Hepatitis B Virus Transmission Research Articles

Genetic diversity and occult hepatitis B infection in Africa: A comprehensive review

BACKGROUND Occult hepatitis B infection (OBI) is a globally prevalent infection, with its frequency being influenced by the prevalence of hepatitis B virus (HBV) infection in a particular geographic region, including Africa. OBI can be transmitted through blood transfusions and organ transplants and has been linked to the development of hepatocellular carcinoma (HCC). The associated HBV genotype influences the infection. AIM To highlight the genetic diversity and prevalence of OBI in Africa. METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and involved a comprehensive search on PubMed, Google Scholar, Science Direct, and African Journals Online for published studies on the prevalence and genetic diversity of OBI in Africa. RESULTS The synthesis included 83 articles, revealing that the prevalence of OBI varied between countries and population groups, with the highest prevalence being 90.9% in patients with hepatitis C virus infection and 38% in blood donors, indicating an increased risk of HBV transmission through blood transfusions. Cases of OBI reactivation have been reported following chemotherapy. Genotype D is the predominant, followed by genotypes A and E. CONCLUSION This review highlights the prevalence of OBI in Africa, which varies across countries and population groups. The study also demonstrates that genotype D is the most prevalent.

Good Practices and Initiatives for the Control and Elimination of Hepatitis B in the World: A Scoping Review.

Hepatitis B virus (HBV) infection remains a significant global public health challenge, leading to considerable morbidity and mortality. Implementationof effective strategies and novel initiatives is necessary to control and eliminate HBV. To identify the key approaches and actions used worldwide for HBV control and elimination, we conducted a comprehensive scoping review. We searched various sources, including PubMed, Scopus, Web of Science, Google Scholar, the official websites of the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), and relevant articles and reports published in the past decade. Our inclusion criteria focused on studies that reported on strategies for HBV control and elimination, provided evidence of their effectiveness, and assessed their impact on public health outcomes. We included 16 articles in our review, which highlighted a range of strategies, such as universal HBV vaccination, prevention of mother-to-child transmission, mass screening programs, and treatment of chronically infected individuals. These strategies have shown promising results in reducing HBV transmission rate, improving health outcomes, and making progress towardHBV elimination. Moreover, several challenges, including limited access to care, low awareness, stigma, and funding constraints, hinder the effectiveness of elimination programs. The findings underscore the importance of sustained efforts and investment in comprehensive strategies for HBV control and elimination. It is crucial to address barriers to care and enhance public awareness to achieve the goal of eliminating HBV as a public health threat by 2030.

Behavioral prevention of HBV transmission in urban communities toward global elimination of hepatitis in 2030: a systematic review

Hepatitis B is a serious threat to public health on a global scale. The Hepatitis B virus (HBV), which spreads both vertically and horizontally, is easily contracted by anyone. In 2020, the World Health Organization estimates that 257 million people worldwide have hepatitis B, and 900,000 people die from it each year. According to the World Health Organization (2021), there are approximately 39.4 million people in Southeast Asia living with chronic hepatitis B mortality, with 410,000 deaths caused by the disease. HBV can spread through injections, horizontal transmission, blood transfusions, and organ transplants. Cochrane, Science Direct, PubMed, Elsevier, Sage, Willey, DOAJ, and Google Scholar database sources were used to search for supported research on how to prevent hepatitis virus transmission in urban communities. 15 publications address the primary and secondary prevention of hepatitis B transmission in urban settings. Prevention keeps a person in good health and prevents them from progressing to a later, worse stage. Given that the hepatitis B virus can infect anyone, regardless of age, and that it affects people's health worldwide, as well as their families, communities, and families within them. In order to eradicate the hepatitis B virus, society must be aware of the importance of implementing preventive measures on a continuous and long-term basis through health advocacy activities, hepatitis B virus screening campaigns, health education, counseling, hepatitis B vaccination with community-based activities, and secondary prevention through combination therapy treatment in post-liver transplant patients.

Dynamics of Hepatitis B Virus Disease with Infectious Latent and Vertical Transmission

Hepatitis B has become a major health threat because it is a life-threatening liver disease with an estimated 0.25 billion people suffering from this infectious disease worldwide. This paper presents a SLITR (Susceptible-Latent-Infectious-Treatment-Recovery) mathematical model that combines both vaccination and treatment as a means of controlling the hepatitis B virus (HBV). The nonlinear ordinary differential equations for the HBV transmission capacities were resolved and the basic reproduction number R0 computed using the next generation matrix method and simulated numerically using the Runge-Kutta fourth order scheme implemented using MatLab. The stability points for disease-free equilibrium state (DFE), endemic equilibrium state (EE), and basic reproduction number R0 were obtained and the results show that the disease-free equilibrium was both locally and globally asymptotically stable (R0<1) . Similarly, treatment or vaccine administered was effective in alleviating the spread of HBV disease, and when both control strategies are combined, the diseases are quickly controlled and eventually eradicated.

Toward the elimination of hepatitis B: networking to promote the prevention of vertical transmission of hepatitis B virus through population-based interventions and multidisciplinary groups in Africa.

The WHO African Region had 81 million people with chronic hepatitis B in 2019, which remains a silent killer. Hepatitis B virus (HBV), hepatitis delta virus (HDV), and HIV can be transmitted from the mother to child. If the HBV infection is acquired at infancy, it may lead to chronic hepatitis B in 90% of the cases. WHO reports that 6.4 million children under 5 years live with chronic hepatitis B infection worldwide. The prevention of mother-to-child transmission (PMTCT) of HBV is therefore critical in the global elimination strategy of viral hepatitis as we take lessons from PMTCT of HIV programs in Africa. We sought to create a network of multidisciplinary professional and civil society volunteers with the vision to promote cost-effective, country-driven initiatives to prevent the MTCT of HBV in Africa. In 2018, the Mother-Infant Cohort Hepatitis B Network (MICHep B Network) with members from Cameroon, Zimbabwe, and the United Kingdom and later from Chad, Gabon, and Central African Republic was created. The long-term objectives of the network are to organize capacity-building and networking workshops, create awareness among pregnant women, their partners, and the community, promote the operational research on MTCT of HBV, and extend the network activities to other African countries. The Network organized in Cameroon, two "Knowledge, Attitude and Practice" (KAP) surveys, one in-depth interview of 45 health care workers which revealed a high acceptability of the hepatitis B vaccine by families, two in-person workshops in 2018 and 2019, and one virtual in 2021 with over 190 participants, as well as two workshops on grant writing, bioethics, and biostatistics of 30 postgraduate students. Two HBV seroprevalence studies in pregnant women were conducted in Cameroon and Zimbabwe, in which a prevalence of 5.8% and 2.7%, respectively, was reported. The results and recommendations from the MICHep B Network activities could be implemented in countries of the MICHep B Network and beyond, with the goal of providing free birth dose vaccine against hepatitis B in Africa.

Chronic Hepatitis B in Women of Childbearing Age and Pregnant Women in China: A Cross-Sectional Study.

Pregnant women and women of childbearing age were enrolled in our study and their knowledge about the Hepatitis B virus (HBV) and chronic hepatitis B (CHB) was evaluated. A questionnaire was distributed to every woman in the cross-sectional study. The questionnaire was answered by all participants before they received health education and advice about HBV and CHB from the doctors visited. Data collected from all answers were analyzed using the χ2 test and logistic regression models. A total of 206 pregnant women and women of childbearing age with CHB infection were enrolled in the study during their first visit to the Infectious Diseases Clinic of the Third Affiliated Hospital of Guangzhou Medical University. Some women of childbearing age (40.8%) and pregnant women with CHB infection (30.6%) still believed HBV could be transmitted through diet and/or mosquito bites. Some women of childbearing age and pregnant women with CHB infection had limited knowledge of the prevention of HBV transmission (111 of 206, 53.9%). Women with higher levels of education had more knowledge about HBV (senior middle school, P = 0.02; university, P <0.01). The majority of participants were willing to take antiviral medicine to decrease the mother-to-child transmission (MTCT) rate of HBV. Some women of childbearing age and/or pregnant women with CHB infection have relatively limited knowledge about HBV or CHB. This situation contributes to the timeliness, or lack thereof, of these women with CHB to see a doctor and receive antiviral therapy. As a result, the morbidity and mortality of HBV-related complications could increase along with the rate of MTCT of HBV.

Evaluation of the Efficacy and Safety of Tenofovir Disoproxil Fumarate in Intercepting Mother-to-Child Transmission of Hepatitis B Virus.

Vertical transmission of hepatitis B virus (HBV), especially in Asia, is a key target in the global elimination of HBV. This study assessed the effects of tenofovir disoproxil fumarate (TDF) in pregnant women for mother-to-infant transmission of HBV. A total of 122 pregnant women at our hospital met the inclusion criteria for high HBV DNA viral loads. They were randomly divided into TDF-treatment (n=70) and placebo (n=52) groups. Maternal liver function and serum HBV DNA load were tested before and after treatment. Clinical and laboratory data of infants were assayed at delivery and 7-months post-partum visit and compared between the two groups. There was no difference in clinical characteristics of participants between the two groups. There were no significant differences in liver function markers, including alanine aminotransferase, total bilirubin, blood creatinine, and blood urea nitrogen levels before and after TDF treatment. The serum HBV DNA viral load of the TDF-treated group became significantly lower than those of the control group and their own pre-medication levels. Infants showed no significant difference in body growth, including weight, height, head size, and five-min Apgar score. At 7 months after birth, 94.29% of infants in the TDF group and 86.54% of control-group infants had protective HBsAb levels ≥ 10 mIU/ml (p>0.05). The HBV infection rate of infants in the TDF-treated group was lower than that in the non-treated group. In high-HBV-DNA-load pregnant women, TDF administered from 28 weeks gestational age to delivery was associated with a lower risk of mother-to-infant transmission of HBV.

Altered TLR7 Expression-Mediated Immune Modulation Is Supportive of Persistent Replication and Intrauterine Transmission of HBV.

Hepatitis B Virus (HBV) is posing as a serious public health threat mainly due to its asymptomatic nature of infection in pregnancy and vertical transmission. Viral sensing toll-like receptors (TLR) and Interleukins (IL) are important molecules in providing an antiviral state. The study aimed to assess the role of TLR7-mediated immune modulation, which might have an impact in the intrauterine transmission of HBV leading to mother to child transmission of the virus. We investigated the expression pattern of TLR7, IL-3, and IL-6 by RT-PCR in the placentas of HBV-infected pregnant women to see their role in the intrauterine transmission of HBV. We further validated the expression of TLR7 in placentas using Immunohistochemistry. Expression analysis by RT-PCR of TLR7 revealed significant downregulation among the Cord blood (CB) HBV DNA positive and negative cases with mean ± standard deviation (SD) of 0.43 ± 0.22 (28) and 1.14 ± 0.57 (44) with p = 0.001. IL-3 and IL-6 expression revealed significant upregulation in the CB HBV DNA-positive cases with p = 0.001. Multinomial logistic regression analysis revealed that TLR7 and IL-3 fold change and mother HBeAg status are important predictors for HBV mother to child transmission. Immunohistochemistry revealed the decreased expression of TLR7 in CB HBV DNA-positive cases. This study reveals that the downregulation of TLR7 in the placenta along with CB HBV DNA-positive status may lead to intrauterine transmission of HBV, which may lead to vertical transmission of HBV.

Prevalence of Hepatitis B Viral Infection in Pregnant Women at the Suhum Municipality, Ghana

Background. Global prevalence of chronic hepatitis B virus (HBV) infection was estimated between 257 and 291 million since 2020, posing a great public health challenge. In Africa, an estimated 60 million cases of HBV were reported in the same year. Pregnant women might be susceptible to HBV infection dependent on their level of awareness and knowledge about the causes, transmission, and prevention of HBV. The aim of the study was to assess the awareness and prevalence of HBV infection and prolonged bleeding risk among pregnant women at the Suhum Municipality of Ghana. Methods. The study was a cross-sectional design involving pregnant women who were sampled following their visit to the antenatal unit at the Suhum Government Hospital. Sociodemographics including history of HBV screening and vaccinations were obtained from consented individuals using pretested questionnaires. Also, venous blood samples were obtained for platelet count, whereas bleeding time assay was performed to assess functional platelet disorders. Results. Hepatitis B prevalence was 4.4%, with 14.1% prevalence of mild thrombocytopenia and 1.5% prevalence of prolonged bleeding time. Pregnant women who had tertiary education and previous screening were about 8 times (AOR=7.78, 95% CI: 1.50-40.50) and 14 times (AOR=13.66, 95% CI: 1.72-108.75) more likely to have knowledge of hepatitis B than those without tertiary education and previous screening, respectively. Conclusion. The prevalence of HBV was 4.4%. Education status and previous screening were associated with demonstration of knowledge about HBV; therefore, intensification of education and screening are recommended.

Hepatitis B Virus Prevalence and Transmission in the Households of Pregnant Women in Kinshasa, Democratic Republic of Congo.

The World Health Organization Africa region has high regional hepatitis B virus (HBV) prevalence, and evidence suggests more frequent horizontal HBV transmission than other regions. Context-specific epidemiological studies are needed to inform additional HBV prevention measures. In the cross-sectional Horizontal and Vertical Transmission of Hepatitis B (HOVER-HBV) study, we introduced HBV surface antigen (HBsAg) screening alongside existing HIV screening as part of routine antenatal care in high-volume maternity clinics in Kinshasa, Democratic Republic of Congo. We recruited households of pregnant women ("index mothers") who were HBsAg-positive and HBsAg-negative, defining households as index-positive and index-negative, respectively. Household members underwent HBsAg testing and an epidemiological survey. We evaluated HBsAg prevalence and potential transmission correlates. We enrolled 1006 participants from 200 households (100 index-positive, 100 index-negative) across Kinshasa. HBsAg-positivity prevalence was more than twice as high in index-positive households (5.0% [95% confidence interval {CI}, 2.8%-7.1%]) as in index-negative households (1.9% [95% CI, .6%-3.2%]). HBsAg-positivity prevalence was 3.3 (95% CI, .9-11.8) times as high among direct offspring in index-positive versus index-negative households. Factors associated with HBsAg positivity included older age, marriage, and having multiple recent partners or any new sexual partners among index mothers; and older age, lower household wealth, sharing nail clippers, and using street salons among offspring in index-positive households. Vertical and horizontal HBV transmission within households is ongoing in Kinshasa. Factors associated with infection reveal opportunities for HBV prevention efforts, including perinatal prevention, protection during sexual contact, and sanitation of shared personal items.

Knowledge and Risk Assessment of Hepatitis B Infection among Barbers and Beauty Salon Workers in Mwanza, Tanzania

Background and Objective Community-acquired hepatitis B virus (HBV) infection is increasing in developing countries. In Tanzania, there is an exponential increase in barbershops and beauty salons, which are potential sites of transmission of HBV. Occupational exposure rates and HBV vaccination rates among salon workers are unknown; their level of knowledge about infection prevention and control (IPC) is also unknown. This study aimed to evaluate the risk of infection and the knowledge of barbers and beauty salon workers about HBV transmission and prevention. Methods A cross-sectional study was conducted using a convenience sample of 200 barbers and beauty salon workers from 13 barber shops and 13 beauty salons in the urban district of Mwanza, Tanzania. Data were collected using a self-administered questionnaire, entered into EpiData version 3.1, and analyzed with Stata version 13. Categorical variables were expressed as frequencies, and association levels were compared using Fisher’s exact test. Results Fifty-four percent of the study participants were female, and the mean age was 25 (21.0–29.5) years. A total of 126 (63%) participants were aware of the existence of HBV infection, of which only 22% had general good knowledge of HBV transmission and prevention. Both HBV awareness (P &lt; 0.001) and good knowledge of its transmission and prevention (P = 0.03) were positively associated with higher levels of education. Seventy-three (36.5%) participants reported a history of occupational injuries. Merely 27.8% of participants were familiar with the correct methods of decontamination beauty tools, and only 14.3% understood the correct procedures for post-exposure wound care. Vaccination coverage was low with only (2%) of barbers and beauty salon workers having received vaccines. Conclusion and Implications for Translations The frequent occupational injuries and inadequate vaccination among barbers and beauty salon workers amplify their risk of HBV infection. They also lack basic knowledge about HBV transmission and prevention, placing the clients they serve at high risk for infection. We recommend that training on HBV Infection Prevention and Control (IPC) should focus on this specific group, and the implementation of these measures should be closely monitored in barbershops and beauty salons. Moreover, this vulnerable group should be considered for a global vaccination program.

Hepatitis B vaccine uptake and associated factors among adults of Gulu city in Northern Uganda: A community-based cross-sectional study.

Hepatitis B virus (HBV) infection is a global public health problem against which vaccination is recommended for all high-risk adults. HBV is highly endemic in Northern Uganda, however, there is a paucity of literature regarding HBV vaccine uptake and associated factors within the community in the region. In this study, we aimed to determine the level of HBV vaccine uptake and associated factors among adults in Gulu city, Uganda. We conducted a community-based, cross-sectional study in Gulu city among eligible adults between March and May 2022. Data on HBV vaccination status and sociodemographic characteristics were collected using an interviewer-administered questionnaire. Full uptake of HBV vaccine was defined as receipt of all 3 recommended doses, and partial uptake for 1 or 2 doses. Multivariable logistic regression analysis was performed using STATA 16.0 to determine factors independently associated with HBV vaccine uptake. P<0.05 was considered statistically significant. In total, 360 participants were enrolled, of whom 212 (58.9%) were female, 183 (50.8%) were aged 30 years or younger, and 143 (39.7%) had attained tertiary education. Overall, 96 (26.7%) participants had full uptake of HBV vaccine and 73 (20.3%) had partial uptake. Factors that were statistically significantly associated with full uptake of HBV vaccine were good knowledge regarding HBV transmission (aOR = 1.9, 95% Confidence Interval (CI) = 1.03-3.46, p = 0.040) and receiving health education on HBV vaccination (aOR = 4.4, 95% CI = 2.3-8.4, p<0.001). There is a low uptake of HBV vaccine in Gulu city, Uganda. The Uganda Ministry of Health should correct misconceptions, create awareness of the severity of HBV infection through health education regarding HBV infection within the community in Gulu City; and set mechanisms to follow-up clients due for next HBV vaccination.

Seroprevalence of hepatitis B virus infection (HBsAg) and associated factors among antenatal clinic attendees in a secondary-level facility in southern Ghana

IntroductionVertical transmission of Hepatitis B Virus (HBV) infection is the predominant mode of HBV transmission in highly endemic settings worldwide where the HBV seroprevalence is above 8%. Newborns who contract HBV at birth have a higher risk of chronic infections that can result in liver cancer and liver cirrhosis. Preventing mother-to-child transmission of HBV through screening of pregnant women during the antenatal period and universal vaccination of newborns are important strategies for eliminating new childhood HBV infections. This study sought to estimate the prevalence of HBV infection among pregnant women in the study area and to determine the factors associated with a positive HBV disease status. The findings from this study will help in obtaining a baseline for comparing future trends and identifying risk factors for HBV that need to be eliminated in southern Ghana. MethodsThis was a cross-sectional hospital-based analytic study in which 225 pregnant women were surveyed using a semi structured questionnaire. Blood samples were taken and analysed qualitatively for HBsAg. The data were entered into Epi-data version 3.1 and exported into STATA version 17 for analysis, with a significance level set at <0.05. ResultsThis study revealed that the seroprevalence of HBV infection (HBsAg positivity) was 8.0% CI (5%–12.4%) among the pregnant women. The HBV vaccination coverage was 50.2%. Pregnant women with a history of sexually transmitted diseases were six times more likely to test positive for HBsAg aOR: 6.36 (CI = 0.35–2.92, p = 0.019). Additionally, women who had received at least one dose of the HBV vaccine had lower odds of having HBV infection than did those who failed to vaccinate (aOR = 0.08, 95% CI = 0.01–0.66, P = 0.020). ConclusionsThe prevalence of HBV infection is relatively high in this population. HBV vaccination and sexually transmitted infections play significant roles in HBV infection and transmission in the study area. Interventions to promote HBV vaccination among the adult population as well as among newborns and STI prevention strategies are needed to reverse the trend of HBV infections in the study area.

Hepatitis B virus infection on Kwajalein Atoll, Marshall Islands: a seroprevalence, knowledge and attitudes study.

A study was conducted to determine the seroprevalence of chronic hepatitis B virus (HBV) infection among children and their mothers on Kwajalein Atoll in the Marshall Islands two decades after routine vaccination was introduced in the 1990s. Mothers' knowledge and attitudes towards HBV disease and vaccination were also assessed. Results of a national seroprevalence survey conducted in 2016-2017 and antenatal records were used to determine the prevalence of HBV seropositivity in children aged 6-8years and their biological mothers. The associations between demographic, social and vaccination-related factors and seropositivity were explored using Fisher's exact tests. HBV seroprevalence was 0.3% in children and 6.8% in their mothers (during pregnancy). Coverage of timely HBV vaccination was 90.3% for the birth dose and was significantly associated with factors related to place of residence (P<0.001), place of birth (P<0.001) and number of antenatal visits (P<0.001). Maternal attitudes towards infant vaccination and antenatal screening were largely positive (95.8% and 96.7%, respectively) despite low vaccination rates (20.9%) among mothers. Knowledge levels were low for disease complications, treatment and transmission. Prevalence of HBV in children and mothers residing on Kwajalein Atoll in 2016-2017 was lower than the national average for the Marshall Islands. Timely birth dose administration appears to have been effective in preventing mother-to-child transmission of HBV in this setting and should be promoted in remote settings where antiviral therapy is not available. Provision of out-of-cold-chain HBV vaccines should be considered to improve access in remote settings.

Real-world implementation of a multilevel interventions program to prevent mother-to-child transmission of HBV in China.

Reducing hepatitis B virus (HBV) mother-to-child transmission (MTCT) is a fundamental step toward the HBV elimination goal. The multicentred, multilevel SHIELD program aimed to use an intense intervention package to reduce HBV MTCT in China. This study was conducted in diverse health settings across China, encompassing 30,109 pregnant women from 178 hospitals, part of the interim analysis of stage II of the SHIELD program, and 8,642 pregnant women from 160 community-level health facilities in stage III of the SHIELD program. The study found that the overall MTCT rate was 0.23% (39 of 16,908; 95% confidence interval (CI): 0.16-0.32%) in stage II and 0.23% (12 of 5,290; 95% CI: 0.12-0.40%) in stage III. The MTCT rate was lower among participants who were compliant with the interventions (stage II: 0.16% (95% CI: 0.10-0.26%); stage III: 0.03% (95% CI: 0.00-0.19%)) than among those who were noncompliant (3.16% (95% CI: 1.94-4.85%); 1.91% (95% CI: 0.83-3.73%); P < 0.001). Our findings demonstrate that the comprehensive interventions among HBV-infected pregnant women were feasible and effective in dramatically reducing MTCT.

Comprehensive approach to controlling chronic hepatitis B in China.

Hepatitis B virus (HBV) infection was highly endemic in China, where the prevalence of HBsAg was 9.7% in 1992. Comprehensive strategies, including universal infant hepatitis B vaccination with emphasis on timely birth-dose and 3-dose coverage, dramatically reduced the mother-to-infant transmission and early childhood acquisition of HBV, resulting in estimated HBsAg prevalence rates of 5.6% and 0.1% in the general population and among children aged <5 years in 2022, respectively. Clinical guidelines on the prevention and treatment of chronic hepatitis B have been periodically updated based on emerging evidence from clinical research. The continuously improved reimbursement policy and the massively reduced price of antiviral drugs through government negotiation and central procurement have increased treatment accessibility and affordability. However, due to the low rates of diagnosis and treatment, China still faces a large challenge in achieving the 2030 goal of lowering HBV-related mortality by 65%. A public health approach involving concerted efforts from the government, medical community, industry, and society as a whole would be necessary to increase the uptake of HBV tests and treatment to achieve the global goal of eliminating viral hepatitis as a public health threat by 2030.

Seroepidemiology of Asymptomatic Plasmodium falciparum CoInfections with Hepatitis B And C Virus among Blood Donors in Modakeke Area Office, Ile Ife, Osun State, Nigeria

Despite the remarkable achievements in the reduction of malaria mortality, the disease had remained the most common cause of morbidity and mortality. Infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) might associate with increased mortality rate as the infections may predisposes to the development of serious liver diseases such as liver cirrhosis, liver failure and hepatocellular carcinoma (HCC). The aim of the present study was to determine the Asymptomatic Plasmodium falciparum co-infections with hepatitis B and C viruses among blood donors in Modakeke Area Office, Ile Ife, Osun State, Nigeria. The study was conducted in Modakeke Area Office, Ile Ife, Osun State. The study was conducted in Modakeke health facility, Ile Ife, Osun State. Five (5) ml of venous blood was obtained from each of 400 blood donors into plain bottles and labeled accordingly. Thick and thin films of the donor’s blood samples were made on slides dried for five minutes at 37°C then stained using Giemsa stain. The slides were then examined microscopically for presence and densities of malaria parasites. Species identification and determination of the Hematological parameters were also conducted on the slides. Sera were separated from the remaining aliquots of the blood and screened for hepatitis-B and C surface antigens (HBsAg and anti-HCV). The overall mean parasitaemia of malarious blood donors was 786.20µl/blood while that of blood donors with hepatitis virus infection was 53 representing 13.3% of the total donor examined. Donors infected with HBV, HCV and co-infection of HBV and HCV had viraemia of 25 (6.3%), 21 (5.3%) and 7(1.8%) respectively. Among the age groups, high prevalence of Hepatitis viral infection rate of 57.9% was recorded among aged group 18-26 years. The infection rate of 15.8%, 13.6% and 10.5% of HBV, HCV was recorded from age group 18-26years respectively. The highest co-infection rate of HBV and HCV of 18.8% was recorded from age group 54-62years, while high mean malaria parasitaemia of 1,882.78 (µl of blood) was also recorded among donors aged 18-26 years. High hepatitis viral infection rate of 22.2% with 16.7% of HCV were recorded among females, while 6.3% of HBV and 1.9% of co-infection was observed among males and the mean malaria parasitaemia of 2,382.80 µl of blood was observed among females. High prevalence of Hepatitis infection rate of 17.1%, 8.6% of HCV, (6.3%) of HBV and 2.3% of co-infection were recorded among single donors. The mean malaria parasitaemia of 786.89 (µl of blood) was observed among married donors, there was significant difference between marital status and hepatitis infection (p= 0.0043) and between HCV (p=0.009). High prevalence of hepatitis viraemia of 21.4% and co-infection 5.6% was recorded among artisans, while 14.6% HBV infection rate was recorded among civil servants and 14.3% of HCV was recorded among donors who are farmers. The mean malaria parasitaemia of 1,150.15 µl/blood was recorded among donors who are traders. Donors that have acquired primary education have high prevalence of hepatitis infection rate of 38.5%, with 15.4% of HBV and (23.1%) co-infection (HBVand HCV). HCV (6.7%) was high among donors with secondary education; high mean malaria parasitaemia of 2,096.84 µl of blood was recorded among donors with primary education. Blood B+ve had high hepatitis viral infection rate of 21.7%, HCV 13.0% and co-infection of 5.8% while 7.8% of HBV was recorded among O+ve donors. The mean malaria parasitaemia of 1,378.50 (µl of blood) was recorded among B-ve donors. The total mean PCV in the study was 42.63, White blood cell count was 5,281.25, lymphocytes count was 42.88, eosinophils was 1.53 and neutrophil count was 55.72. The total percentage of elevated AST was 5.0%, ALT was 6.0% and ALB was 10.5%. There was significant difference between malaria and ALT (p=0.000) also, there was significant difference between HCV and ALB (p=0.000). There was significant difference between HBV and AST (p=0.001), ALT (p=0.028) and ALB (p=0.028).The hepatitis viral infection had significant difference with ALB (p=0.000). The logistic regression shows that there was an association between hepatitis viral infection and aged group 27-35years (p=0.022), female (p=0.006), trading (p=0.001), tertiary (p=0.003) A+ve (p=0.018) and B+ve (p=0.001). In conclusion, Although, the prevalence of malaria was low, while that of hepatitis viral infection was high in the local government area, critical screening of blood donors is of prime importance because they serve as an asymptomatic reservoirs and a potential source of transmission of these infections. The strengthening of creating awareness on the general public regarding Malaria, HBV and HCV transmission and prevention should be embarked on.

Hepatitis B Vaccination Coverage among Healthcare Workers and Evaluation of Immune Response by Estimating Anti-HBs Antibody Titers over Time at a Tertiary Care Hospital: A Cross-sectional Study

Introduction: Healthcare Workers (HCWs) are at a high-risk of acquiring Hepatitis B Virus (HBV) infection. However, this risk can be prevented through Hepatitis B vaccination. In some institutes, HCWs have a lower percentage of HBV vaccination, leading to a higher risk of HBV transmission. Therefore, the coverage of vaccination is an important point, along with the evaluation of protective immune status. Aim: To assess the vaccination coverage and evaluate the immune response post-vaccination through Anti-Hepatitis B surface Antibodies (Anti-HBs) titre. Materials and Methods: This cross-sectional study was conducted at Government Medical College, Pali, Rajasthan, India, over a period of one year from April 2021 to March 2022, following approval from the Institutional Ethics Committee (IEC). A total of 455 HCWs below 60 years of age were included in the study, and their demographic details such as age, gender, occupation, needle stick injury, blood exposure to mucous membranes and breached skin, hepatitis B vaccination status, and time duration since vaccination were noted. Additionally, their Anti-HBs titer was examined. The participants were initially classified into three groups: completely vaccinated, partially vaccinated, and non vaccinated. Among those who were vaccinated, they were further divided into two groups: vaccination ≤5 years (Group A) and &gt;5 years (Group B). Furthermore, those who received a booster dose were divided into Group I (≤1 year) and Group II (&gt;1 year). Blood samples were collected to assess the anti-HBs levels quantitatively in the sera using Enzyme Linked Immuno Sorbent Assay (ELISA). The data was entered into Microsoft Excel and later imported into Statistical Package for Social Sciences (SPSS) version 22.0 for statistical analysis. Results: Participants had a mean age of 29.65±9.603 years. Among them, 43 (30.1%) were doctors, and 37 (25.9%) were medical students who were found to be completely vaccinated. On the other hand, among other HCWs, 15 (10.5%) were nurses, 16 (11.2%) were nursing students, and 32 (22.4%) were lab technicians who were vaccinated. None of the support staff were vaccinated (p-value=0.0001). A total of 143 participants were completely vaccinated, and 97.9% (n=140) had protective immunity to Hepatitis B. The anti-Hbs titre was 567.32±434.494 in group A and 265.74± 211.80 in group B (p-value=0.0001). Similarly, it was 688.34±424.617 in group I and 221.14±141.221 in group II (p-value &lt;0.0001).The anti-Hbs titre did not significantly increase among the partially vaccinated participants (n=162). It was found to be 25.47±27.595 in group A and 14.60±19.939 in group B (p-value=0.004). There was no significant difference in the results between males and females (p-value=0.961). Conclusion: The coverage of complete vaccination among HCWs was significantly low, which is crucial for obtaining a protective Anti-Hbs titre. Incomplete vaccination does not result in a sufficient level of anti-Hbs titre, and there may be a significant decline in the immune response over time (p-value&lt;0.05). Therefore, it is essential to estimate the titre after 1-2 months of complete vaccination to ensure that individuals are fully protected against Hepatitis B.

Serological and Molecular Characterization of Occult HBV Infection in Blood Donors from South Italy.

Despite good vaccine coverage and careful blood donor selection policies, hepatitis B virus (HBV) is still the most frequent viral infection among blood donors (BDs) in Italy, mostly in the occult form (OBI). We studied the virological features of OBI in BDs from South Italy by serology, molecular testing for HBV-DNA, and sequencing for HBV genotypes and mutations. One hundred and two samples from 95 BDs (22.1% first time, 87.9% regular, median age 57 years) positive for HBV-DNA and negative for HBsAg were retrospectively analyzed. HBV biomarkers were detected in 96.9% (anti-HBc in 44.2%, anti-HBc plus anti-HBs in 49.5%, anti-HBs alone in 3.2%). No risk factor was declared by 45.3% of donors. HBV-DNA levels were very low (median: 7 IU/mL). All samples harbored HBV genotype D and single or multiple mutations in the S gene were found in 28/36 sequences analyzed and in 75% of donors. Mutations were unrelated to gender, donor group or serological patterns. An HBsAg assay with enhanced sensitivity was positive in samples from seven donors (7.4%), two of which negative for HBV-DNA by real-time PCR. OBI still represents a risk for HBV transmission from blood donations; screening by highly sensitive serological and molecular assays is warranted.

Management and Elimination of mother-to-child transmission of hepatitis B virus: A therapeutical Approach

A major worldwide health issue is the persistent transmission of the chronic form of the hepatitis B virus (HBV) from mothers to their unborn children (MTCT) during the perinatal period. In endemic areas, HBV infection occurs mainly during infancy and early childhood, with MTCT accounting for approximately half of the transmission routes of chronic HBV infections. Prevention of MTCT is an important step in reducing the global burden of chronic HBV. In addition to such considerations regarding the transmission of HBV to the child, the combination of HBV infection and pregnancy raises several unique management issues. Up to 9% of newborns still acquire HBV infection, especially from mothers who have the hepatitis B e antigen (HBeAg), despite routine passive-active immunoprophylaxis with hepatitis B immunoglobulin (HBIG) and the hepatitis B vaccine. The failure of passive-active immunoprophylaxis in newborns, the impact and requirement of routine hepatitis B immunoglobulin (HBIG) injections to mothers, the safety of antiviral prophylaxis, and the safety of nursing are some of the complications associated with managing HBV infection throughout pregnancy. Chronic HBV infection during pregnancy is usually but may flare after delivery. These unresolved issues are highlighted in this review and we aim to an optimal approach to the management of preventing MTCT of HBV infection.&#x0D; Keywords: Hepatitis B, perinatal period transmission, immunoprophylaxis, breastfeeding, viremia.