HBV Infection Rate Research Articles

Basic characteristics and survival analysis of patients with hepatocellular carcinoma

Objective: To analyze the basic characteristics of patients with hepatocellular carcinoma (HCC), and further explore the major factors affecting the prognosis of HCC patients. Methods: A total of 800 HCC patients were randomly selected from the Cancer Hospital, Chinese Academy of Medical Sciences. Their clinical and follow-up information was obtained from medical record. Univariate analysis of variance, Kaplan-Meier method and Cox regression analysis were used to analyze the patients' age at diagnosis and survival time, etc. Results: The average age of diagnosis was 55.04 years among all the 800 HCC patients, and the sex ratio of male to female was 4.48. The infection rates of HBV and HCV were 78.6% (629/800) and 5.8% (46/800), respectively. The smoking rate was 41.0% (328/800) and the alcohol consumption rate was 38.5% (328/800). 259 (32.4%) patients underwent radical treatments with liver resection as major therapy, and 541 (67.6%) patients adopted non-radical treatments with transcatheter arterial chemoembolization (TACE) as major therapy. The 1-, 3- and 5-year survival rates of the HCC patients were 73.2%, 53.7% and 42.4%, respectively. The risk factors for prognosis included alcohol abuse and treatment methods. The HR of alcohol abuse was 1.326 (95%CI: 1.058 to 1.661) and HR of treatment methods was 3.301 (95% CI: 2.483 to 4.387). Conclusions: Men account for the majority of HCC patients, and most patients have a lower age at diagnosis and adopt non-radical treatments. The exposure rates of HBV infection and alcohol abuse of HCC patients are significantly higher than those of general population. The major risk factors affecting prognosis and survival are treatments and alcohol abuse. Alcohol abuse and HBV may have synergistic effects on the survival of HCC patients.

High rate of Hepatitis B virus infection among hairdressers in Ibadan, Nigeria

ABSTRACTHepatitis B virus (HBV) infection is a major public health problem for over two billion people infected globally. Occupationally exposed persons are at high risk of HBV infection and, apart from medical personnel, there is dearth of information concerning the prevalence and awareness of HBV among this population in Nigeria. This study was designed to determine the levels of HBV awareness and prevalence of HBV infection among hairdressers in Ibadan, Nigeria. Hairdressers and teachers (unmatched controls) in four local government areas in Ibadan were tested for HBV infection using ELISA technique. Dried blood spot (DBS) samples were collected from 171 participants. DBS elutes from the samples were tested for HBV surface antigen (HBsAg). The rate of HBV infection was higher (p = 0.005) among the hairdressers (13.0%) than teachers (4.8%). However, teachers were better informed about HBV (38%) compared to hairdressers (13%; p = 0.0001). Differences in HBV awareness and occupation type were found to be significant (P = 0.001). Hairdressers are at high risk of HBV infection and may constitute a major source of HBV spread among urban dwellers, especially in areas where awareness is low. Routine HBV screening and appropriate interventions for hairdressers are recommended to interrupt HBV transmission.

Transfusion transmitted infections in frequently transfused thalassemic children living in Fayoum Governorate, Egypt: Current prevalence and risk factors.

Regular blood transfusion therapy remains the primary treatment in thalassemia major (TM). Transfusion-transmitted infections (TTIs) and iron overload are considered to be the major drawbacks of this therapy. This cross-sectional study aimed to update the prevalence of the hepatitis C virus (HCV) antibody, PCR-confirmed HCV, hepatitis B surface antigen (HBsAg), and human immunodeficiency virus (HIV) antibody among TM children. Clinical and epidemiological factors that can affect HCV infection prevalence rate were studied. This study evaluated 121 children with βTM, including 61 males and 60 females with a mean age of 7.99±3.57years. Patients were evaluated for the HCV, HBsAg, and HIV-1 & 2 antibodies. All tests were performed using ELISA. HCV positive cases were confirmed by RT-PCR. Twenty-five patients were positive for the HCV antibody (20.7%); 22 were confirmed positive by PCR. Six patients (5%) were HBsAg-positive. No patients were HIV-positive. Older age were associated with an increased frequency of HCV positive infection (P<0.003). More frequent transfusion, ≥10 times/year, and older age, ≥10years, were reported as predictors of HCV infection (P=0.018 and 0.011, respectively). A significant association of HCV between HBV infections was reported (P value=0.01). There was no significant effect of the pre-transfusion or post-transfusion hemoglobin level on the frequency of HCV positive cases. HCV still represents a major health challenge for frequently transfused Egyptian patients. The prevalence rate of HBV infection remains relatively high. Therefore, it is necessary to implement measures to improve blood transfusion screening.

PREVALENCE OF HBV, HIV, AND HIV-HBV CO-INFECTIONS AMONG HEALTHCARE WORKERS IN IBADAN, NIGERIA

BackgroundHIV and HBV are endemic in Nigeria. HBV is globally the leading cause of death due to liver disease amongst HIV-infected persons. The study was done to ascertain the prevalence...

Long-term persistence in protection and response to a hepatitis B vaccine booster among adolescents immunized in infancy in the western region of China

ABSTRACT Objectives: To evaluate the persistence of protection from hepatitis B (HB) vaccination among adolescents immunized with a primary series of HB vaccine as infants, and the immune response to booster doses. Methods: Healthy adolescents aged 15–17 y vaccinated with HB vaccine only at birth were enrolled. Baseline serum hepatitis B surface antigen (HBsAg), antibody against hepatitis B surface antigen (anti-HBs) and antibody against hepatitis B core antigen (anti-HBc) were detected by Enzyme-Linked Immunosorbent Assay (ELISA) and anti-HBs level was measured using Chemiluminescent Microparticle Immunoassay (CMIA). The rate of HBV infection was calculated. The seroprotection rate of anti-HBs (≥ 10 mIU/ml) and GMC level were used to evaluate the persistence of immunity from HB vaccination. Those with anti-HBs < 10 mIU/ml were immunized with booster doses of HB vaccine and the anamnestic response was assessed. Results: Of 180 adolescents who received a primary series of HB vaccinations as infants, 3 (1.7%) had HBV infection and 74 (41.1%) had anti-HBs ≥ 10 mIU/ml with a GMC of 145.11 mIU/ml. The remaining 103 (57.2%) with anti-HBs < 10 mIU/ml received a booster dose of 20 μg HB vaccine and achieved the seroprotection rate of 84% (84/100) and a GMC of 875.19 mIU/ml at one month post-booster. An additional dose of 60 μg HB vaccine was administered to the 16 adolescents with anti-HBs < 10 mIU/ml after the first booster. All of them obtained anti-HBs seroprotection with a GMC of 271.02 mIU/ml at 1.5 months after an additional dose. Conclusions: Vaccine-induced immunity persisted for up to 15–17 y in 89.3% (158/177) of participants after a primary HB vaccination in infancy. Administering a booster dose of 20μg HB vaccine elicited an anamnestic immune responses in the majority of individuals with baseline anti-HBs <10 mIU/ml.

Seroprevalence of HBV and HIV Co-infection in Children in Nnewi, South-East, Nigeria

Background: Human immunodeficiency virus/HBV coinfection remains an important public health issue due to the risk of rapid progression to chronic liver disease and death. Despite the foregoing, there is paucity of data on Hepatitis among HIV-infected children receiving treatment in a tertiary hospital at Nnewi, South-East Nigeria. Objectives: This study was carried out to determine the prevalence of HBsAg in HIV-infected and non-HIV-infected children at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria. Methods: A cross sectional case control study was carried out among 120 HIV infected and 120 non-HIV infected children. The care givers and/or children were interviewed using a semi-structured questionnaire to obtain their socio-demographic characteristics, possible risk factors for HBV transmission and HBV vaccination history. All the participating children were screened for Hepatitis B surface antigen. Results: The prevalence of hepatitis B surface antigen among HIV-infected and non-HIV infected were 5.8% and 0.8% respectively (p=0.03). Most of the children with HBV were males. The mean age of those infected with HBV was significantly higher than those without HBV infection. History of unsafe parenteral injections (p=0.03) and blood transfusion (p=0.02) were significantly associated with HBV surface antigen seropositivity. Conclusion: This study has demonstrated that the rate of HBV infection among HIV infected children is higher than that of the non-HIV infected children with increased risk of HBV seropositivity from parenteral injection and blood transfusion also amongst HIV infected. Adequate screening of blood and its products before transfusion is advocated.

Clinical Characteristics of 223 Chinese Patients with Hemophilia in A Medical Center of Gansu Province in China

To analyze the clinical characteristics, diagonsis and treatment of patients with hemophilia in Gansu province of China. The clinical data of 223 cases of hemophilia in our center between January 2010 and May 2015 were collected and analyzed retrospectively, these 223 cases of hemophilia were from 14 cities in Gansu and neighboring provinces, including 203 cases of hemophili A (HA) and 20 cases of hemophili B (HB), among them 222 cases were male, only 1 female(HA), 177 cases were from Rural areas (79.4%). The median age of first bleeding was 2 years old, and the average age of confirmed as hemophilia was 5.6±6.5 years, the delayed time of diagnoses of HA and HB was 2.50±4.91 and 2.07±4.76 years, respetively, among all the patients 168 caese complicated with joint hemorrhage (75.3%), 123 cases with joint deformities (55.2%). 91.6% of the patients were treated according to demand, the HBV and HCV infection rates were 1.7% and 6.2% respectively. The first-visited hospital of 86.9% patients was hospitalized below 3 grade of level, only 15.9% of these patients were considered to diagnose as hemophili. The accurate level of diagnosis rate for hemophiliacs in Gansu province is low, the delay time of diagnosis is longer, the ratios of complicated joint hemorrhage, total accumulative joint deformity were high, HCV infection rate is also high.

Influence of three booster doses hepatitis B vaccine on the persistence of immune-protection among infants with normal and high antibody response to primary vaccination: a matched case-control study

To examine the influence of three-booster-doses hepatitis B vaccines on children with normal and high antibody response to primary vaccination. Antibody against hepatitis B surface antigen (anti-HBs) were detected after primary vaccination and children with normal or high response to hepatitis B primary vaccination at infancy, were identified. Children who were given three booster doses were selected to form the booster group and who were given no booster dose were 1∶1 matched with the same gender and residence to form the control group. Blood samples were obtained from all the participants and tested for anti-HBs and anti-HBc, 5 years after the primary vaccination. The positive rates of anti-HBs response to primary vaccination were 97.39% (224/230, 95% CI: 94.41%-99.04%) in the booster group and 53.91% (124/230, 95% CI: 47.24%-60.48%) in the control group (P<0.05), 5 years after the primary vaccination. Geometric mean concentration (GMC) of anti-HBs were 1 140.02 (887.46-1 464.46) mIU/ml in the booster group and 11.53 (8.73-15.23) mIU/ml in the control group (P<0.05). The prevalence rates of breakthrough HBV infection were 0.87% (2/230) in the booster group and 2.17%(5/230) in the control group (P>0.05). RESULTS from the multivariable analysis showed that the booster doses (OR=38.75, 95%CI: 16.23-92.54) and the level of anti-HBs after the primary vaccination (OR =3.06, 95%CI:1.51-6.17) were independently associated with the positive rates of anti-HBs, 5 years after the primary vaccination (P<0.05). Programs with three booster doses to children that showing normal and high antibody response to primary vaccination could improve the persistence of anti-HBs but possibly would not be able to prevent the HBV infection.

Seroprevalance of Hepatitis B Virus Markers Among Village Midwives in Khartoum State, Sudan, 2014

Background information: HBV infection is a serious health problem and a leading cause for morbidity and mortality. Objective: To determine HBV markers ((Anti-HBcore (IgM), Anti-HBcore (IgG), HBsAb, HBsAg, and HBeAg)) among Village Midwifes in Khartoum State, Sudan, 2014. Method: It is a cross sectional study where 335 village midwives were surveyed. A pre-tested close ended questionnaire was used for demographic data. Five ml of venous blood was collected; sera were separated and stored at-20° centigrade for Eliza testing. All specimens were tested for Anti-HBcore (IgM), Anti-HBcore(IgG) and HBsAb. Positive specimens for Anti-HBcore were tested for HBsAg and positive specimens for HBsAg were tested for HBeAg. Data was analyzed by using statistical package of social sciences (SPSS) version (16). Z-test for single proportion was used to compare between the actual prevalence of HBV markers and the expected rates in the absence of risk. P value equal or less than 0.05 was considered statistically significant value. Result: Positive Anti-HBcore (IgG) accounted to 113 (34%), positive HBsAgwas 57 (57%), and positive HBsAb was 7%. The results were significant at 5% confidence level, since all P-values were less than 0.001. There was no positive HBeAgto express high infectivity rate or Anti-HBcore (lgM) to reflect acute infection rate among the respondents. Conclusion: Infection rate of HBV was high, while the related immunity was low among Village Midwives in Khartoum State, Sudan.

HBV carriage in children born from HIV-seropositive mothers in Senegal: The need of birth-dose HBV vaccination.

Hepatitis B is a major public health problem in Senegal, a country with high prevalence and a transmission occurring mainly during infancy. Only, one 6-8 weeks vaccination campaign was initiated in 2005 and it was part of the expanded program of immunization. The aim of this study was to determine the prevalence of HBsAg in children born from HIV-seropositive mothers by using dried blood specimens. Specimens were collected between July 2007 and November 2012 from children aged 2-48 weeks in Dakar and decentralized sites working on HIV mother-to-child transmission prevention. HBsAg detection was performed using Architect HBsAg Qualitative II kit (Abbott Diagnostics, Ireland) and for all reactive samples confirmation was done using Architect HBsAg Qualitative II Confirmatory kit (Abbott Diagnostics, Ireland). Nine hundred thirty samples were collected throughout the country with 66% out of Dakar, the capital city. The median age was 20 weeks and 88% of children were less than 1 year of age with a sex ratio of 1.27 in favor of boys. HBsAg was detected in 28 cases giving a global prevalence of 3%. According to age, HBsAg prevalences were 5.1% for children less than 6 weeks, 4.1% and 4.6%, respectively, for those aged 12-18 weeks and 18-24 weeks of age. The HIV prevalence was 2.6% with no HIV/HBV co-infection. This study showed a high rate of HBV infection in children under 24 months, highlighting the need to promote birth-dose HBV vaccination as recommended by WHO.

Prevalence of Hepatitis B Infection Among Pregnant Women Presenting for Antenatal Care at a Tertiary Hospital in Central California With a Focus on Hmong Women

Introduction: The overall prevalence of chronic hepatitis B infection (HBV) in the United States (US) is estimated to be low around 0.4 % however it is much higher in certain ethnic groups such as, the Hmong. It is suggested that the primary mode of transmission of HBV among these high prevalence groups is vertical transmission. However, data regarding the true prevalence of HBV among Hmong women of childbearing age is limited. The aim of this study was to expand the limited data on HBV prevalence among this population so that further studies on prevention and treatment can be explored. Methods: Retrospective chart review was performed to identify pregnant women who had presented for antenatal care from 2008-2013 to Community Regional Medical Center, a tertiary medical center in the Central California Valley using ICD-9 codes for obstetrical visits. Among these pregnant women those who had HBV were then further identified using ICD-9 codes for HBV. Data was stratified based on ethnicity and race. The data was tabulated using Microsoft Excel and prevalence rates with 95% confidence intervals (CIs) were calculated. Results: Between 2008 and 2013, there were 122,727 antenatal care related visits to our center. Of those, 38,662 individual pregnant women were identified and121 were found to have HBV. We identified a total HBV prevalence of 0.3% (95% CI, 0.26-0.37) in our sample consistent with the estimated overall prevalence in the US. However, among Asian Americans it was higher at 2.6% (95% CI, 2.08-3.2) with highest among Hmong at 3% (95% CI, 2.31-3.83). Native Hawaiian/Pacific Islanders also had a higher prevalence at 2.7% (95% CI, 0.33-9.3). Lowest prevalence was seen among Caucasians and African-Americans at 0.1% [Table 1].Table 1: Prevalence of HBV among Pregnant Women Presenting for Antenatal CareConclusion: With the implementation of HBV screening for all pregnant women and universal vaccination, the overall rates of HBV infection have declined. However, this may not be the case among certain races and ethnicities. Our study identified disparity in HBV infection among pregnant women with high prevalence among Asian Americans especially, the Hmong women compared to the general pregnant population in the US. This study offers a representative sample of the pregnant women in the Central California Valley and a high risk ethnic group such as the Hmong that can aid efforts to screen and prevent vertical transmission of HBV.

Discrepancy in impact of maternal milk on vertical transmission between Hepatitis B virus and Human cytomegalovirus

This study aims to elucidate the role of breastfeeding on vertical transmission of HCMV and HBV and to investigate the difference in perinatal transmission via breast milk between HBV and HCMV. This detailed study monitored the kinetics of viral DNA load in maternal milk for both HBV and HCMV, demonstrated the rate of transmission to infants, and compared HBV infection rate with that of HCMV. There was no difference in overall DNAlactia+ between HBV (23.86%) and HCMV (29.54%, P=0.140) for seropositive mothers, while HBsAg prevalence (0.75%) was significantly lower than HCMV IgG+ (27.44%, P<0.001) for the breast-fed babies. Between breast-fed babies of seropositive mothers and those of seronegative mothers, HBV infection rate had no difference (HBsAg+: 0.75% vs 0%, P=0.538; DNAemia+: 0.38% vs 0%, P=0.664), but HCMV infection rate of the former was significantly higher than that of the latter (IgG+: 27.07% vs 18.00%, P=0.045; DNAemia+: 15.79% vs 4.00%, P=0.027). Breastfeeding is not a risk factor for maternal-to-infant transmission of HBV after the recommended prophylaxis is implemented. However, viral DNA positive breast milk is a main source for vertical transmission of HCMV to infants who are not protected by a standard immunoprophylaxis protocol.

Study on risk factors of hepatitis B virus infection among patients receiving hemodialysis by multi-level statistical model analysis

To understand the current status of HBV infection among patients receiving maintenance hemodialysis (MHD) and related influencing factors. A questionnaire survey was conducted among 1,524 MHD patients selected from hemodialysis units in 16 hospitals in Shanxi province from 1 November 2012 to 30 December 2014 to collect their demographic information and learn about their risk behaviors. Serological detection was conducted for them. Statistical software package SAS 9.3 was used for fitting a two level logistic regression model to identify the independent risk factors for HBV infection. Among the 1 524 MHD patients, the positive rate of HBsAg was 5.25% and the HBV infection rate was 38.85%. The HBV infection rate varied with hospital (t=2.33, P=0.034). The two-level logistic regression empty model showed that intra-class correlation coefficient was 0.106 4, indicating that about 10.64% of the total variation was caused by the differences in hospitals. After introducing explaining variables, the results showed that the HBV infection rate in age group 50-65 years group was higher than that in age group 0-35 years (OR=1.560, 95% CI: 1.061-2.293). Family history of HBV infection and dental surgery were the risk factors for HBV infection (OR=2.052 and 1.267, 95% CI: 1.176-3.582 and 1.009-1.591). Receiving HepB vaccination was a protective factor for HBV infection (OR=0.734, 95% CI: 0.541-0.996). The HBV infection rates were different among MHD patients in different hospitals. Old age (50-65 years), family history of HBV infection and dental surgery were the risk factors and receiving HepB vaccination was a protective factor for HBV infection among MHD patients.

Seroprevalence and factors associated with surface antigen of Hepatitis B virus and anti Hepatitis C virus antibody among southern region of India, Tamil Nadu

Hepatitis B and C are emerging viral infections, leading cause of liver cirrhosis and hepatocellular carcinoma with particular relevance in liver transplantation around the world. Though several studies from different countries have estimated the prevalence of this viral infection, few studies only exists in Indian population. Our specific aim is to find out the prevalence and predicting factors of the HBV and HCV infections in urban, suburban, rural, tribal populations in southern region of India. Study was conducted from different areas of southern region and blood was collected along with questionnaires from all participants for serological analysis of HBV and HCV. The prevalence of HBV infection in the population was 3.3%, and HCV infection was 0.3% and prevalence rate of HBV infection was urban (4.5%), suburban (1.6%), rural (3.2%), tribal (0%). Incidentally, this is the first report from southern region of India in a large scale with clear area wise prevalence rate of infection. The multinomial logistic regression analysis showed that the risk of HBV infection was greater for gender (OR- 0.589, 95% CI- 0.363 to 0.955, P = 0.032), place of living (OR- 0.702, 95% CI- 0.536 to 0.920 P = 0.010), marital status (OR- 2.783, 95% CI-1.130 - 6.853, P = 0.026) and occupation (OR- 0.789, 95% CI- 0.657 to 0.948, P = 0.011). Epidemiology of HBV and HCV infections were in this southern region evidently elucidated that low prevalence for hepatitis C virus and slightly high prevalence for hepatitis B virus with higher rates in urban areas than other Northern regions of India.

Prevalence of hepatitis B and C virus infections among military personnel

BackgroundData regarding Hepatitis B and C viruses (HBV and HCV) prevalence among military personnel in Brazil are lacking, but the work-related risk of exposure can be high. The objective of this study was to estimate the seroprevalence of HBV and HCV and the risk factors associated to HBV exposure among Brazilian military personnel. MethodsA cross-sectional study was conducted and included 433 male military adults aged 18–25 years old working in Rio de Janeiro during October 2013. All individuals completed a questionnaire to assess their risk of exposure and provided a blood sample to HBV and HCV testing. ResultsNone of the participants presented HBsAg or anti-HBc IgM, 18 (4.1%) were positive for total anti-HBc, 247 (57.0%) were positive for anti-HBs, and 3 (0.7%) were anti-HCV reactive. The majority of military personnel with past HBV infection (anti-HBc reactive) and HBV immunity (anti-HBs reactive) had a history of prior dental procedures (88.9% and 77.3%), consumption of alcohol at least once a week (50% and 55.9%), and practiced oral sex (61.1% and 58.3%, respectively). In addition, anti-HBc positivity was common among individuals with a history of surgery (44.4%) and practice of anal sex (50%). At univariate analysis, age group was associated to anti-HBc and anti-HBs positivity. ConclusionsLow rates of HBV and HCV infection were observed among Brazilian military personnel in comparison to the general Brazilian population. HBV immunity rates were relatively low indicating the need for vaccination campaigns in this group.

Infantile hepatitis B in immunized children: risk for fulminant hepatitis and long-term outcomes.

BackgroundInfantile hepatitis B after neonatal immunoprophylaxis is a rare yet distinct disease. This study aimed to analyze the long-term outcomes and risk factors in immunized infants with hepatitis B.MethodsThe clinical parameters and outcomes of 41 infants born after universal immunization, and admitted for HBV-positive hepatitis were studied. All patients were followed for at least 6 months (median = 4.4 years, range 0.6–18.1 years). Patient survival, changes of HBsAg and HBeAg status, and complications were analyzed.ResultsAmong the 41 cases (32 males, 9 females), 21 presented with fulminant hepatitis (FH), and 20 with non-fulminant hepatitis (NFH). Ninety-five percent (36/38) of the mothers were positive for hepatitis B surface antigen (HBsAg). Multivariate analyses revealed younger age of onset (age <7 months) and negative maternal hepatitis B e antigen (HBeAg) were associated with FH (p = 0.03 and p = 0.01, respectively). An infantile fulminant hepatitis B risk score using maternal/infant HBeAg positivity and onset age was proposed. Among the FH cases, the rate of mortality, HBsAg clearance, and chronic HBV infection were 47.6%, 38.1%, and 14.3%, respectively. Among the NFH cases, 35% developed chronic infection. Of the 9 chronically infected children received long-term follow-up, 8 had HBeAg seroconversion before 4 years of age. One case of FH developed hepatocellular carcinoma 14 years later.ConclusionsMaternal HBsAg + /HBeAg- and early onset age were risk factors for FH in immunized infants. A significant portion of patients with FH or NFH evolve to chronic HBV infection, with HBeAg seroconversion in young childhood. Close surveillance for hepatocellular carcinoma is warranted in patients surviving infantile hepatitis B.

Impact of the free-vaccine policy on timely initiation and completion of hepatitis B vaccination in Fujian, China.

The extent to which the free-vaccine policy impacts the initiation and completion of a hepatitis B vaccine series is poorly understood. The aim of this study was to evaluate the impact of the free-vaccine policy on hepatitis B vaccination. A provincial survey was conducted in 2006 in Fujian Province, south-east of China, where the free-vaccine policy for hepatitis B was announced in 2002 and implemented in 2003. A total of 1628 children were investigated, and 1443 (88.6%) were included in this analysis. Among the children studied, 55.2% were vaccinated within 24 h of birth, and 76.1% completed the hepatitis B vaccine series on time. The rate of hepatitis B surface antibody positivity increased from 29.9% among children born in 1992 to 90.5% among children born in 2005, while the corresponding HBV infection rate decreased from 30.4% to 1.72%. Logistic regression indicated that, compared to children born between 1996 and 2001, the odds ratios (ORs) for timely initiation were 2.57 (95% confidence interval [CI], 1.71-3.84), 5.24 (95% CI, 3.26-8.43) and 9.06 (95% CI, 4.48-18.34) among children born in 2003, 2004 and 2005, respectively; the corresponding ORs for completing the vaccine series were 4.23 (95% CI, 1.97-9.10), 3.76 (95% CI, 1.81-7.82) and 4.94 (95% CI, 1.74-14.00) among children born in 2003, 2004 and 2005, respectively. Children with delayed vaccine initiation (>24 h after birth) were less likely to complete the vaccine series than those who received a timely first dose (OR = 0.02, 95% CI, 0.005-0.09). The impact of the free-vaccine policy on vaccine initiation and vaccine series completion did not differ by children's residence area (rural vs urban). As hypothesized, the odds of completing the vaccine series increased after the free-vaccine policy was announced in 2002 among children with delayed initiation (>24 h after birth) but not among those with timely initiation (≤ 24 h after birth). In conclusion, the free-vaccine policy significantly improved the timely initiation and completion of the vaccine series. The impact of this policy on completion of the vaccine series was larger among children with delayed vaccine initiation.

What Is the Risk of Transmission From HBcAb Positive Donors To the Recipient in Kidney and Pancreas Transplantation?

Introduction: There is variation of practice amongst UK kidney and pancreas transplant units in implanting grafts from HBcAb +ve donors due to the perceived risk of transmission of hepatitis B (HBV). Centres transplanting such grafts have variable practice of antiviral prophylaxis with lamivudine ranging from no prophylaxis to life-long prophylaxis. The aim of this study was to assess the rate of HBV infection in HBsAg -ve recipients of renal and pancreas allografts receiving organs from HBcAb +ve, HBsAg -ve donors. Methods: We surveyed the UK kidney and pancreas transplant units regarding their practices of accepting HBcAb +ve donor grafts and the subsequent use of antiviral prophylaxis. All patients receiving a kidney (KT) and or pancreas (PT) allograft from HBcAb +ve, HBsAg -ve donors between Jan 2002 and Dec 2011 were identified retrospectively from the UK Transplant Registry. Post transplant virology data were also collected. All patients had a minimum follow-up of 2 years. Results: The survey was incomplete at the time of this analysis and hence is not presented. A total of 277 patients were identified who underwent KT (n=252) or PT (n=25) from HBcAb +ve donors. Of these 2 KT recipients were HBsAg +ve prior to transplantation and were excluded from the analysis. Of the remaining 275, seven recipients (6 KT, 1 PT) had documented evidence of HBV positive virology post transplant (2.5%). At the time of this analysis, 178 patients (159 KT, 19 PT) had documented negative virology (65%) and 98 (93 KT and 5 PT) were recorded as ‘not reported’ (35%). Of the 11 KT in our centre, no HBV transmission recorded. All received 100 day lamivudine prophylaxisConclusions: The risk of HBV transmission following kidney and pancreas transplantation from HBcAb +ve donors remains low. Use of antiviral prophylaxis can help reduce this risk further. We suggest 100-day post-transplant lamivudine prophylaxis in kidney and pancreas transplantation. There is a need for clear guidelines for the safe and effective use of HBcAb +ve grafts

Lack of Association between Intact/Deletion Polymorphisms of the APOBEC3B Gene and HIV-1 Risk

ObjectiveThe human APOBEC3 family of proteins potently restricts HIV-1 replication APOBEC3B, one of the family genes, is frequently deleted in human populations. Two previous studies reached inconsistent conclusions regarding the effects of APOBEC3B loss on HIV-1 acquisition and pathogenesis. Therefore, it was necessary to verify the effects of APOBEC3B on HIV-1 infection in vivo.MethodsIntact (I) and deletion (D) polymorphisms of APOBEC3B were analyzed using PCR. The syphilis, HBV and HCV infection rates, as well as CD4+ T cell counts and viral loads were compared among three APOBEC3B genotype groups (I/I, D/I, and D/D). HIV-1 replication kinetics was assayed in vitro using primary cells derived from PBMCs.ResultsA total of 248 HIV-1-infected Japanese men who have sex with men (MSM) patients and 207 uninfected Japanese MSM were enrolled in this study. The genotype analysis revealed no significant differences between the APOBEC3B genotype ratios of the infected and the uninfected cohorts (p = 0.66). In addition, HIV-1 disease progression parameters were not associated with the APOBEC3B genotype. Furthermore, the PBMCs from D/D and I/I subjects exhibited comparable HIV-1 susceptibility.ConclusionOur analysis of a population-based matched cohort suggests that the antiviral mechanism of APOBEC3B plays only a negligible role in eliminating HIV-1 in vivo.

Occult hepatitis B virus infection among Iranian blood donors: a preliminary study.

Although serological screening tests for blood-borne hepatitis viruses have effectively reduced the risk of HBV transmission through transfusion of infected blood, there is still a possibility that infected blood units from occult carriers being released into the blood supply. The aim of this study was to determine the prevalence of anti-HBc among Iranian blood donors and evaluate the presence of HBV DNA in HBsAg negative plasma samples. In the present study, 5000 HBsAg negative samples were collected from donors in blood transfusion centers in Tehran. All HBsAg negative samples were tested for the presence of anti-HBc antibody and anti-HBs antibody (HBsAb) using ELISA method. Also, all HBsAg negative samples were tested for the presence of HBV DNA by real-time PCR. Four hundred ninety nine (9.98%) out of the 5000 HBsAg negative blood donors were anti-HBc positive. Out of 499 anti-HBc positive samples that were tested for anti-HBs, 394 (78.4 %) were anti-HBs positive, and 275 (62.7%) had an antibody titer greater than 100 IU/mL. HBV DNA was detected in two samples. In countries with intermediate rate of HBV infection like Iran, the prevalence of anti-HBc antibody in HBsAg negative blood donors is found to be high. As a result, routine anti-HBc screening of HBsAg-negative blood donors without complementary tests (anti-HBs / HBV-DNA) can limit the number of blood transfusions. Therefore, it might be better to include the detection of HBV DNA along with the routine tests.