Hepatitis B Surface Antigen Test Research Articles

A cross-sectional survey of hepatitis B virus screening in patients who received immunosuppressive therapy for rheumatoid arthritis in Japan.

Patients with a history of hepatitis B virus (HBV) infection who are receiving immunosuppressive therapy are at risk of HBV reactivation and disease. Therefore, HBV screening is required prior to administering antirheumatic drugs with immunosuppressive effects. This study aimed to determine the status of hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), and hepatitis B surface antibody (HBsAb) screening prior to the initiation of drug therapy, including new antirheumatic drugs, in patients with rheumatoid arthritis. This retrospective cross-sectional study used data from April 2014 to August 2022 from the Japanese hospital-based administrative claims database. The inclusion criteria were rheumatoid arthritis and first prescription date of antirheumatic drugs. A total of 82,282 patients with rheumatoid arthritis who were first prescribed antirheumatic drugs between April 2016 and August 2022 were included. Of the eligible patients, 9.7% (n=7,959) were screened for all HBV (HBsAg, HBsAb, and HbcAb) within 12 months prior to the date of initial prescription. The HBsAg test was performed in 30.0% (n=24,700), HBsAb test in 11.8% (n=9,717), and HBcAb test in 13.1% (n=10,824) of patients. The proportion of patients screened for HBV infection has been increasing since 2018; however, the proportion of patients screened for rheumatoid arthritis remains low. Our findings suggest that HBV screening may be insufficient in patients who received antirheumatic drugs. With the increasing use of new immunosuppressive antirheumatic drugs, including biological agents, healthcare providers should understand the risk of HBV reactivation and conduct appropriate screening.

Opportunistic screening using point-of-care testing leads to successful linkage to care of HBV-infected migrant populations in a low endemic country

Background and aimsIn low endemic countries, screening for hepatitis B surface antigen (HBsAg) in migrants is cost-effective in reducing the disease burden of hepatitis B virus (HBV) infections, but linkage to care (LTC) remains a challenge. This study aims to guide future screening initiatives, with 3 objectives: 1. to compare LTC between different ethnic groups screened for HBsAg with point-of-care testing (POCT) in an outreach setting; 2. to estimate the proportion of HBsAg seropositivity for ethnic minorities; and 3. to investigate the association between seropositivity and HBV risk factors. MethodsOpportunistic outreach screenings using finger prick HBsAg tests were performed at civic integration programmes between 11/2017 and 09/2022. If an individual tested positive, an appointment was given immediately at the outpatient hepatology clinic for follow-up and confirmation of HBsAg positivity in blood. Dedicated personnel contacted these individuals to motivate them for further LTC, which was defined as being assessed by a hepatologist, a blood test and an abdominal ultrasound. ResultsA total of 677 people from different ethnicities (Asian, Middle Eastern and African) were serologically screened using POCT. The observed positivity for HBsAg was 3.4 % (95% CI 2.17-5.05, 23/677). Apart from ethnicity and male sex, none of the surveyed HBV risk factors were associated with HBsAg seropositivity. All HBsAg positive individuals were linked to care and assessed by a hepatologist, despite the COVID-19 pandemic increase in time to follow-up of 82 days (95% CI 51–112 days) vs. 24 days (95% CI 5–43 days, p = 0.008)).Among HBV-infected patients, 31.8% (7/22), 100 % (22/22) and 26.1% (6/23) met the criteria for treatment indication, intrafamilial transmission risk and need for hepatocellular carcinoma surveillance, respectively. ConclusionThe proportion of HBsAg seropositivity in ethnic minorities was 3.4%. POCT and commitment of dedicated personnel can overcome previously identified barriers resulting in a 100% LTC.

A comparative analysis of blood-borne infections among sickle cell anemia patients and first-time donors in Gabon

Managing sickle cell disease often requires transfusions, exposing multi-transfused sickle cell patients to a heightened risk of transfusion-transmitted infections. This study aimed to assess the seroprevalence of the human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) in multi-transfused sickle cell patients and first-time donors in Libreville. The serological testing for HBsAg, anti-HIV, and anti-HCV antibodies was conducted using commercial enzyme immunoassays and confirmed by the COBAS modular analyzer (Roche Diagnostics). The seroprevalence of HIV, HCV antibodies, and HBsAg was 4%, 10%, and 10%, respectively, in multi-transfused sickle cell patients and 5%, 0%, and 8% in first-time donors. Interestingly, HIV and HBsAg seroprevalence were similar in both groups, indicating that transfusion was not associated with these infections. However, HCV antibody seroprevalence was significantly higher in multi-transfused sickle cell patients than in first-time donors (10% vs. 0%, p<0.001). Furthermore, the presence of anti-HCV antibodies in multi-transfused sickle cell patients was significantly associated with the number of donations received (7.20±2.37 vs. 3.96±2.06, p=0.042). These findings suggest that while blood transfusion is not a significant risk factor for HIV and HBsAg transmission, it may increase the risk of HCV transmission, particularly in multi-transfused sickle cell patients.

HBsAg Status, Molecular Detection and Therapy Evaluation of Hepatitis B Patient

The management of chronic hepatitis B involves various therapeutic approaches, including nucleotide analogs (NUCs) and pegylated-interferon alpha (peg-IFN), either in isolation or in combination. Reverse transcriptase enzyme is competitively inhibited by NUCs, which effectively suppresses HBV replication and lowers viral load. Concerning their cost-effectiveness, high response rates, low side effects, and oral administration, NUCs are recommended. Prolonged use, particularly of NUCs with a low genetic barrier or as monotherapy, can, however, lead to resistance, long-term safety issues, and the need for ongoing treatment. Physicians and other healthcare professionals are extremely concerned about the emergence of resistance and possible safety concerns related to the long-term use of NUCs. Moreover, the requirement for continuous therapy presents notable obstacles concerning patient adherence, distribution of healthcare resources, and overall economic viability. To clarify these problems and direct the creation of more potent and long-lasting treatment plans for chronic hepatitis B, urgent research is required. Hepatitis B surface antigen (HBsAg) detection is frequently accomplished via the use of the Chemiluminescent Microparticle Immunoassay (CMIA), which is a crucial early serologic marker for screening and diagnosis. Polymerase chain reaction (PCR) molecular testing is employed to confirm the presence of HBsAg. Polymerase Chain Reaction (PCR) was the technique we utilized to verify the outcomes. Twenty-eight of the HBsAg-positive patients at W.Z. Johannes Kupang Hospital had positive PCR results, highlighting the significance of molecular confirmation. The results of this study emphasize the value of precise HBsAg testing and the supplementary function of molecular confirmation in the treatment of patients with chronic hepatitis B. Furthermore, it clarifies the current therapeutic approaches applied to this patient population, highlighting the necessity of customized therapeutic approaches based on each patient's unique profile and potential complications.

Assessment of the Prevalence of Hepatitis B Virus Co-Infection and Its Risk Factors Among Pregnant Women Attending Antenatal Clinics in Jaling and Takum Local Government, Taraba State, Nigeria

Hepatitis B Virus (HBV) infections are co-endemic throughout most of the tropical and sub-Saharan Africa and both present a major threat to public health. This study was conducted to determine the prevalence of Hepatitis B Virus co-infection in pregnant women attending antenatal clinics in Jalingo and Takum Local government Areas, Taraba State, Nigeria. The study was conducted in Jalingo and Takum Local Governments Areas between September 2018 to December 2018.A total of five hundred and twenty (520) pregnant women were screened on antenatal day. Hepatitis B surface antigen (HBsAg), test was carried out using WONDFO(R)HBsAg test strips and use of ante-sera for blood group. A questionnaire was also prepared to collect demographic data and some risk factors. The prevalence of HBV in Jalingo (12.3%) and Takum (15.2%).co- infection HBV in Jalingo (11.9%) and Takum (15.3%). Hepatitis B infection in relation to age group showed that age group 26 - 30 had the highest infection (21.3%) while age group 16-20 had the least infection(8.2%) .This result showed no significant difference between age distribution of Hepatitis B infection based on Educational status showed those without Formal Education had the highest prevalence (88.8% ) and (19.4%) for Hepatitis B. Occupational related prevalence showed that Traders had the highest prevalence of (86%) and (17.2%) for Hepatitis B χ2= 10.346 (P.>0.5).pregnancy status also showed varied infection rates , those in their first trimester had the highest prevalence( 84.2%) for Hepatitis B virus infection but there was no significant difference (P>0.5) between pregnancy status and Hepatitis B. Relationship between Hepatitis B risk factors on the other hand showed a closer association with Blood transfusion (O.R=1.179), sharing of towel (O.R=1.079), Multiple sex partners (O.R=2.989) and use of unsterilized syringe (O.R=3.163). Hepatitis B control in pregnancy is necessary so as to reduce the incidence of adverse pregnancy complications. The Hepatitis B screening should be incorporated into the routine antenatal screening on their first day of booking. Keywords: Hepatitis B infection, antenatal, pregnant women, Jalingo and Takum, Nigeria.

Gaps in Prenatal Hepatitis B Screening and Management of HBsAg Positive Pregnant Persons in the U.S., 2015–2020

The Advisory Committee for Immunization Practices (ACIP) recommends testing all pregnant women for hepatitis B surface antigen (HBsAg) and testing HBsAg-positive pregnant women for hepatitis B virus deoxyribonucleic acid (HBV DNA). HBsAg-positive pregnant persons are recommended by the American Association for the Study of Liver Diseases to receive regular monitoring, including alanine transaminase (ALT) and HBV DNA and antiviral therapy for active hepatitis and to prevent perinatal HBV transmission if HBV DNA level is >200,000 IU/mL. Using Optum Clinformatics Data Mart Database claims data, pregnant women who received HBsAg testing and HBsAg-positive pregnant persons who received HBV DNA and alt testing and antiviral therapy during pregnancy and after delivery during January 1, 2015-December 31, 2020 were analyzed. Among 506,794 pregnancies, 14.6% did not receive HBsAg testing. Pregnant women more likely to receive testing for HBsAg (p<0.01) were persons aged ≥20 years, were Asian, had >1 child, or received education beyond high school. Among the 0.28% (1,437) pregnant women who tested positive for hepatitis B surface antigen, 46% were Asian. The proportion of HBsAg-positive pregnant women who received HBV DNA testing during pregnancy and in the 12 months after delivery was 44.3% and 28.6%, respectively; the proportion that received hepatitis B e antigen was 31.6% and 12.7%, respectively; the proportion that received ALT testing was 67.4% and 47%, respectively; and the proportion that received HBV antiviral therapy was 7% and 6.2%, respectively. This study suggests that as many as half a million (∼14%) pregnant persons who gave birth each year were not tested for HBsAg to prevent perinatal transmission. More than 50% of HBsAg-positive persons did not receive the recommended HBV-directed monitoring tests during pregnancy and after delivery.

Evaluation of HBsAg Seroclearance in Patients with Hepatitis B.

Hepatitis B surface antigen (HBsAg) seroclearance/seroconversion is regarded as an indicator of the ultimate immune control of hepatitis B virus (HBV) infections. HBsAg loss is the most important endpoint, as it shows deep suppression of HBV replication and viral protein expression. This study was aimed to retrospectively evaluate the HBsAg seroclearance/seroconversion status in patients with acute or chronic hepatitis B (CHB) diagnosis. Patients diagnosed with acute or CHB at the Harran University Faculty of Medicine Department of Gastroenterology between January 2012 and December 2020 were included in this study. This study was designed as a retrospective historical cohort. Experimental analysis of the data was done with the help of the SPSS version 22.0 package program. Of 1,053 patients with positive HBsAg, 854 patients with sufficient data in their files were included in this study. There were 494 (57.8%) males and 360 (42.2%) females; the mean age was 42.71 ± 14.31 (range 18-88). The mean duration of illness was 86.13 ± 72.92 months. In the 9-year follow-up of 854 patients, 65 (7.9%) of the last HBsAg test were negative and seroclearance had developed. The last anti-HBs test was positive in 49 (75.4%) of 65 patients who developed seroclearance, and it was found that seroconversion had developed. Twenty-seven of 30 (90%) of the patients who developed seroclearance had liver transplantation. Sixteen of 19 (84.2%) of them had acute hepatitis B, 14 of 477 (2.9%) were hepatitis carriers, 5 of 201 (2.5%) had e-negative CHB, 2 of 36 (5.6%) had cirrhosis, and 1 of 43 (2.3%) of them were delta hepatitis who developed seroclearance disease; none of the 38 e-positive CHB patients developed seroclearance. In the 9-year follow-up of patients who were positive for HBsAg at their first admission, approximately one-tenth (7.9%) developed seroclearance, and two-thirds also developed seroconversion. After liver transplantation and acute hepatitis B, almost all patients developed seroclearance, whereas, in approximately 3% of carriers (e-negative CHB and cirrhotic patients) seroclearance developed. Taşkın MC, Uyanikoglu A, Cindoglu C. Evaluation of HBsAg Seroclearance in Patients with Hepatitis B. Euroasian J Hepato-Gastroenterol 2022;12(2):65-68.

Positive status of Hepatis B Virus seroprevalence in local people and immigrants

Background In our study, we aimed to examine the seroprevalence of hepatitis B virus (HBV) infection and whether there is a sociodemographic difference between the two groups according to the hepatitis B surface antigen (HBsAg) results obtained in the blood samples given by the Turkish population and Syrian immigrants living in Bursa in their primary, secondary, and tertiary care applications. &#x0D; Material and Methods All patients with HBsAg serology who applied to family health centers, migrant health centers, 2nd and 3rd level hospitals in Bursa province during the 5-year period from January 2017 to the end of December 2021 were included in our study.&#x0D; Results During our study, HBsAg tests were taken from 955,528 people until the end of 2017-2021. The rate of Turkish citizens was 96.1% (n: 918,140), and the rate of Syrian origin was 3.9% (n: 37,388). Of all patients, 39.4% (n: 376,388) were male, and 60.6% (n: 579,140) were female. The HBsAg test was negative in 96.4% (n: 921,582) and positive in 3.6% (n: 33,946) of the patients. HBsAg positivity was found to be 3.6% in Turks and 2.4% in Syrians. HBsAg positivity was found to be 4.6% in men and 2.9% in women. The highest HBsAg positivity rate was 7.4% in the 50-59 age group. &#x0D; Conclusions The dissemination of the hepatitis B vaccine, which is currently in use, seems to be the most crucial weapon in the hands of humanity to prevent this infection and the diseases it will cause.

Analysis of HBsAg, anti-HCV, anti-HIV, VDRL, and TPHA test results in patients diagnosed with condyloma acuminata Short title: Genital warts and coinfections

Objective: Anogenital warts (AGWs) are among the most common sexually transmitted viral infections characterized by verrucae located in the anogenital region due to human papillomavirus. Although tests for other sexually transmitted diseases are recommended for patients diagnosed with AGWs, there is not sufficient information concerning the frequency of coinfections. This study aimed to determine the frequency of coinfection with hepatitis B, hepatitis C, human immunodeficiency virus (HIV) and syphilis in patients diagnosed with AGWs. Materials and Methods: For the 401 patients who presented to the Dermatology Clinic of XXX Hospital between 2014 and 2020 and were diagnosed with AGWs by a dermatologist, the hepatitis B surface antigen (HBsAg), anti-hepatitis C virus antibody (anti-HCV), anti-HIV, venereal disease research laboratory and treponema pallidum hemagglutination test results, and demographic characteristics were recorded. As controls, 350 patients who presented to the same hospital for a check-up and who did not have AGWs according to systemic examinations were evaluated, and the HBsAg, anti-HCV and anti-HIV results and demographic characteristics of these patients were also recorded for comparisons. Results: Hepatitis B was positive in 12 (3%) patients in the AGW group and seven (2%) patients in the control group. Hepatitis C was positive in two (0.5%) patients in the AGW group and negative in all the controls. While two (0.5%) patients in the AGW group were HIV-positive, all the controls were HIV-negative. Conclusion: The frequencies of hepatitis B, hepatitis C and HIV were found to be significantly higher in the AGW group than in the control group.

Clinical Outcomes and Quantitative HBV Surface Antigen Levels in Diverse Chronic Hepatitis B Patients in Canada: A Retrospective Real-World Study of CHB in Canada (REVEAL-CANADA)

Hepatitis B surface antigen (HBsAg) loss is associated with improved clinical outcomes for individuals with chronic hepatitis B (CHB); however, the effects of varying HBsAg levels on clinical outcomes in diverse cohorts are understudied. In this cross-sectional, multicentre, retrospective study, the data on adult subjects enrolled in the Canadian HBV Network with CHB seen from 1 January 2012 to 30 January 2021 with the treatment and virologic data within 1 year of HBsAg testing were analyzed. Patients were tested for HBsAg using qualitative (for HBsAg-negative samples) and/or commercial quantitative assays. Fibrosis or hepatic necroinflammation was determined by the liver stiffness measurement (LSM). The baseline data were summarized using descriptive statistics and compared by using univariable/multivariable analyses. This study included 844 CHB patients, with a median age of 49.6 years (IQR 40.1-60.5), and 37% were female. In total, 751 patients (78.6%) had known ethnicity data, and 76.7% self-reported as Asian, 11.4% as Black, 6.8% as White, and 4.8% as other. Among the 844 patients, 237 (28.0%) were HBsAg (-) (<LLOQ), 190 (22.5%) had qHBsAg 1-100, 91 (10.8%) had qHBsAg 100-500, 54 (6.4%) had qHBsAg 500-1000, and 272 (32.2%) had qHBsAg >1000 IU/mL. Overall, 80% (682) had known HBeAg status at the last follow-up, and the majority (87.0%) were HBeAg-negative. In addition, 54% (461/844) had prior antiviral therapy, 19.7% of which (16.3, 23.7, n = 91) were HBsAg (-). The treated patients had a lower risk of cirrhosis (16.46, 95% CI 1.89-143.39, p = 0.01) or HCC (8.23, 95% CI 1.01-67.39, p = 0.05) than the untreated patients. A lower proportion of the HBsAg-loss group had cirrhosis (5.7% vs. 10.9%, p = 0.021) and HCC (0.9% vs. 6.2%, p = 0.001). In this retrospective, ethnically diverse cohort study, CHB patients who received antiviral therapy and/or had HBsAg loss were less likely to develop cirrhosis and HCC, confirming the results of the studies in less diverse cohorts. No association was found between the qHBsAg level and fibrosis determined with LSM. Individuals who achieved HBsAg loss had low-level qHBsAg within 1 year of seroclearance.

Efficacy of Different Testing Scenarios in Reducing Transfusion-Transmitted Hepatitis B Virus (TT-HBV) Infection Risk.

The efficacy of different screening scenarios in reducing hepatitis B virus (HBV) transmission risk as compared to the risk without screening was modeled in 9,337,110 donations from four geographical regions that had been subjected to hepatitis B surface antigen (HBsAg) and individual donation nucleic acid amplification testing (ID-NAT). We used the Weusten models for estimating infectivity risk for Red Blood Cell (RBC) transfusions in eight HBV infection stages and then evaluated multiple screening strategies based on minipool (MP) and ID-NAT options of different sensitivity for their efficacy in reducing this risk. The efficacy in reducing HBV transmission risk by screening scenarios across the regions varied between 81% (HBsAg only) and 99.2% (ID-NAT and anti-HBc). Highly sensitive ID-NAT alone achieved a slightly higher risk reduction (97.6–99.0%) than minipool of 6 donations (MP6)-NAT in combination with HBsAg and anti-HBc (96.3–98.7%). In ID-NAT screened lapsed and repeat donors, the additional risk removed by HBsAg testing was minimal (<0.1%). The modeling outcomes in this and two previous reports using this multi-regional database suggest that one could consider an ID-NAT alone testing scenario as an alternative to MP-NAT and serology-based testing algorithms and restrict serologic testing to first-time donors only.

S3276 A Rare Case of Non-Small Cell Lung Cancer Causing False Positive Hepatitis B Surface Antigen

Introduction: Hepatitis B surface antigen (HBsAg) is a protein on the surface of HBV which can be a distinctive serological marker of acute or chronic hepatitis B infection. We present a case of 74-year-old male with a false positive HBsAg test. Case Description/Methods: A 74-year-old African American male with medical comorbidities of stage IV non-small cell lung cancer (NSCLC) and HTN presented to the hospital for an acute kidney injury with proteinuria. Hepatitis B virus (HBV) panel was obtained and revealed positive HBsAg. HBsAg was previously negative two years prior. Patient had multiple risk factors for hepatitis B infection including prior use of IV cocaine and multiple sexual partners. The patient denied any recent vaccinations. Liver function tests were normal. Physical examination did not reveal chronic liver disease manifestations. HBs Antibody (HBsAb) was positive with a quantitative value of 0.53. Hepatitis B core immunoglobulin M (HBc IgM), HBcAb total, HBeAg, HBeAb were all negative with undetectable serum HBV DNA. The HBsAg was not confirmed as a true positive after repeat testing with an antibody neutralizing procedure involving a human antibody to HbsAg. Discussion: Accurate interpretation of laboratory tests is imperative in diagnosing hepatitis B. There was high suspicion that patient had false positive HBsAg. The patient’s serological profile did not fit acute or chronic hepatitis B. The patient had no evidence of acute hepatitis B with negative HBc IgM, HBV DNA and no evidence of chronic hepatitis B with HBcAb total being negative. Furthermore, a positive HBsAb is not seen in acute and chronic hepatitis B. Transient HBsAg has been seen in patients for up to 2 weeks after HBV vaccination, however, our patient had not been vaccinated recently. The most common cause is the presence of heterophile antibodies. These naturally occurring human antibodies can bind to a variety of chemical structures including animal antibodies seen in immunochemistry assays. They can be neutralized by specific inactivating binders. Other viral infections such as Epstein-Barr Virus (EBV), transfusions, or systemic disease can cause false positives. A likely suspect was the patient’s NSCLC causing a paraneoplastic syndrome which would be the first instance of such in the literature. There have been cases of parathyroid adenoma and basal cell carcinoma causing false positivity. Patients with false-positive HBsAg need further workup to prevent misdiagnosis and potentially harmful management.

Rate of hepatitis B infection in hospital patients and blood donors in Ha'il, KSA and associated risk factors

HBV infection is HBV infection is still a major public health and economic concern worldwide. Therefore, epidemiological studies are still at high concern. There are no epidemiological studies conducted for the prevalence of hepatitis B infection in Ha'il in Saudi Arabia so far. This study aimed to estimate the rate of hepatitis B infection and identifying potential risk factors, among patients/blood donors at King Khalid general hospital in Ha'il, KSA. Therefore, a retrospective analysis was performed to estimate Hepatitis B surface antigen (HBsAg) positivity among patients/blood donors. Data of 3727 patients/blood donors for HBsAg test was collected and analyzed using Microsoft Excel. Correlations and regression analysis were performed using the statistical package for social sciences (SPSS) programs. The level of statistical significance for the study was set at p &lt; 0.05. The results showed that the rate of HBsAg among patients/blood donors was 1.1%. The rate of HBsAg was higher in male, age group &gt;50 years old, blood donors and kidney artificial unit as well as gastroenterology/hepatology patients and in September. Logistic regression analysis demonstrated that only male (P&lt;0.01), progressing age (P&lt;0.001), blood donors (P&lt;0.05) as well as gastroenterology/hepatology patients (P&lt;0.01) made significant contributions to prediction.

Prevalence of Hepatocellular Carcinoma in HIV Patients Co-infected or Triple Infected With Hepatitis B and Hepatitis C in a Community Hospital in South Bronx.

BackgroundHuman immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) share common modes of transmission; hence HBV and HCV infection are more prevalent among HIV patients. The co-infection with HIV/HBV, HIV/HCV, or HIV/HBV/HCV carries significant morbidity, with higher progression rates to end-stage liver disease or hepatocellular carcinoma (HCC).MethodsWe conducted a retrospective study among HIV adult patients co-infected with HBV or HCV and those with HCV, HIV, and HBV triple infection enrolled in the outpatient clinic of BronxCare Hospital between the years 2010 and 2021. Records were reviewed to obtain demographic data, including age and sex, hepatitis B surface antigen (HBsAg), anti-HCV antibodies, and CD4 T-lymphocyte count test results. Male and female patients ≥18 years with confirmed HIV by double enzyme-linked immunoassay (ELISA) and western blot, who underwent serology testing for both HBsAg and anti-HCV, were included in the study.ResultsIn this study, 11355 HIV patients were included, comprising 7020 (61.8%) males and 4335 (38.2%) females. A total of 410 (3.6%) were hepatitis B positive, 1432 (12.6%) were hepatitis C positive, and 127 (1.1%) were both hepatitis B and C positive. Fifty-two (0.5%) patients were diagnosed with HCC. The majority of the patient with HCC (50%, n =26) were hepatitis C serology positive (p<0.001) while 9.6% (n=5) were positive for both hepatitis C and hepatitis B (p<0.001).ConclusionHIV/HBV/HCV triple-infected patients had a lower rate of HCC compared to HIV/HCV co-infected patients. HIV without hepatitis C or hepatitis B is an independent risk factor for HCC.

An appraisal of routine Antenatal laboratory parameters at booking in Bowen University Teaching Hospital, Ogbomoso, Oyo State Nigeria

Antenatal care (ANC) involves a planned and coordinated medical and psychosocial support that optimally begins before conception and extends throughout the antepartum period. Routine laboratory tests at booking are part of this range of evidence-based interventions to ensure healthy mothers and infants. The usual recommended routine ANC laboratory tests in low resource countries include; packed Cell Volume (PCV), Blood/Rhesus group, Hemoglobin genotype, Venereal Disease Research Laboratory (VDRL), Human Immunodeficiency Virus (HIV), Hepatitis B surface antigen (HBsAg) and urinalysis.&#x0D; A review of Antenatal booking investigation results of consecutive presenting pregnant women at Bowen University Teaching Hospital (BUTH), Ogbomoso between January 1, 2019 and June 30, 2021 were analyzed alongside with other relevant information such as age, parity, occupation, level of education, year of last childbirth.&#x0D; Eight hundred and fifty-two pregnant women participated in the study, out of which 522 (61.3%) were &lt;30 years while 312 (36.6%) and 18 (2.1%) were 30-39 years and ≥40 years respectively. Most of the women were age 20 – 29 years (60.6%) and only 2 (0.7%) were teenagers. Majority of the participants had parity of 1-4 (94.7%) while only 33 were grand multiparous. A total of 387 (45.4) women had normal PCV while 465 (54.6) had a PCV in the range of mild to moderate anaemia. None was severely anaemic. The commonest blood group was ‘O’ 390 (45.7%). Most of the mothers 771 (90.4%) were Rhesus D positive while 81 (9.6%) of them were negative. Only three women were positive for HIV while 6 and 78 women had a positive VDRL and HbSAg test results respectively.&#x0D; Most of the women are young (&lt;40 years), have blood group O rhesus D positive and were anaemic at booking. Most of the participants are non-reactive to VDRL, HIV and HBsAg tests. The high percentage of anaemic cases in this study have justified the critical role of routine ANC laboratory tests in providing prompt detection and thus modification or management of pre-existing conditions or risk factors that may influence the course and outcome of pregnancy and labour.

Cutoff Value of Qualitative HBsAg for Confirmatory HBsAg Using the Chemiluminescence Microparticle Immunoassay Method.

Confirmatory hepatitis B surface antigen (HBsAg) is an assay used to distinguish weakly reactive from false-positive HBsAg results. To determine the signal to cutoff (S/CO) value of chemiluminescence microparticle immunoassay (CMIA) HBsAg assay that should trigger follow-up confirmatory HBsAg testing. All specimens with an initial S/CO value of 0.90-100.00 were subjected to repeat HBsAg testing after high-speed centrifugation. The specimens with an initial S/CO value in that range remained in the same range and were then followed up with confirmatory HBsAg testing. In total, 132 specimens had an S/CO value between 0.90 and 100.00 after high-speed centrifugation, followed by confirmatory HBsAg retesting. The S/CO value of HBsAg specimens for which the results required verification with confirmatory HBsAg was 0.98 (100% sensitivity, 3.3% specificity) through 9.32 (47.1% sensitivity, 100% specificity). The HBsAg S/CO values (as determined by the chemiluminescent microparticle immunoassay [CMIA] method) that should trigger confirmatory HBsAg testing are 0.98-9.32.

A Comparison of Rapid Screening Test and ELISA for the Diagnosis of Hepatitis B Surface Antigen in Patients Attending a Tertiary Care Hospital, Tamil Nadu, India

Introduction: Hepatitis B virus infection is a major public health problem and leading cause of death worldwide. World Health Organisation (WHO) estimates that in 2015 about 257 million population were living with chronic Hepatitis B virus infection with a global prevalence of 3.5%. Among the several viral antigens of Hepatitis B, Hepatitis B Surface Antigen (HBsAg) is an important viral antigen which is recognised as a superior marker for Hepatitis B virus detection. For proper diagnosis of infection as well as disease management and prevention, identification of appropriate test kit is necessary. Aim: To compare the results of rapid screening tests and ELISA for the diagnosis of HBsAg. Materials and Methods: A cross-sectional study was conducted from July 2019-August 2019 in a tertiary care hospital. A total of 200 blood samples received for HBsAg testing were centrifuged. Serum of all the 200 blood samples were tested for HBsAg using both rapid Immuno Chromatographic Card (ICT) method (HEPAVIEW - one step test for HBsAg, Viola Diagnostic System, A Division of Tulip Diagnostics Pvt., Ltd.) and Enzyme Linked Immuno Sorbent Assays (ELISA) (Merilisa HBsAg- Meril Diagnostics Pvt., Ltd.) method. Data for rapid card method and ELISA were noted and entered into MS excel spread sheet and analysed. Results: Among the total 200 blood samples tested by HbsAg rapid card, five samples were positive and the remaining 195 were negative. For rapid card test, the sensitivity was 83.4%, specificity 100%, Positive Predictive Value (PPV) 100% and Negative Predictive Value (NPV) 99.4% and for ELISA the sensitivity, specificity, PPV and NPV were all 100%. Conclusion: The overall performance of the rapid ICT for HBsAg was less sensitive to ELISA. So, only ELISA can be encouraged in all setups irrespective of their developmental and economical status not only to prevent the complications of Hepatitis B infection but also for early diagnosis and better treatment of patients.

919. Rates of False-Positive Hepatitis B Surface Antigen Is Low in Cancer Patients

BackgroundAccurate interpretation of hepatitis B virus (HBV) laboratory testing is paramount in avoiding inaccurate diagnosis and incorrect management that could lead to unnecessary and overtreatment. This is particularly relevant in patients with cancer where universal testing is recommended in order to avoid HBV reactivation. Hepatitis B surface antigen testing (HBsAg) positivity indicates chronic or acute HBV infection. The rates and outcomes of a false-positive HBsAg have not been established for patients with cancer.MethodsThree hundred and ninety-seven patients with any type of cancer and positive HBsAg seen at MD Anderson Cancer Center from January 2016 – January 2021 were retrospectively reviewed in this study approved by the institutional review board. Cases of false-positive HBsAg were defined as those patients with a positive HBsAg but negative HBsAg quantitative, negative HBV core antibody (total Ig), and undetectable HBV DNA within 30 days of positive HBsAg testing. Serum samples from patients were tested for HBsAg using Vitros Enhanced Chemiluminescent Immunoassay (Ortho-Clinical Diagnostics, Raritan, NJ, USA). Data collection includes demographics, past medical history, underlying cancer and its stage, prior cancer treatment, risk factors for HBV, co-infections (hepatitis C, HIV), symptoms, liver function tests, anti-HBV treatment, and interruptions on cancer treatment.ResultsOut of 397 patients with a positive HBsAg, 33 were excluded as they did not meet the diagnostic criteria or have insufficient HBV data. Of them, 3 cases (0.8%) were identified as false positive HBsAg. All 3 patients were female, white, and had progressive malignancy (Table 1). No prior history of liver disease or liver function abnormalities were noted with these 3 patients. Initially, antiviral treatment was started on 1 patient which was discontinued shortly after confirmation of false-positive HBsAg. All 3 patients had additional workup and evaluation by an HBV specialist. In 2 patients, cancer treatment was canceled or delayed. ConclusionAlthough uncommon, cancer patients with false-positive HBsAg need further workup to avoid overtreatment and unnecessary interruptions in cancer careDisclosures Jessica P. Hwang, MD, MPH , Merck (Grant/Research Support)

Association of cancer prevention awareness with liver cancer screening participation rates among a high-risk population: results from rural Anhui Province.

Association of cancer prevention awareness with liver cancer screening participation rates among a high-risk population: results from rural Anhui Province.

Hepatitis B screening practices and viral control among persons living with HIV in urban Senegal.

Chronic hepatitis B virus (HBV) infection affects >10% of the general population and is the leading cause of liver cirrhosis and cancer in West Africa. Despite current recommendations, HBV is often not tested for in clinical routine in the region. We included all people living with HIV (PLWH) in care between March and July 2019 at Fann University Hospital in Dakar (Senegal) and proposed hepatitis B surface antigen (HBsAg) test to those never tested. All HBsAg‐positive underwent HIV and HBV viral load (VL) and liver stiffness measurement. We evaluated, using logistic regression, potential associations between patient characteristics and (a) HBV testing uptake; (b) HIV/HBV co‐infection among individual HBsAg tested. We determined the proportion of co‐infected who had HBV DNA >20 IU/ml on ART and sequenced HBV polymerase in those with HBV replication.of 1076 PLWH in care, 689 (64.0%) had never had an HBsAg test prior to our HBV testing intervention. Women and individuals >40 years old were less likely to have been previously tested. After HBV testing intervention,107/884 (12.1%) PLWH were HBsAg‐positive. Seven of 58 (12.1%) individuals newly diagnosed with HIV/HBV co‐infection had a detectable HBV VL, of whom five were HIV‐suppressed. Two patients on ART including 3TC and AZT as backbone showed the presence of the triple resistance mutation 180M/204I/80V. In this Senegalese urban HIV clinic, the majority of patients on ART had never been tested for HBV infection. One in ten co‐infected individuals had a detectable HBV VL despite HIV suppression, and 8% were not receiving a TDF‐containing regimen.