Predictors Of Hepatitis Research Articles

Evaluation of Vaccination Status, Awareness, and Seroprevalence of Hepatitis B Virus Infection among Female Sex Workers in Jos

Study’s Excerpt/Novelty This study is the first to systematically evaluate the immunization status, awareness, and seroprevalence of hepatitis B virus (HBV) infection specifically among female sex workers in Jos, Nigeria, highlighting a significant gap in the existing literature. It reveals a high HBV prevalence rate of 24.4% within this population, with critical insights into demographic variations such as age, marital status, and educational level. The findings underscore an urgent need for targeted vaccination programs, given the alarmingly low immunization coverage, with only 10.5% of participants fully vaccinated against HBV. Full Abstract The hepatitis B virus (HBV) is the cause of hepatitis B infection, which can lead to malignancy and chronic liver cirrhosis. There is a dearth of research on the incidence of HBV among Nigerian women who work as sex workers despite the country being characterized as an endemic zone with prevalence among different occupational groups. The study evaluates the immunization status, awareness of the virus, and seroprevalence and predictors of hepatitis B virus infection among female sex workers. A descriptive cross-sectional study including 86 female sex workers in Jos brothels was conducted. Blood samples were collected using the RecombiLISAHbsAg ELISA kit (CTK Biotech Inc., San Diego, USA) to qualitatively detect HBsAg.Twenty (21) out of the 86 subjects tested positive, yielding a 24.4% prevalence rate. The highest prevalence was found among women in the 36–40 age range (40%), while the lowest (0.0%) was found among those in the age group <20 years. Married sex workers recorded the highest prevalence of 50%, while separated/divorced recorded the lowest prevalence of 10.0%. Also, female sex workers without a formal education had the highest prevalence of 66.7%. In comparison, the lowest prevalence of 0.0% was found among those with tertiary education. Those who engaged in sex work for less than five years had the highest prevalence of 30.8%, while the lowest was recorded among those who had five years and above in the sex trade, with a prevalence rate of 0.0%. There was no statistically significant correlation seen between these high percentages and HBV infection. Out of the 86 female sex workers, only 9 had received all three doses of the immunization. This high frequency of vaccine-preventable illness is intolerable; therefore, immunizing this high-risk HBV reservoir population should be justified

Prevalence and predictors of hepatitis C infection among antenatal attendees in a tertiary hospital in Southern Nigeria.

Hepatitis C virus infection as it specifically relates to pregnancy has been a neglected condition, thus its recognition and treatment in pregnancy is relevant because of the risks of the long-term complications of the infection in the mother, potential effects of the infection on the pregnancy and risk of vertical transmission to the newborn. To determine the proportion of pregnant women with serologic markers of hepatitis C infection, identify risk factors as well as factors that predict the occurrence of the infection in them. Over a 3-week period, blood samples from 456 pregnant women were assessed for antibodies to hepatitis C virus, while a pre-tested questionnaire was used to obtain socio-demographic data and the presence of risk factors in the University of Uyo Teaching Hospital, Nigeria. The prevalence of HCV infection in pregnancy was 4.6%. No known risk factors for HCV infection in pregnancy were identified. Only increasing gestational age was a predictor of HCV infection in pregnancy in the study. The prevalence of hepatitis virus infection among the study population was high. Second trimester and increasing gravidity were protective of the infection in pregnancy. There is therefore need for introduction of general routine screening of all pregnant women presenting for antenatal care.

Serological prevalence and predictors of Hepatitis B infection among Adult Patients attending Out-Patient Clinic, General Hospital, Ilorin Kwara State Nigeria.

Hepatitis B is a viral infection that is ravaging sub-Sahara African countries including Nigeria. Several studies have been done on hepatitis B infection among different population groups including pregnant women, blood donors and children but very few have reported findings among primary care adult patients. The aim of this study was to determine the prevalence of hepatitis B infection among the primary care patients and the possible associated risk factors.
 It was a hospital-based descriptive cross-sectional study done among adults attending out-patient clinic of the General Hospital Ilorin. A sample size of 338 was estimated with the use of EPI-info 7 statistical software and Enzyme-based immunoassay testing was used to screen for hepatitis B virus infection among the study participants. The sero-prevalence of hepatitis B infection among the study population was 14.5%. Identified risk factors associated with hepatitis B infection in this study were family history of hepatitis B infection, blood transfusion and unsupervised home delivery.
 In conclusion, the findings in this study have shown that hepatitis B infection was highly endemic among adult primary care patients. Blood transfusion and unsupervised home deliveries were the predictors of hepatitis B infection among these study participants.

Predictors of hepatitis C cure among people who inject drugs treated with directly observed therapy supported by peer case managers in Kenya.

Directly observed therapy (DOT) maximizes adherence and minimizes treatment gaps. Peer case managers (PCM) have also shown promise as a component of integrated HCV treatment strategies. DOT and PCM-support have been underexplored, particularly in low- and middle-income countries (LMICs). The objective of this study was to evaluate predictors of sustained virologic response (SVR) among people who inject drugs (PWID) attending medication-assisted treatment (MAT) and needle and syringe programs (NSP) sites in Kenya. We recruited PWID accessing MAT and NSP in Nairobi and Coastal Kenya. PWID were treated with ledipasvir/sofosbuvir using DOT supported by PCMs. We used bivariate and multivariate logistic regression to examine the impact of sociodemographic, behavioral, and clinical factors on SVR. Among 92 PWID who initiated HCV treatment, 79 (86%) were male with mean age of 36.3 years (SD=±6.5); 38 (41%) were HIV-positive, and 87 (95%) reported injecting drugs in the last 30 days. Just over half of participants were genotype 1a (55%), followed by genotype 4a (41%) and mixed 1a/4a (3%). Most participants, 85 (92%) completed treatment and 79 (86%) achieved SVR. While sociodemographic and behavioral factors including recent injection drug use were not significantly associated with achieving SVR, being fully adherent (p=0.042), number of doses taken (p=0.008) and treatment completion (p= 0.001) were associated with higher odds of achieving SVR. DOT with PCM-support was an effective model for HCV treatment among PWID in this LMIC setting. Adherence was the most important driver of SVR suggesting DOT and PCM support can overcome other factors that might limit adherence. Further research is necessary to ascertain the effectiveness of other models of HCV care for PWID in LMICs given NSP and MAT access is variable, and DOT may not be sustainable with limited resources.

Reduction of Hepatitis B Surface Antigen May Be More Significant in PEGylated Interferon-Alpha Therapy Combined with Nucleotide Analogues than Combined with Nucleoside Analogues in Chronic Hepatitis B Patients: A Propensity Score Matching Study.

Nucleotide analogues (NTs) monotherapy may have a more significant effect on reducing hepatitis B surface antigen (HBsAg) than nucleoside analogues (NSs) due to their immunomodulatory function. However, this superiority remains unknown when combined with PEGylated interferon α (PegIFNα). Therefore, this study aimed to explore whether NTs have more significant antiviral effects than NSs in combination therapy with PegIFNα. Chronic hepatitis B (CHB) patients treated with PegIFNα plus nucleos(t)ide analogues (NAs) were retrospectively recruited. Efficacy and the predictors of hepatitis B surface antigen (HBsAg) reduction >1 log10 IU/mL after 48 weeks were analyzed. A total of 95 patients were included and divided into the PegIFNα + NTs group and the PegIFNα + NSs group. Propensity score matching (PSM) was performed. The PegIFNα + NTs group had a greater reduction of HBsAg (-3.52 vs. -2.33 log10 IU/mL, P=0.032) and a higher proportion of patients with HBsAg reduction >1 log10 IU/mL (100.0% vs. 72.2%, P=0.003) even after PSM. However, HBsAg and hepatitis B e-antigen (HBeAg) loss rates, HBeAg seroconversion rates, degree of HBeAg and hepatitis B virus (HBV) DNA decline, HBV DNA undetectable rates, and alanine aminotransferase (ALT) normalization rates showed no significant differences. Subgroup analyses showed the difference in the reduction of HBsAg was particularly evident in HBeAg-positive and the "add-on" subgroups. PegIFNα plus NTs (OR = 36.667, 95% CI = 3.837-350.384) was an independent predictor for HBsAg reduction >1 log10 IU/mL after 48 weeks. This study suggests that PegIFNα plus NTs may lead to more HBsAg reduction, especially in HBeAg-positive and "add-on" patients.

Predictors of Hepatitis B screening and vaccination status of young psychoactive substance users in informal settlements in Kampala, Uganda.

Young psychoactive substance users exhibit high-risk behaviours such as unprotected sexual intercourse, and sharing needles and syringes, which increases their risk of Hepatitis B infection. However, there is limited evidence of screening, and vaccination status of this subgroup. The aim of this study was to establish the predictors of screening and completion of the hepatitis B vaccination schedule. A cross-sectional study using respondent driven sampling was used to enrol respondents from twelve out of fifty-seven informal settlements in Kampala city. Data were collected using an electronic structured questionnaire uploaded on the KoboCollect mobile application, and analysed using Stata version 14. A "modified" Poisson regression analysis was done to determine the predictors of screening while logistic regression was used to determine the predictors of completion of the Hepatitis B vaccination schedule. About 13.3% (102/768) and 2.7% (21/768) of the respondents had ever screened for Hepatitis B, and completed the Hepatitis B vaccination schedule respectively. Being female (aPR 1.61, 95% CI: 1.11-2.33), earning a monthly income >USD 136 (aPR 1.78, 95% CI: 1.11-2.86); completion of the Hepatitis B vaccination schedule (aPR 1.85, 95% CI: 1.26-2.70); lack of awareness about the recommended Hepatitis B vaccine dose (aPR 0.43, 95% CI: 0.27-0.68); and the belief that the Hepatitis B vaccine is effective in preventing Hepatitis B infection (aPRR 3.67, 95% CI: 2.34-5.73) were associated with "ever screening" for Hepatitis B. Knowledge of the recommended Hepatitis B vaccine dose (aOR 0.06, 95% CI: 0.01-0.35); "ever screening" for hepatitis B (aOR 9.68, 95% CI: 2.17-43.16) and the belief that the hepatitis B vaccine is effective in preventing Hepatitis B infection (aOR 11.8, 95% CI: 1.13-110.14) were associated with completion of the hepatitis B vaccination schedule. Our findings indicate a low prevalence of Hepatitis B screening and completion of the Hepatitis B vaccination schedule among young psychoactive substance users in informal settings. It is evident that lack of awareness about Hepatitis B is associated with the low screening and vaccination rates. We recommend creation of awareness of Hepatitis B among young people in urban informal settlements.

Coverage, inequity and predictors of hepatitis B birth vaccination in Myanmar from 2011\u20132016: results from a national survey

BackgroundHepatitis B virus birth dose (HepB-BD) vaccination is recommended to reduce mother to infant transmission. We evaluated the HepB-BD status of women who gave birth between 2011 and 2016 (N = 3,583) using the 2015–2016 Myanmar Demographic and Health Survey.MethodsFrequency distributions of HepB-BD vaccination across maternal and health system factors, concentration indices, and logistic regression models were used to estimate coverage, inequity, and factors associated with vaccination.ResultsThe majority of participants were younger than 30 years of age, lived in rural areas, and were multiparous. Almost all received antenatal care (ANC), but only 43% received recommended ANC services, and 60% gave birth at home. The overall HepB-BD coverage rate was 26%. Vaccination coverage was higher in urban areas and was inequitably concentrated among children of more educated and wealthier women. HepB-BD coverage was also positively associated with receipt of ANC at non-governmental facilities, and delivery at a facility, skilled provider at birth and Cesarean delivery. After adjusting for sociodemographic and health system factors, receipt of the HepB-BD was positively associated with weekly media exposure, receipt of recommended ANC, and Cesarean delivery, and inversely associated with home delivery.ConclusionsBoth socioeconomic and health systems factors influenced suboptimal and inequitable vaccination coverage. Improved access to quality ANC and delivery services may increase HepB-BD coverage although targeted approaches to reach home births are likely required to achieve national goals.

Earlier and Higher Rate of Hepatitis B Virus Relapse After Discontinuing Tenofovir Versus Entecavir in Hepatitis B e Antigen–Positive Patients

This study investigated the incidence and predictors of hepatitis B virus (HBV) relapse in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B who discontinued entecavir (ETV) or tenofovir disoproxil fumarate (TDF). A total of 205 and 111 HBeAg-positive patients without cirrhosis who had stopped ETV or TDF treatment, respectively, for at least 6 months were recruited. In the entire cohort, patients with HBeAg seroconversion during treatment, and propensity score-matched patients, those who discontinued TDF had significantly higher rates of virological and clinical relapse than patients who discontinued ETV therapy. Multivariate analysis identified that TDF was independently associated with virological and clinical relapse in the entire cohort and subgroup analysis. Patients with HBeAg loss without anti-HBe antibody formation during treatment had significantly higher rates of off-therapy HBV relapse and HBeAg seroreversion than patients with HBeAg seroconversion during treatment. The hepatitis B core-related antigen (HBcrAg) level at end of treatment (EOT) was independently associated with HBV relapse and HBeAg seroreversion in all patients and patients with HBeAg seroconversion during treatment. TDF therapy, HBeAg loss without seroconversion during treatment, and higher HBcrAg levels at EOT are significant predictors of HBV relapse in HBeAg-positive patients who discontinued ETV or TDF.

Prevalence and predictors of hepatitis B virus (HBV) infection in east Africa: evidence from a systematic review and meta-analysis of epidemiological studies published from 2005 to 2020

BackgroundThe epidemiology of hepatitis B virus (HBV) in the general population in east Africa is not well documented. In this meta-analysis, we examined 37 full published research articles to synthesise up-to-date data on the prevalence and predictors of the HBV burden for the effective prevention and management of the virus in our region.MethodsWe examined 37 full published research articles found using PubMed, Scopus, African Journal Online (AJOL), and Google Scholar between May and October 2020. Dichotomous data on HBV prevalence and predictors of infection were extracted from the individual studies. The HBV prevalence, test of proportion, relative risk, and I2 statistics for heterogeneity were calculated using MedCalc software version 19.1.3. Begg’s tests was used to test for publication bias. Sources of heterogeneity were analysed through sensitivity analysis, meta-regression, and sub-group analysis at 95% CI. P < 0.05 was considered significant for all analyses.ResultsThe prevalence of HBV was generally high (6.025%), with publications from Kenya (8.54%), Uganda (8.454%) and those from between 2011 and 2015 (8.759%) reporting the highest prevalence (P < 0.05). Blood transfusion, scarification, promiscuity, HIV seropositivity, and being male were independent predictors significantly associated with HBV infection (P < 0.05), with the male sex being the most strongly associated predictor of HBV infection. Meta-regressions for the pooled HBV prevalence and sample size, as well as the year of publication, lacked statistical significance (P > 0.05). Omitting the study with the largest sample size slightly increased pooled HBV prevalence to 6.149%, suggesting that the studies are robust. Begg’s test showed no evidence of publication bias for overall meta-analysis (p > 0.05).ConclusionThe burden of HBV is still high, with the male sex, blood transfusion, body scarification, and HIV seropositivity being potential predictors of infection. Thus, it is important to scale up control and prevention measures targeting persons at high risk.

Predictors of hepatitis C treatment outcomes in a harm reduction-focused primary care program in New York City

BackgroundThe social determinants of health that influence steps in the entire Hepatitis C Virus (HCV) treatment cascade must be identified to achieve HCV elimination goals. This project aimed to evaluate the association of these factors with HCV treatment completion and return for sustained virologic response (SVR) testing.MethodsWe used retrospective cohort data from our primary care-based HCV treatment program that provides comprehensive harm reduction care to those who use or formerly used drugs. Among persons who began direct-acting antiviral HCV treatment between December 2014 and March 2018, we identified two outcomes: HCV treatment completion and return for SVR assessment 12 weeks after treatment end. Several predictors were ascertained including sociodemographic information, substance use, psychiatric symptoms and history, housing instability, and HCV treatment regimen. We then evaluated associations between predictors and outcomes using univariate and multivariable statistical methods.ResultsFrom a cohort of 329 patients treated in an urban primary care center, multivariable analysis identified housing instability as a single significant predictor for HCV treatment completion (odds ratio [OR]: 0.3; 95% confidence interval [CI]: 0.1–0.9). Among patients completing treatment, 226 (75%) returned for SVR assessment; the sole predictor of this outcome was Medicaid as primary insurance (compared to other insurances; OR 0.3; 0.1–0.7).ConclusionsInnovative strategies to help unstably housed persons complete HCV treatment are urgently needed in order to reach HCV elimination targets. Educational and motivational strategies should be developed to promote individuals with Medicaid in particular to return for SVR viral load testing, a critical post-treatment component of the HCV treatment cascade.Trial registration Not applicable.

Three heads are better than two: Hepatitis B core-related antigen as a new predictor of hepatitis B virus-related hepatocellular carcinoma

Patients with chronic hepatitis B virus (HBV) infection are at risk of developing hepatocellular carcinoma (HCC), and serum markers reflecting viral replication are potential predictors for HCC development. Besides the levels of serum HBV DNA and hepatitis B surface antigen (HBsAg), hepatitis B core-related antigen (HBcrAg) quantification is an emerging serological marker for viral replication. Unlike HBV DNA and HBsAg, HBcrAg is a covalently closed circular DNA-derived protein marker, consisting of hepatitis B e antigen (HBeAg), p22cr, and hepatitis B core antigen. In treatment-naïve HBV patients, higher HBcrAg levels are shown to be associated with an increased risk of HCC in several studies. More importantly, HBcrAg may complement HBV DNA level to predict HCC development. For example, an Asian treatment-naïve cohort study’s data showed that HBcrAg level of 4 log U/mL was effective to stratify HCC risk in HBeAg-negative patients with intermediate viral loads, who may not need antiviral therapy because of the low to moderate risk of HCC. In patients receiving prolonged nucleos(t)ide analogue with profound viral suppression, most data indicated that HBV DNA and HBsAg levels no longer serve as HCC predictors. However, several studies suggested on-treatment HBcrAg levels may remain as an HCC predictor. In summary, HBcrAg level can be a useful biomarker for treatment-naïve patients, but its value in on-treatment patients needs validation. The next challenge is how to combine HBcrAg with the other viral markers to construct a better HCC prediction model, optimizing the management of HBV patients.

Incidence and predictors of hepatitis B surface antigen clearance among people living with HIV and hepatitis B

Incidence and predictors of hepatitis B surface antigen clearance among people living with HIV and hepatitis B

Immunity to Hepatitis B is Undetectable in the Majority of Adolescents and Young Adults Seeking Outpatient Medication Treatment for Opioid Use Disorder.

To assess prevalence and predictors of hepatitis B immune status among adolescents and young adults (AYA) seeking outpatient medication treatment for opioid use disorder (MOUD). A retrospective medical chart review was conducted of AYA seeking MOUD between January 1, 2013 through December 31, 2015. Inclusion criteria included: diagnosis of opioid use disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; received hepatitis serologic testing; and no evidence of prior or current hepatitis B infection. Hepatitis B immunization initiation was defined as a record of at least 1 hepatitis B vaccination; while receipt of at least 3 vaccinations indicated immunization completion. The presence of hepatitis B surface antibody (anti-HBs) was the primary outcome measure. Of the 193 patients that met eligibility criteria, the presence of anti-HBs was evident in 62 (32.1%). Hepatitis B immunization initiation and completion before presenting for MOUD was documented in 102 (52.9%) and 84 (43.5%). In multivariable logistic regression modeling, hepatitis B immunization initiation after infancy was associated with increased odds of having protective anti-HBs relative to immunization series initiation in infancy (OR 8.96, 95% CI 1.57-51.05). Completion of hepatitis B immunization series after infancy as compared to completion in infancy also increased the odds of protective anti-HBs (OR, 6.68, 95% CI 2.10-21.24). Rates of immunity to hepatitis B were low in AYA seeking MOUD. It is important to immunize patients seeking MOUD for hepatitis B and follow up with checks for seroconversion.

Seroepidemiological patterns and predictors of hepatitis B, C and HIV viruses among pregnant women attending antenatal care clinic of Atat Hospital, Southern Ethiopia.

Introduction:Viral hepatitis is a serious blood-borne and sexually transmitted systemic communicable disease affecting the liver. Commonly, it is caused by hepatitis B and C viruses. HIV infection has been one of the largest public health challenges that can also be transmitted vertically.Objective:To determine seroepidemiological patterns and predictors of hepatitis B, C and HIV viruses among pregnant women attending antenatal care clinic at Atat Hospital, Southern Ethiopia.Methods:Hospital-based cross-sectional study was conducted among 222 pregnant women from May to July, 2017. A structured questionnaire was used to collect socio-demographic characteristics and predicators of hepatitis B, C and HIV infections through face-to-face interview. Venous blood sample of 5 mL was collected from study participants, and serum was tested for HBsAg, anti-HCV and anti-HIV using rapid test kits and further confirmed by enzyme-linked immunosorbent assay. Logistic regression analysis was used to identify predictors of hepatitis and HIV infections. A p-value less than 0.05 was considered statistically significant.Results:The overall seroprevalence of hepatitis B, C and HIV infections were 4.5%, 1.8% and 2.7%, respectively. In multivariate analysis, the prevalence of hepatitis B virus infections was significantly higher among patients having history of poly-sexual practices (adjusted odds ratio = 11.31; 95% confidence interval = 1.24–28.69, p = 0.003), history of abortion (adjusted odds ratio = 8.64; 95% confidence interval = 5.5–30.36, p = 0.034), home delivery by traditional birth attendants (adjusted odds ratio = 9.06; 95% confidence interval = 2.01–13.36, p = 0.005) and blood transfusion (adjusted odds ratio = 18.1; 95% confidence interval = 2.63–114.24, p = 0.001). HIV co-infection was present in 40% and 100% of hepatitis B virus and hepatitis C virus positive pregnant women, respectively. All hepatitis C virus positive women had a history of ear piercing, abortion and home delivery.Conclusion:Hepatitis B, C and HIV were all uncommon infections in this population, with hepatitis B virus the most common. All hepatitis C virus positive pregnant women were co-infected with HIV. Significant association was found between hepatitis B virus infection and predictors. Therefore, continuous screening of pregnant women for hepatitis B and C infections should be performed.

Predictors of hepatitis B and C virus reactivation in patients with psoriasis treated with biologic agents: a 9-year multicenter cohort study

The increasing use of biologics is accompanied by a risk of hepatitis B (HBV) and C virus (HCV) reactivation. To determine the predictors of HBV and HCV reactivation in patients with psoriasis receiving biologics. This study screened 2060 patients with psoriasis (3562 treatment episodes) who were taking biologics from 2009 to 2018. There were 359 patients with psoriasis with HBV (561 treatment episodes) and 61 with HCV infection (112 treatment episodes). During 8809 and 1522 person-months of follow-up, 88 treatment episodes for HBV involved HBV reactivation, and 14 episodes of HCV involved reactivation. The reactivation rate was significantly higher in treatment episodes of chronic HBV infection than in that of occult HBV (34.3% vs 3.2%, P=.001) and resolved HBV (34.3% vs 5.0%, P<.001). The multivariate analysis revealed that being hepatitis B surface antigen seropositive, being hepatitis B e-antigen seropositive, and tumor necrosis factor-α-inhibitor therapy were risk factors for HBV reactivation, whereas antiviral prophylaxis was effective in reducing the risk of HBV reactivation. No predictors were significantly associated with HCV reactivation. Observational design and a lack of a comparison group. Patients with psoriasis on biologics have a risk of HBV and HCV reactivations, particularly those who are seropositive for hepatitis B surface antigen and hepatitis B e-antigen and undergoing tumor necrosis factor-α-inhibitor therapy.

Profile and predictors of hepatitis and HIV infection in patients on hemodialysis of Quetta, Pakistan.

Hemodialysis (HD) is the most commonly used treatment in patients with end-stage renal failure or disease (ESRD) worldwide. Blood-borne viral diseases are the major causes of mortality and morbidity in patients on HD. This study aims to analyze the prevalence and to concentrate on the key risk factors that are responsible for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection in patients on HD visiting two dialysis centers in the city of Quetta in southwestern Pakistan. The overall incidence of HBV was found to be 16.1%, the overall incidence of HCV was found to be 43.2%, and two patients (1.6%) were found to be positive for both HBV and HCV. HIV was not found among patients seen at both hospitals during the study period. The main risk factors for development of a viral infection were the length of time on HD (p = 0.007), number of sessions (p = 0.001), and level of education (p = 0.092). Biochemical and hematological parameters including urea, creatinine, uric acid, and calcium levels, red blood cell count, white blood cell count, hemoglobin levels, and platelet count were also studied in patients on HD. HD is becoming one of the major factors causing a viral infection because a patient can possibly become infected during an HD session via a blood transfusion, dialysis machines, instruments and/or other contaminated equipment. In order to control the spread of viral infections, increased public awareness, vaccinations, and health education programs for both health care providers and patients are needed, and proper screening programs should be instituted before dialysis is performed.

Predictors of hepatitis B surface antigen loss, relapse and retreatment after discontinuation of effective oral antiviral therapy in noncirrhotic HBeAg-negative chronic hepatitis B.

Reliable predictors of outcomes after treatment discontinuation in HBeAg-negative chronic hepatitis B (CHB) patients have not been established. We investigated the role of hepatitis B surface antigen (HBsAg), interferon-inducible protein-10 (IP10) and hepatitis B core-related antigen (HBcrAg) serum levels as predictors of HBsAg loss, relapse and retreatment in noncirrhotic HBeAg-negative CHB patients who discontinued long-term antiviral therapy. All HBsAg-positive (n=57) patients of the prospective DARING-B study were included and followed monthly for 3months, every 2/3months until month-12 and every 3/6months thereafter. HBsAg, IP10 and HBcrAg levels were measured by enzyme immunoassays, and SCALE-B score was calculated. Twelve patients achieved HBsAg loss before retreatment with 18-month cumulative incidence of 25%. Independent predictors of HBsAg loss were baseline HBsAg and month-1 IP10 levels. Of 10 patients with baseline HBsAg ≤100IU/mL, 70% cleared HBsAg and 10% required retreatment. Of 23 patients with baseline HBsAg >1000IU/mL, 4% cleared HBsAg and 43% required retreatment. Of 24 patients with intermediate baseline HBsAg (100-1000IU/mL), 17% cleared HBsAg and 21% required retreatment; in this subgroup, month-1 IP10 was significantly associated with HBsAg loss, which occurred in 30% and 7% of cases with IP10 >150 and ≤150pg/mL, respectively. Baseline HBcrAg was undetectable in all patients who cleared HBsAg and was associated with retreatment. SCALE-B was associated with HBsAg loss but not with relapse or retreatment. In conclusion, HBsAg, IP10 and HBcrAg serum levels can be useful for the decisions and management of treatment discontinuation in noncirrhotic Caucasian patients with HBeAg-negative CHB.

Short and sporadic injecting cessation episodes as predictors of incident hepatitis C virus infection: findings from a cohort study of people who inject drugs in Montréal, Canada.

For most people who inject drugs (PWID), drug injecting follows a dynamic process characterized by transitions in and out of injecting. The objective of this investigation was to examine injecting cessation episodes of 1-3-month duration as predictors of hepatitis C virus (HCV) acquisition. Cohort study. Montréal, Canada. A total of 372 HCV-uninfected (HCV RNA-negative, HCV antibody-positive or -negative) PWID (mean age=39.3years, 82% male, 45% HCV antibody-positive) enrolled between March 2011 and June 2016. At 3-month intervals, participants completed an interviewer-administered questionnaire and were tested for HCV particles (HCV RNA). At each visit, participants indicated whether they injected in each of the past 3months (defined as three consecutive 30-day periods). Injecting cessation patterns were evaluated on a categorical scale: persistent injecting (no injecting cessation in the past 3months), sporadic injecting cessation (injecting cessation in 1 of 3 or 2 of 3months) and short injecting cessation (injecting cessation in 3 of 3months). Their association with HCV infection risk was examined using Cox regression analyses with time-dependent covariates, including age, gender, incarceration, opioid agonist treatment and other addiction treatments. At baseline, 61, 26 and 13% of participants reported persistent injecting, sporadic injecting cessation and short injecting cessation, respectively. HCV incidence was 7.5 per 100 person-years [95%confidence interval (CI)=5.9-9.5; 916 person-years of follow-up]. In adjusted Cox models, sporadic injecting cessation and short injecting cessation were associated with lower risks of incident HCV infection compared to persistent injecting (adjusted hazard ratios=0.56, 95% CI=0.30-1.04 and 0.24, 95% CI=0.09-0.61), respectively. Short and sporadic injecting cessation episodes were common among a cohort of people who inject drugs in Montréal, Canada. Injecting cessation episodes appear to be protective against hepatitis C virus acquisition, particularly when maintained for at least 3months.

FRI-220-Antiviral effect and predictors of hepatitis B surface antigen seroconversion in children of 1-6 years old with chronic hepatitis B

FRI-220-Antiviral effect and predictors of hepatitis B surface antigen seroconversion in children of 1-6 years old with chronic hepatitis B

Predictors of hepatitis B vaccination completion among people who use drugs participating in a national program of targeted vaccination

BackgroundTargeted vaccination strategies are necessary to prevent people who use drugs (PWUD) becoming infected with hepatitis B virus (HBV). The aims of this study were to provide an overview of the activities for PWUD in a decentralised vaccination program in the Netherlands and to explore the determinants associated with completing a standard hepatitis B vaccination series. MethodsWe used data for behavioural risk groups from the register of the national vaccination program. The data concerned PWUD who were immunised against hepatitis B in the Netherlands between 2002 and 2011. A standard series of three vaccinations (at 0, 1, and 6 months) was offered at inclusion and was continued if serological markers for past or chronic HBV infection were absent. Completion of a vaccination series (at least three vaccinations, irrespective of timing) was a dependent variable in our logistic regression analysis. ResultsThe program reached 18,054 PWUD. Of the 15,746 participants eligible for vaccination (i.e. they were neither carriers of hepatitis B nor immune to hepatitis B), 9089 (58%) completed a series of three hepatitis B vaccinations. Factors associated with a higher completion rate of a vaccination series (p < 0.01) were: starting vaccination in the earlier years of the program, older age of PWUD, intravenous drug use, vaccine administration by addiction care centres, and flexibility in location of vaccine delivery. ConclusionDespite using a standard HBV vaccination schedule and no financial incentives, vaccination completion among PWUD was relatively high. Our results suggest that flexibility of vaccination location and administration of vaccines by healthcare workers with sustainable contact with PWUD could improve vaccination programs for this risk group.