but limited evidence exists regarding their impact on transplant outcomes. This study aimed to investigate the effects of donor HBV infection on transplant outcomes. Donor and recipient data between 2015 and 2021 were collected. A total of 743 kidney transplant cases were screened, including 94 donor hepatitis B surface antigen (HBsAg)+/recipient HBsAg- (D+R-) and 649 donor HBsAg-/recipient HBsAg- (D-R-) cases. The analysis endpoints included recipient HBV infection, delayed graft function (DGF), peak estimated glomerular filtration rate (eGFR) within 12 months, recipient survival, and death-censored graft survival (DCGS). The D+R- group had a significantly higher risk of HBV infection compared to the D-R- group (6/72 vs. 3/231; relative risk, 6.4; p = 0.007). The risk of HBV transmission decreased significantly with increasing hepatitis B surface antibody (HBsAb) titer (p for trend = 0.003). Furthermore, the D+R- group did not exhibit an increased risk of DGF compared to the D-R- group (odds ratio, 0.70; p = 0.51) in the multivariable mixed model. Both groups had similar peak eGFR within 12 months (β = 1.01, p = 0.71), and this had no impact on patient survival (hazard ratio [HR], 0.36; p = 0.10) and DCGS (HR, 0.79, p = 0.59) in the shared-frailty Cox model. The use of HBsAg-positive donor kidneys appears relatively safe for HBV-immunized recipients in the short term. D+R- does not negatively affect graft function recovery and provides comparable posttransplant outcomes. Maintaining an HBsAb titer over 100 IU/L before transplantation is critical to reduce the risk of HBV transmission.

Hepatitis B Vaccination Status, Knowledge, and Attitudes among Healthcare Workers in Military Hospital, Khartoum State: A Cross-sectional Study

Abstract Background: Hepatitis B virus (HBV) is a significant public health issue that causes a substantial number of cases of hepatitis-related illness and death. It is particularly important to vaccinate healthcare workers (HCWs), as they face a higher risk of HBV infection due to their exposure to infected blood and other bodily fluids in their line of work. The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention currently recommends HBV vaccination for adult populations at risk of infection. Therefore, this study aimed to assess the vaccination status, knowledge, and attitudes of HCWs toward HBV vaccination in a military hospital. Materials and Methods: An institution-based descriptive cross-sectional study performed between May 2022 and September 2022 for HCWs working in Omdurman Military Hospital who were available at the time of data collection; data were collected using a self-administered and online questionnaire; the obtained results were analyzed. Results and Conclusion: Only 50% of HCWs in military hospitals possessed adequate knowledge, while the majority exhibited a positive attitude toward HBV infection. In terms of vaccination status, approximately two-thirds of HCWs were immunized, but only half of them completed the recommended number of vaccine doses. The educational activities of the infection control training programs should be strengthened to enhance the awareness of HCWs regarding HBV infection and vaccination. It is necessary to implement comprehensive vaccination programs against hepatitis B in various medical fields. In addition, a mandatory and cost-free policy for hepatitis B vaccination should be established for HCWs and medical students.

Occult HBV Infection in Patients Infected by HIV or HCV: Comparison between HBV-DNA and Two Assays for HBsAg.

We investigated the frequency and serological correlates of occult hepatitis B virus infection (OBI) and the potential impact of a highly sensitive assay for HBsAg in subjects infected by human immunodeficiency virus (HIV) or hepatitis C virus (HCV), who are also at risk for hepatitis B virus (HBV) infection, often in an occult form. Samples from 499 patients with HIV, all HBsAg negative and anti-HBc positive, and 137 patients with HCV were tested for HBV-DNA, anti-HBc, anti-HBs, and HBsAg by a conventional and highly sensitive assay. HBV biomarkers were detected in 71.5% of HCV-RNA-positive, with a higher prevalence of cases positive only for anti-HBc in patients with HCV than in those with HIV. HBV-DNA was detectable in 0.6% of HIV-positive and 7.3% of HCV-RNA-positive patients. Among patients with HCV, four were positive for HBsAg and negative for HBV-DNA, bringing the rate of HBV-active infection in this group to 10.2%. Active HBV infection was not related to gender or specific patterns of HBV biomarkers but was higher in HCV patients coinfected by HIV compared to those infected only by HCV. Monitoring patients at high risk for HBV infection and reactivation may require testing for both HBV-DNA and HBsAg.

Seroprevalence of hepatitis B infection among blood donors in Western zone of Tanzania

BackgroundThere is limited information on burden of hepatitis B infection in the Western zone of Tanzania. In this study, we analyzed a dataset from blood donors to determine Hepatitis B virus (HBV) seroprevalence and related socio-demographic factors among blood donors in the Western regions of Tanzania. Material and methodsThis was a cross-sectional retrospective hospital-based study, in which data were retrieved from the blood donor dataset at the Zonal Blood Transfusion Center. The analyzed information from the dataset included reported Transfusion Transmissible Infections (TTIs), which included Hepatitis B, donor demographics, donor status, donor type, donation place, and the year of donation. The analyzed data was retrieved within five years from January 2018 to December 2022. Rates of hepatitis B surface antigen (HBsAg) were determined and univariate and multivariate analyses were conducted to determine the association between infection and demographic risk factors. ResultsA total of 9604 retrospective blood donors were screened. Majority 8963 (93.3 %) were men, and most of them were under 45 years (89.6 %). Overall, HBsAg seroprevalence was 6.9 % (661), with Katavi (7.8 %) being relatively higher in the studied three regions. The highest HBsAg seroprevalence of 8.2 % (199) was found in the age group ranging from 35 to 44 years. Moreover, 2 (9.5 %) polygamists and 15 (17.1 %) car drivers had relatively high seroprevalence. Results from the multivariate analysis indicated that, car drivers (OR 5.44, 95 % CI; 2.43–12.20, p < 0.001), and first-time donors (OR 5.19, 95 % CI 2.56 = 10.52, P < 0.001), were highly associated with increased chance of getting hepatitis B infection. ConclusionThe findings from this study indicated that, there was high seroprevalence of HBV infection in the Western regions of Tanzania during the studied time period. These findings call for more advocacy on HBV immunization for all groups of persons found at high risk for HBV infection.

An update of Seroprevalence of HBV among healthcare workers in Yemen: a review of data published between 2001 and 2020

Hepatitis B virus (HBV) infection is a major global health problem. Healthcare workers (HCWs) are at high risk of HBV infection. The aim of this review was to summarize HBV seroprevalence in HCWs in Yemen. Electronic databases (PubMed, Google Scholar, and Google) had been used to search for studies on HBV seroprevalence in HCWs in Yemen. Among 1119 HCWS seem in this review, 78 (6.97%) were seropositive for HBV infection. HBV infection correlated significantly with HCWs. HCWs (2.76%-21.4%) infected with HBV. HCWs in Yemen are considered at moderate to high risk of HBV infection according to WHO classification. The prevalence of HBV infection in recent years decreased compared with that published during 2001-2004.

Overview of the Hepatitis B Epidemiology and Vaccination among Healthcare Workers

Introduction: Healthcare workers (HCWs) who are at high risk for HBV infection, have been recommended to receive the HB vaccine for over 20 years. This review aimed to highlight the enablers and obstacles facing the universal coverage of hepatitis B epidemiology and vaccination among healthcare workers. Methods: A search was conducted using the following terms related to hepatitis B, vaccination, and healthcare workers in Africa: hepatitis B, hepatitis B virus, vaccination, immunization, healthcare workers, health workers, and health personnel. This review included cross-sectional, case-control, and cohort studies. Studies in English or French from any location were selected. A search was conducted for articles published from 1970 to 2022 in PubMed and the Excerpta Medica Database (Embase) using search terms related to hepatitis B and healthcare workers. Results: This study analyzed 25 cross-sectional studies on healthcare workers (HCWs) in African countries to determine the prevalence of hepatitis B vaccination. The majority of the studies were conducted in hospitals and included HCWs from West and East Africa. After assessing the quality of the studies, 5 (14.3%) were found to be of high quality, 17 (77.1%) were of moderate quality, and 3 (8.6%) were of low quality. The proportion of HCWs who were fully vaccinated against hepatitis B varied widely, ranging from 0.8% in Rwanda to 72.0% in Libya. The overall pooled full vaccination coverage among HCWs in Africa was 24.7%. Subgroup analyses showed significant variation in vaccination coverage among HCWs in different regions of Africa and Asia, with the highest coverage in North Africa and the lowest in Central and East Africa. Conclusions: Healthcare workers (HCWs) are at higher risk of infection with Hepatitis B virus (HBV) compared to individuals who do not work in hospitals, with frequencies of infection up to 4 times higher. HBV can be transmitted between patients and HCWs, as well as between HCWs and their relatives, contributing to the ongoing chain of transmission.

Burden of HIV, HBV and syphilis among children in urban Ethiopia: Community-based cross-sectional study.

Children have largely been ignored in the fight against sexually transmitted infection (STI). Among children, STI is reported to be a globally emerging public health challenge. We evaluated the burden of HIV, hepatitis B virus (HBV) and syphilis among children (< 15 years old) and its determinants in urban Ethiopia. For this study, we used data from the Ethiopian Population-based HIV Impact Assessment (EPHIA), collected through a nationally representative, community-based study conducted in Ethiopia from October 2017 to April 2018. We used plasma samples from 4729 children. Moreover, we linked the data and analysed them alongside their respective mothers. Child and maternal HIV status was determined using the national testing algorithm. Plasma samples from children were also tested for syphilis and HBV surface antigen. A descriptive analysis was done followed by bivariable analysis with 95% confidence interval (CI) at a significance level of p< 0.05. We finally evaluated predictors of STIs using regression analysis. HIV, HBV and syphilis prevalence rates among urban children in Ethiopia were 0.36%, 1.48% and 0.28%, respectively. Children living in Gambella and Addis Ababa had a 6.41-fold (95% CI:3.20-9.88) and 4.20-fold (95% CI:3.24-5.46) higher risk of HIV infection compared with those in Dire Dawa. Children of HIV-positive mothers had a 10.31-fold (95% CI:3.20-18.19) higher risk of HIV infection, and if those mothers were not taking highly active antiretroviral therapy (HAART), the risk was 7.27 times higher (95% CI:2.57-12.64). Those who were from HIV-positive mothers with viral load ≥ 1000 copies/mL had a 18.64-fold (95% CI:6.36-31.24) higher risk of HIV infection and those with a history of breastfeeding had a 3.27-fold (95% CI:1.11-5.67) higher risk. Children from Addis Ababa had a 3.26-fold (95% CI:1.64-6.66) higher risk of HBV infection compared with those from Dire Dawa. Moreover, for those from HIV-positive mothers and whose mother was not taking HAART, the risk of HBV transmission was 6.37 (95% CI:2.20-19.96) and 3.62 (95% CI:1.27-11.29), respectively. Children living in Gambella, Somali, Afar and Tigray had a 7.21-fold (95% CI:2.30-18.68), 3.10-fold (95% CI:1.28-3.74) and 1.32-fold (95% CI:1.11-3.38) higher risk of acquiring active syphilis compared with those living in Dire Dawa, respectively. Those from HIV-positive mothers also had a 4.22-fold (95% CI:1.16-8.39) higher risk of acquiring active syphilis. The burden of HIV, HBV and syphilis was high among children in urban Ethiopia. The key determinants for the high burden of HIV, syphilis and HBV were maternal factors including maternal HIV status and breastfeeding. This might be due to the challenges associated with mother-to-child transmission. Hence, the programme shall focus on the elimination of the triple infections of HIV, syphilis and HBV.

Seroconversion among healthcare workers vaccinated with hepatitis B vaccine of RIMS Hospital, Imphal, Manipur

Hepatitis B, caused by hepatitis B virus (HBV) is a vaccine preventable disease. Health care workers are at high risk of HBV infection due to their exposure to infectious materials. Anti-hepatitis B surface antigen antibody (Anti HBs) titre of 10 IU/mL indicates protection.Aims: To determine the antibody titre among health care workers of RIMS Hospital, Imphal.Settings and Design: Cross-sectional studyMethods and Material: Blood samples were collected from 164 health care workers vaccinated with hepatitis B vaccine and anti HBs titre was estimated by ELISA.Statistical analysis used: Descriptive and inferential statistics. The quantitative variables were expressed as mean and standard deviation while categorical variables were expressed as percentage. Odds ratio was used for calculation of protective antibody titre. Association between antibody titres and time since vaccination was analysed using Pearson correlation.Results: Protective titre seen in 130(79.26%) participants while on-protective titre is seen in 34(20.73%) participants. While only 15.57% of fully vaccinated individuals have non-protective anti HBs titre, 40% of partially vaccinated HCWs do not have protective titre.Conclusions: Completion of a three-dose series of hepatitis B vaccine is important to achieve seroconversion. A second series of vaccine may be recommended for seroconversion failure after the first series of vaccine followed by re-testing of anti Hbs titre. Booster dose is not recommended for seroconverted individuals with low antibody titre.

Association between self-monitoring of blood glucose and hepatitis B virus infection among people with diabetes mellitus: a cross-sectional study in Gansu Province, China

ObjectiveThe purpose was to explore the association between self-monitoring of blood glucose (SMBG) and hepatitis B virus (HBV) infection among people with diabetes.DesignA cross-sectional comparative study.SettingSix township hospitals in Gansu...

Association of Elongation Factor Tu GTP-binding Domain-containing 2 Gene (EFTUD2) Polymorphism with the Risk of Hepatitis B Virus Infection

ABSTRACT Background The elongation factor Tu GTP-binding domain-containing 2 gene (EFTUD2) participates in antiviral immune responses. However, the association between genetic polymorphisms of EFTUD2 and hepatitis B virus (HBV) infection susceptibility has not been well-studied. We analyzed the relationship between single nucleotide polymorphisms (SNPs) of EFTUD2 and HBV infection susceptibility and clarified the potential function. Methods In total, 448 control subjects and 379 patients with chronic HBV infection from Zhangjiagang First People’s Hospital (Jiangsu, China) were enrolled. Sequenom iPLEX assay was used to detect genotypes of four SNPs (rs1071682, rs2277617, rs2289674, and rs3809756). Dual-luciferase reporter vectors with wild-type A and mutant-type C alleles of EFTUD2 rs3809756 were transfected into HepG2 cells to explore effects on transcription activity. Results Only rs3809756 was significantly associated with HBV infection susceptibility (P < .05). The risk of HBV infection was higher in individuals carrying the rs3809756-CC genotype than in those carrying the rs3809756-AA genotype (odds ratio [OR] = 1.945, 95% confidence interval [CI] = 1.129–3.351, P = .017). Subgroup analysis based on the dominant model revealed that rs3809756-AC and rs3809756-CC carriers had a significantly higher risk of HBV infection than rs3809756-AA carriers among patients who were male (OR = 1.732, 95% CI = 1.218–2.464, P = .002), were aged ≥47 years (OR = 1.502, 95% CI = 1.050–2.148, P = .026), or without liver cirrhosis (OR = 1.407, 95% CI = 1.077–1.838, P = .012). In the dual-luciferase reporter assay, the relative luciferase activity of rs3809756-C was significantly lower than that of rs3809756-A (P < .05). Conclusion EFTUD2 rs3809756A>C was associated with HBV infection susceptibility and might be involved in the downregulation of promoter activity.

Immune response to hepatitis B vaccination and factors associated with poor immune response among healthcare workers.

Hepatitis B virus (HBV) infection is a major global health problem, and healthcare workers (HCWs) are at high risk for HBV infection. Current guidelines strongly recommend immunization and screening for high-risk groups. We evaluated immunization and screening for HBV vaccination, assessed post-vaccination immune status of HCW's and characterized potential risk factors associated with poor immune response. From January 2010 to December 2018, we retrospectively analyzed comprehensive health checkup data for a total of 303 HCWs who received an HBV vaccination. After vaccination, HBV surface antibody (anti-HBs) titers were collected and the distribution of immune response types was determined. Risk factors for poor immune responses were identified using logistic regression. A total of 213 HCWs were analyzed after exclusion based on the exclusion criteria. In total, 28 (13.2%) HCWs had anti-HBs titers <100 mIU/mL (hyporesponsive/nonresponsive groups), and 185 (86.8%) had anti-HBs titers ≥100 mIU/mL (hyperresponsive group). Follow-up observations found that 75% (21/28) of the hyporesponsive/nonresponsive groups did not have increased anti-HBs titers or did not maintain an increased response. A multivariate analysis showed that HBV antibody titers at the time of employment were a significant risk factor (OR, 6.12; CI, 1.34-27.93; P = 0.019). More attention should be paid to groups that are hyporesponsive/nonresponsive after vaccination and to those with low anti-HBs titers at the beginning of employment. HCWs can be further protected from HBV if their results are discussed at postvaccination follow-ups.

1066. Immune Escape Mutant Detection Using Commercially Available Methods for Hepatitis B Surface Antigen Serological Testing

BackgroundAlthough overall infection rates of Hepatitis B virus (HBV) in the United States (US) remain stable, as many as 2.2 million persons are still chronically infected with Hepatitis B Virus (HBV)1. Persons who inject drugs (PWID) are at a higher risk of HBV infection and since 2009 three states (KY, TN, WV) have reported up to a 114% increase in cases of acute HBV infection due to higher infection rates among a non-Hispanic white populations (30–39 years), and injection drug users2. Hepatitis B vaccination is recommended as primary prevention for adults who are at increased risk for HBV infection, including PWID. However, data from the National Health Interview Survey indicate that hepatitis B vaccination coverage is low among adults in the general population3, and it is likely to be lower among injection drug users.Hepatitis B Surface Antigen (HBsAg) is the first serological marker to appear after HBV exposure and infection; this marker is included in the recommended panel for acute hepatitis diagnosis and accurate detection is necessary for early and accurate diagnosis. Serological testing challenges exist for HBsAg due to the high degree of genetic variability which can further be exacerbated by endogenous and exogenous pressures. The immuno-dominant region may have one or more mutations described as immune escape mutations which can decrease or abrogate HBsAg binding to antibodies used in immunoassays. Although the prevalence of these mutations is not well documented in the United States, international studies have shown that up to 79% of HBV-reactivated patients (vs 3.1% of control patients; p< 0.001) carry HBsAg mutations localized in immune-active HBsAg regions4.MethodsA study was conducted using a panel of 10 unique recombinant HBsAg immune escape mutants. Panel members were tested by commercially available HBsAg serological immunoassays.ResultsIt was found that although commercially available HBsAg immunoassays are the primary diagnostic tool for HBV diagnosis, not all HBsAg immune escape mutants are detected, with some method detecting as few as 5 out of 10 of these mutant samples.Figure 1 ConclusionImprovement is needed in commercially available methods for the accurate detection of HBsAg.Disclosures Robert Gish, MD, Abbott (Consultant)AbbVie (Consultant, Advisor or Review Panel member, Speaker’s Bureau)Access Biologicals (Consultant)Antios (Consultant)Arrowhead (Consultant)Bayer (Consultant, Speaker’s Bureau)Bristol Myers (Consultant, Speaker’s Bureau)Dova (Consultant, Speaker’s Bureau)Dynavax (Consultant)Eiger (Consultant, Advisor or Review Panel member)Eisai (Consultant, Speaker’s Bureau)Enyo (Consultant)eStudySite (Consultant, Advisor or Review Panel member)Exelixis (Consultant)Fujifilm/Wako (Consultant)Genentech (Consultant)Genlantis (Consultant)Gilead (Consultant, Advisor or Review Panel member, Speaker’s Bureau)GLG (Consultant)HepaTX (Consultant, Advisor or Review Panel member)HepQuant (Consultant, Advisor or Review Panel member)Intercept (Consultant, Speaker’s Bureau)Ionis (Consultant)Janssen (Consultant)Laboratory for Advanced Medicine (Consultant)Lilly (Consultant)Merck (Consultant)Salix (Consultant, Speaker’s Bureau)Shionogi (Consultant, Speaker’s Bureau)Viking (Consultant)

Hepatitis B virus infection, knowledge and vaccine uptake among hairdressers in Ikorodu, Lagos State

Abstract Background Hepatitis B is a major public health concern. Hepatitis B virus (HBV) continues to thrive in developing countries including Nigeria. Occupationally exposed persons like people working in women's beauty salon are at high risk of HBV infection and may play a critical role in the disease transmission via contaminated needles and sharps. The aim of this study therefore was to estimate HBV infection, knowledge level, occupational risk perception and vaccine uptake among people working in women's beauty salons. Also to get them screened and encourage those that are negative to get vaccinated to curb the spread of this infection. Methods This was a cross-sectional study carried out on 199 people working in women's beauty salons in Ikorodu Local government area of Lagos State. HBsAg screening using a rapid diagnostic test kit was carried out for all respondents to determine their infection status. Questionnaire which assessed their knowledge level and occupational risk perception were completed by trained interviewers and data was analysed using SPSS software. Results The result of this study showed that only 2.01% respondents tested positive for the HBsAg screening. Majority of the respondents (69.3%) have poor knowledge about HBV transmission, prevention and vaccine. While most (78.9%) of the respondents don't know their occupational risk of exposure to HBV, 9.0% rated themselves at high risk of occupational exposure. Significant association was observed between level of knowledge and risk perception (P &amp;lt; 0.001). The level of vaccine uptake was very poor as only 1 out of 199 respondents has taken 3 doses of HBV vaccine, 60.9%(120) have not been vaccinated. Conclusions The respondents exhibited poor level of knowledge about HBV transmission, prevention, vaccination and went about their occupation without adequate protection form HBV. Key messages Screening of people working in women beauty salon is highly imperative to identify those with infection so that they can be treated on time while those that are negative should be vaccinated. Due to the potential roles of people working in women’s beauty salon in HBV transmission, education programs and vaccine coverage policy should be adopted for people in this occupation.

High Risk of HBV Infection Among Vaccinated Polytransfused Children With Malignancy.

The national Egyptian hepatitis B virus (HBV) vaccination program coverage of all infants started in 1992. The study aimed to assess immunity against HBV and occurrence of HBV breakthrough infections in vaccinated polytransfused children with malignancies. Eighty-nine polytransfused children with malignancies were recruited; 37 were on chemotherapy (male:female 20:17; mean age 7.7±4.0 y), and there were 52 naive patients (male:female 31:21; mean age 7.6±3.2 y). In addition, 162 age-matched and sex-matched healthy controls were recruited. Patients' sera were tested for quantitative anti-hepatitis B surface (HBs) (enzyme-linked immunoassays technique), hepatitis B surface antigen (HBsAg), total anti-hepatitis B core, and HBV-DNA (nested polymerase chain reaction for surface, core, and x-regions). There was a significant lower percentage of having protective anti-HBs (10 to 100 IU/L) level among those receiving chemotherapy (13.5%) than those without (44.2%) and controls (32.1%). Twenty-one (67.7%) of those on chemotherapy were HBsAg positive compared with 10 (32.2%) of those without. Overall, 46 patients were HBV-DNA positive; 38 were c-region positive, 5 were s-region positive, 2 positive for the c-region and the s-region, and 1 tested positive for the c-region and the x-region. Of 46 patients, 20 were also positive for HBsAg (overt infection), while 26 had occult HBV infection (HBsAg-negative). Anti-HBs ≥10 IU/L co-existed among 45% of patients with overt infection and in 50% of those with occult infection. There was nonsignificant impact of receiving chemotherapy on the level of HBV-DNA. Vaccinated children with malignancies, especially those under chemotherapy, are at a significant risk of HBV infection. The co-existence of anti-HBs with HBsAg and/or HBV-DNA may represent a possible residual transfusion-transmission risk with mutant HBV strains.

Characterization of occult hepatitis B in high-risk populations in Kenya

Occult hepatitis B infection (OBI) is defined as the presence of hepatitis B virus (HBV) DNA in the liver or serum in the absence of detectable HBV surface antigen (HBsAg). OBI poses a risk for the development of cirrhosis and hepatocellular carcinoma. The prevalence of OBI in Kenya is unknown, thus a study was undertaken to determine the prevalence and molecular characterization of OBI in Kenyan populations at high risk of HBV infection. Sera from two Nairobi cohorts, 99 male sex workers, primarily having sex with men (MSM-SW), and 13 non-MSM men having HIV-positive partners, as well as 65 HBsAg-negative patients presenting with jaundice at Kenyan medical facilities, were tested for HBV serological markers, including HBV DNA by real-time PCR. Positive DNA samples were sequenced and MSM-SW patients were further tested for hepatitis C virus (HCV) infection. Of the 166 HBsAg-negative samples tested, 31 (18.7%; 95% confidence interval [CI] 13.5-25.3) were HBV DNA positive (i.e., occult), the majority (20/31; 64.5%) of which were HBV core protein antibody positive. HCV infection was not observed in the MSM-SW participants, although the prevalence of HBsAg positivity was 10.1% (10/99; 95% CI 5.6-17.6). HBV genotype A was predominant among study cases, including both HBsAg-positive and OBI participants, although the data suggests a non-African network transmission source among MSM-SW. The high prevalence of HBV infection among MSM-SW in Kenya suggests that screening programmes be instituted among high-risk cohorts to facilitate preventative measures, such as vaccination, and establish entry to treatment and linkage to care.

Incident hepatitis B virus infection and immunisation uptake in Australian prison inmates

IntroductionDespite an effective vaccine, hepatitis B virus (HBV) infection continues to impose a large burden of disease globally. Until childhood immunisation achieves high adult population coverage, people who inject drugs (PWID), including prison inmates remain at risk. PWID have a higher prevalence of HBV than the wider population, and lower rates of vaccine-conferred immunity. This study sought to identify the incidence and predictors of HBV transmission and uptake of immunisation in PWID prisoners in Australia. MethodsLongitudinally collected, stored sera from subjects previously enrolled in a prospective study of hepatitis C in recently incarcerated PWID prisoners (n = 590) were serologically tested for HBV. Interviews recording demographic and behavioural risks were analysed. Multivariate statistical analyses were applied to identify associations of incident infection or immunisation. ResultsUpon imprisonment there were n = 373 (63%) individuals who were HBV susceptible, of whom 140 remained susceptible at the subsequent enrolment into the cohort, and had one or more follow-up visits (a total of 406.73 person years [p.y.]), and so were included in this analysis. There were 7 incident cases of HBV infection (1.7 per 100 p.y.) in this group, with transmission being associated with injecting drug use daily or more often. There were 48 individuals who were successfully immunised (11.8 per 100 p.y.) with younger age and continuous imprisonment predicting this outcome. ConclusionsThe Australian prison environment poses a high risk for HBV infection, and also provides an opportunity for immunisation for PWID. Further efforts are required to improve coverage and prevent ongoing transmissions.

Rheumatologists' awareness of hepatitis B reactivation before immunosuppressive therapy.

HBV reactivation (HBVr) is a well-known complication of immunosuppressive (IS) treatment. The aim of this study was to evaluate the awareness of rheumatologists about the risk of HBVr. A survey was sent via e-mail to 270 members of the Turkish Society for Rheumatology. It consisted of fourteen questions on their awareness of the major society guidelines, approach to hepatitis B virus (HBV) screening according to different IS regimens, decision process in screening patients for HBV, knowledge of antiviral treatments for HBV, follow-up strategies, experience and postgraduate training on HBVr. Forty-eight (17.8%) rheumatologists responded to the survey. Of the respondents, 93.8% reported that they screened all patients before IS treatment, while 6.2% screened patients with a high risk of HBV infection only. The screening rate was 95.8% (46/48) in patients undergoing high-risk IS treatment and 35.4% (17/48) in those undergoing low-risk treatment. All respondents screened for HBsAg, and 83.3% (40/48) screened for anti-HBc IgG and anti-HBs. Forty-four (91.7%) rheumatologists had previously initiated antiviral prophylaxis, and 14 (29.2%) had detected HBVr in at least one patient. Rheumatologists had a high awareness of the necessity for HBV screening before IS treatment. However, the screening rates were still lower than desired, especially in patients receiving IS treatments with moderate or low risk of reactivation.

Prevalence and molecular-genetic characteristics of hepatitis B virus in HIV-positive individuals at the Far Eastern Federal District

Current study was aimed at investigating prevalence of overt and occult hepatitis B infection in HIV-positive individuals as well as molecular-epidemiological characteristics of the circulating hepatitis B virus (HBV) strains in the Far Eastern Federal District (FEFD). A total number of 297 blood serum/plasma samples obtained from HIV-positive patients residing in the FEFD were enrolled in the study. The first control group included 351 blood serum/plasma samples of general population without indication on HIV and HBV-infection that underwent laboratory check up at the Centers for AIDS Prevention and Control. After evaluating the group of HIV-positive patients 20 HIV-HBV positive samples were selected for further detailed analysis. The second control group included 43 patients with chronic hepatitis B. All groups were age and gender-matched. The research included serological and molecular-genetic (real-time PCR, positive for HBV DNA samples underwent clonal sequencing of PCR-amplified HBV P/S gene) assessment of the biological material followed by a phylogenetic analysis of the HBV sequences. Our research revealed that HIV-positive patients are exposed to a higher risk of HBV infection compared to general population enrolled in the study, which is evident from the prevalence of anti-HBcAg antibodies in the groups examined. HIV-positive vs. first control group was positive for anti-HBcAg antibodies at higher rate (35.02%, CI 95: 29.5940.45% versus 22.22%, CI 95: 17.8726.57%, p = 0.0003). Abundance of ongoing HBV-infection markers was also higher in HIV-positive individuals compared to general population (6.73%, CI 95: 3.889.58% versus 0.85%, CI 95: 01.81%, p = 0.0001, respectively). Should be noted, that HBsAg-negative HBV infection in HIV-positive patient cohort comprised 1.01% (CI 95: 02.15%) whereas in general population this index was as low as 0.28% (CI 95: 00.84%). Virus hepatitis С and D were revealed at higher rate in HIV-positive individuals compared to patients with HIV-negative chronic HBV infection (p = 5.84 107 and p = 0.000001 respectively). HCV and HDV prevalence rates comprised 50.0% (CI 95: 27.4677.46%) and 40.0% (CI 95: 17.9762.03%) in HIV-positive patients. Similar indices in control group were 4.65% (CI 95: 010.94%) and 4.65% (CI 95: 010.94%), respectively. The phylogenetic analysis of the six isolated HBV sequences showed that the five samples belonged to genotype D, with dominant subtype D2 (verified in 4 cases). Further, HBV genotype С was detected only in one case. The obtained data indicate a necessity for further in-depth diagnostic examination of viral hepatitis in HIV-positive patients to lower a risk of developing life-threatening complications as well as preventing hepatitis spread in human population.

Prevalence of Undetectable Vaccine-Induced Immunity Against Hepatitis B Virus in US Adults at High Risk for Infection.

In 2015, the Centers for Disease Control and Prevention reported a substantial increase in the number of acute hepatitis B virus (HBV) infections in the United States. Although national guidelines recommend vaccination of adults at high risk for HBV infection, the prevalence of undetectable immunity (i.e., susceptibility) in this population remains unknown. In this study, we analyzed a nationally representative sample using the National Health and Nutrition Examination Survey to evaluate the prevalence, trend, and predictors of undetectable vaccine-induced antibodies against HBV surface antigen (<10 mIU/mL) among high-risk adults from 2003-2014. Among adults at high risk for HBV infection, the prevalence of undetectable immunity decreased from 83.2% in 2003-2004 (95% confidence interval [CI]: 81.3-85.0) to 69.4% (about 64 million) in 2013-2014 (95% CI: 66.0-72.6). The prevalence decreased significantly in individuals with multiple sex partners or sexually transmitted disease and in pregnant women. However, there were no significant changes in men who have sex with men (MSMs), intravenous drug users (IDUs), hepatitis C virus (HCV)-infected and patients with diabetes, and those with elevated aspartate aminotransferase/alanine aminotransferase (AST/ALT). Mexican Americans had the highest prevalence of undetectable immunity (77.6%, 95% CI: 72.6-81.9), followed by non-Hispanic whites (70.1%, 95% CI: 66.9-73.1). Older age, lower socioeconomic status, and having at least 1 high-risk factor were associated with a higher risk of undetectable immunity, whereas an increased risk among the foreign-born disappeared after multivariable adjustment. Conclusion: Approximately 64 million high-risk adults in the United States remain susceptible to HBV infection, especially MSMs, IDUs, diabetics, HCV patients, and populations with elevated AST/ALT. To eliminate HBV, efforts should be made to increase screening and vaccination in high-risk adults.

Disparities in Hepatitis B Virus Infection and Immunity Among New York City Asian American Patients, 1997 to 2017.

To measure disparities in hepatitis B virus (HBV) infection and immunity among a high-risk patient population at a community health center in New York City. We performed a retrospective chart review of 25 565 adults with HBV surface antigen, surface antibody, and total core antibody tests from 1997 to 2017. We categorized HBV test results by infection and immunity status and analyzed by demographic characteristics with χ2 and logistic regression analysis. Of 25 565 adults, 13.4% were currently infected, 52.1% were ever infected, 33.4% were immune from vaccination, and 14.5% were susceptible. Significant factors associated with ever infection were age, male sex, being China-born, limited English proficiency, having Medicaid or no insurance, and family history of HBV (P < .01). Our study demonstrated a high burden of HBV infection among foreign-born Asian Americans seeking care at a community health center. Public Health Implications. It is important to test patients at high risk for HBV infection with all 3 tests to identify those with current infection, risk for reactivation, or need for vaccination, and to assess the effectiveness of public health interventions.