Detection of different categories of hepatitis B virus (HBV) infection in a multi‐regional study comparing the clinical sensitivity of hepatitis B surface antigen and HBV‐DNA testing

The high endemicity of hepatitis B virus (HBV) infection and liver disease in Sardinia led us to assess the occurrence of HBV DNA in 1,411 sera of two selected groups of hepatitis B surface antigen (HBsAg)- negative blood donors: 793 with abnormal serum alanine aminotransferase (ALT) and 618 with normal serum ALT values (determined during routine testing of their blood donation). HBV DNA sequences were detected by dot-blot hybridization in 68 of 793 subjects (9%) with abnormal ALT but only in three of 618 subjects (0.5%) with normal ALT. HBV-core antibody (anti-HBc) was detected in 338 of 793 subjects (43%) with abnormal ALT as well as in 125 of 618 subjects (20.2%) with normal ALT. Among the 71 subjects positive for serum HBV DNA, 22 (31%) were positive for anti- HBc, while 49 (69%) were negative for all serologic markers of HBV infection. Thus, a high frequency of anti-HBc in apparently healthy HBsAg-negative individuals and a high prevalence of serum HBV DNA in the absence of immunologic markers of HBV infection suggest the existence of genetic variants of HBV that may be responsible for some of the presumed NANB hepatitis encountered in Sardinia and possibly other areas of high endemicity for HBV.

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Occult hepatitis B virus infection in a Kenyan cohort of HIV infected anti-retroviral therapy naïve adults

PLoS ONE ◽

10.1371/journal.pone.0244947 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0244947

Author(s):

Adil Salyani ◽

Jasmit Shah ◽

Rodney Adam ◽

George Otieno ◽

Evelyn Mbugua ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Surface Antigen ◽

Hepatitis B Surface Antigen ◽

Hbv Dna ◽

Demographic Characteristics ◽

Hbv Infection ◽

Occult Hepatitis ◽

B Virus ◽

Occult Hepatitis B

Background Occult hepatitis B virus (HBV) infection (OBI) is a phase of HBV infection characterised by the presence of HBV DNA in the absence of detectable hepatitis B surface antigen (HBsAg). OBI is of concern in the HIV-infected due to high prevalence and risk of HBV reactivation. The prevalence and clinico-demographic characteristics of OBI in anti-retroviral therapy (ART) naïve HIV infected adults in Kenya is unknown. Methods A cross sectional study carried was out at three sites in Kenya. HIV infected ART naïve adults were enrolled and demographic data collected. Blood samples were assayed for HBsAg, HBV DNA, alanine aminotransferase, aspartate aminotransferase, antibodies to hepatitis B surface antigen (anti-HBs) and hepatitis B core antigen (anti-HBc). Data on CD4 count, HIV viral load and platelet count were obtained from medical records. Results Of 208 patients, 199 (95.7%) did not report HBV vaccination, 196 (94.2%) were HBsAg negative, 119 (57.2%) had no HBV markers, 58 (27.9%) had previous HBV infection (anti-HBc positive) and 11 (5.3%) had OBI. All 11 (100%) OBI patients were anti-HBc positive. OBI patients comprised 19.0% of HBsAg negative, anti-HBc positive patients. There was no difference in clinico-demographic characteristics between the overt HBV, OBI and HBV negative patients. Conclusion This was the first study on OBI in ART naïve HIV infected adults in Kenya. The lower OBI prevalence compared to other sub-Saharan African countries could be attributed to lower HBV exposure. Most patients were HBV unexposed and unimmunized, outlining the need to implement guideline recommended immunization strategies.

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Hepatitis B virus DNA in the serum of Sardinian blood donors negative for the hepatitis B surface antigen

Blood ◽

10.1182/blood.v73.1.17.17 ◽

1989 ◽

Vol 73 (1) ◽

pp. 17-19 ◽

Cited By ~ 64

Author(s):

ME Lai ◽

P Farci ◽

A Figus ◽

A Balestrieri ◽

M Arnone ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Surface Antigen ◽

Dna Sequences ◽

Blood Donors ◽

Hepatitis B Surface Antigen ◽

Hbv Dna ◽

Hbv Infection ◽

B Virus ◽

Normal Alt

Abstract The high endemicity of hepatitis B virus (HBV) infection and liver disease in Sardinia led us to assess the occurrence of HBV DNA in 1,411 sera of two selected groups of hepatitis B surface antigen (HBsAg)- negative blood donors: 793 with abnormal serum alanine aminotransferase (ALT) and 618 with normal serum ALT values (determined during routine testing of their blood donation). HBV DNA sequences were detected by dot-blot hybridization in 68 of 793 subjects (9%) with abnormal ALT but only in three of 618 subjects (0.5%) with normal ALT. HBV-core antibody (anti-HBc) was detected in 338 of 793 subjects (43%) with abnormal ALT as well as in 125 of 618 subjects (20.2%) with normal ALT. Among the 71 subjects positive for serum HBV DNA, 22 (31%) were positive for anti- HBc, while 49 (69%) were negative for all serologic markers of HBV infection. Thus, a high frequency of anti-HBc in apparently healthy HBsAg-negative individuals and a high prevalence of serum HBV DNA in the absence of immunologic markers of HBV infection suggest the existence of genetic variants of HBV that may be responsible for some of the presumed NANB hepatitis encountered in Sardinia and possibly other areas of high endemicity for HBV.

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The risk of hepatitis B virus infection by transfusion in Kumasi, Ghana

Blood ◽

10.1182/blood-2002-04-1084 ◽

2003 ◽

Vol 101 (6) ◽

pp. 2419-2425 ◽

Cited By ~ 102

Author(s):

Jean-Pierre Allain ◽

Daniel Candotti ◽

Kate Soldan ◽

Francis Sarkodie ◽

Bruce Phelps ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Blood Donors ◽

Hepatitis B Surface Antigen ◽

Hbv Dna ◽

Hbv Infection ◽

Sub Saharan Africa ◽

B Virus ◽

Sub Saharan ◽

Hbv Transmission

The risk of hepatitis B virus (HBV) transmission by transfusion in sub-Saharan Africa is considered to be relatively low, and testing of blood donors is often not done or is done relatively poorly. To re-examine this attitude, we identified HBV chronically infected blood donors from a major hospital in Ghana with a range of hepatitis B surface antigen (HBsAg) assays. Test efficacy was estimated using HBV DNA as a gold standard, and the risk of HBV infection in blood recipients was estimated for different testing strategies. Particle agglutination, dipstick, and enzyme immunoassay (EIA) HBsAg screening detected 54%, 71%, and 97% of HBV infectious donors, respectively. The risk of HBV transmission to recipients less than 10 years old ranged between 1:11 and 1:326 with blood unscreened and screened by EIA, respectively. For older recipients, the risk decreased a further 4-fold because of the high frequency of natural exposure to HBV. A total of 98% of HBsAg-confirmed positive samples contained HBV DNA. HBV DNA load was less than 1 × 104 IU/mL in 75% of HBsAg-reactive samples, most of them anti-HBe reactive. Approximately 0.5% of HBsAg-negative but anti-HBc-positive samples contained HBV DNA. The use of sensitive HBsAg tests is critical to prevent transfusion transmission of HBV infection to young children in a population with a 15% prevalence of chronic HBV infection in blood donors. However, this will not have much effect on the prevalence of this infection unless other strategies to protect children from infection are also advanced in parallel.

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Hepatitis B Virus Reactivation in Lymphoma Patients With Prior Resolved Hepatitis B Undergoing Anticancer Therapy With or Without Rituximab

Journal of Clinical Oncology ◽

10.1200/jco.2008.18.0182 ◽

2009 ◽

Vol 27 (4) ◽

pp. 605-611 ◽

Cited By ~ 436

Author(s):

Winnie Yeo ◽

Tung C. Chan ◽

Nancy W.Y. Leung ◽

Wai Y. Lam ◽

Frankie K.F. Mo ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Surface Antigen ◽

Hepatitis B Surface Antigen ◽

B Cell Lymphoma ◽

Anticancer Therapy ◽

Hbv Dna ◽

Core Antigen ◽

Hbv Reactivation ◽

B Virus

Purpose Reactivation of hepatitis B virus (HBV) infection is a well-recognized complication in cancer patients with chronic HBV (hepatitis B surface antigen [HBsAg] positive) undergoing cytotoxic chemotherapy. In patients who have resolved HBV (HBsAg negative and antibody to hepatitis B core antigen [anti-HBc] ± antibody to hepatitis B surface antigen [anti-HBs] positive), such incidence has been much less common until recent use of rituximab. In this study on HBsAg-negative/anti-HBc–positive lymphoma patients, the objectives were to determine the HBV reactivation rate in patients treated with rituximab-containing chemotherapy and to compare it with the rate in patients treated without rituximab. Patients and Methods Between January 2003 and December 2006, all patients diagnosed with CD20+ diffuse large B-cell lymphoma (DLBCL) had HBsAg determined before anticancer therapy. They were treated with either cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) alone or rituximab plus CHOP (R-CHOP). HBsAg-negative patients had anti-HBc determined; serum was stored for anti-HBs and HBV DNA. All patients were observed for HBV reactivation, which was defined as detectable HBV DNA with ALT elevation during and for 6 months after anticancer therapy. Results Among 104 CD20+ DLBCL patients, 80 were HBsAg negative. Of the latter, 46 patients (44.2%) were HBsAg negative/anti-HBc positive; 25 of these patients were treated with CHOP, and none had HBV reactivation. In contrast, among the 21 patients treated with R-CHOP, five developed HBV reactivation, including one patient who died of hepatic failure (P = .0148). Exploratory analysis identified male sex, absence of anti-HBs, and use of rituximab to be predictive of HBV reactivation. Conclusion Among HBsAg-negative/anti-HBc–positive DLBCL patients treated with R-CHOP, 25% developed HBV reactivation. Close monitoring until at least 6 months after anticancer therapy is required, with an alternative approach of prophylactic antiviral therapy to prevent this potentially fatal condition.

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A new method of concentrating hepatitis B virus (HBV) DNA and HBV surface antigen: an application of the method to the detection of occult HBV infection

Vox Sanguinis ◽

10.1111/j.1423-0410.2008.01091.x ◽

2008 ◽

Vol 95 (3) ◽

pp. 174-180 ◽

Cited By ~ 15

Author(s):

K. Satoh ◽

A. Iwata-Takakura ◽

A. Yoshikawa ◽

Y. Gotanda ◽

T. Tanaka ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Surface Antigen ◽

Hbv Dna ◽

Hbv Infection ◽

New Method ◽

Occult Hbv Infection ◽

Occult Hbv ◽

B Virus

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Low Risk of Hepatitis B Virus Reactivation in HBsAg-negative/Anti-HBc–positive Carriers Receiving Rituximab for Rheumatoid Arthritis: A Retrospective Multicenter Italian Study

The Journal of Rheumatology ◽

10.3899/jrheum.151105 ◽

2016 ◽

Vol 43 (5) ◽

pp. 869-874 ◽

Cited By ~ 27

Author(s):

Valentina Varisco ◽

Mauro Viganò ◽

Alberto Batticciotto ◽

Pietro Lampertico ◽

Antonio Marchesoni ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Hepatitis B Surface Antigen ◽

Hbv Dna ◽

Hbv Infection ◽

Core Antigen ◽

Hbv Reactivation ◽

Serum Hbsag ◽

B Virus

Objective.Patients with resolved hepatitis B virus (HBV) infection, i.e., hepatitis B surface antigen (HBsAg)-negative/antihepatitis B core antigen (anti-HBc)-positive, undergoing rituximab (RTX)-based chemotherapy for hematological malignancies without anti-HBV prophylaxis are at risk of HBV reactivation, but the risk in such patients receiving RTX for rheumatological disorders is not clear. We evaluated this risk in HBsAg-negative/anti-HBc–positive patients with rheumatoid arthritis (RA) undergoing RTX without prophylaxis.Methods.Thirty-three HBsAg-negative/anti-HBc–positive outpatients with RA with undetectable HBV DNA by sensitive PCR assay [73% women, median age 60 years, 85% with HBsAg antibodies (anti-HBs), 37% with antihepatitis B envelope antigen] received a median of 3 cycles of RTX (range 1–8) over 34 months (range 0–80) combined with disease-modifying antirheumatic drugs (DMARD) without prophylaxis. All underwent clinical and laboratory monitoring during and after RTX administration, including serum HBsAg and HBV DNA measurements every 6 months or whenever clinically indicated.Results.None of the patients seroreverted to HBsAg during RTX treatment, but 6/28 (21%) showed a > 50% decrease in protective anti-HBs levels, including 2 who became anti-HBs–negative. One patient (3%) who became HBV DNA-positive (44 IU/ml) after 6 months of RTX treatment was effectively rescued with lamivudine before any hepatitis flare occurred. Among the 14 patients monitored for 18 months (range 0–70) after RTX discontinuation, no HBV reactivation was observed.Conclusion.The administration of RTX + DMARD in patients with RA with resolved HBV infection leads to a negligible risk of HBV reactivation, thus suggesting that serum HBsAg and/or HBV DNA monitoring but not universal anti-HBV prophylaxis is justified.

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Prevalence of hepatitis B virus infection in The Netherlands in 1996 and 2007

Epidemiology and Infection ◽

10.1017/s095026881100224x ◽

2011 ◽

Vol 140 (8) ◽

pp. 1469-1480 ◽

Cited By ~ 34

Author(s):

S. J. M. HAHNÉ ◽

H. E. DE MELKER ◽

M. KRETZSCHMAR ◽

L. MOLLEMA ◽

F. R. VAN DER KLIS ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis B Virus ◽

Hepatitis B ◽

The Netherlands ◽

Hepatitis B Surface Antigen ◽

Hbv Dna ◽

Hbv Infection ◽

Core Antigen ◽

Foreign Born ◽

B Virus

SUMMARYWe aimed to assess differences in the prevalence of hepatitis B virus (HBV) infection in The Netherlands between 1996 and 2007, and to identify risk factors for HBV infection in 2007. Representative samples of the Dutch population in 1996 and 2007 were tested for antibodies to hepatitis B core antigen (anti-HBc), hepatitis B surface antigen (HBsAg) and HBV-DNA. In 2007, the weighted anti-HBc prevalence was 3·5% (95% CI 2·2–5·5) and the HBsAg prevalence was 0·2% (95% CI 0·1–0·4). In indigenous Dutch participants, the anti-HBc prevalence was lower in 2007 than in 1996 (P=0·06). First-generation migrants (FGMs) had a 13-fold greater risk of being HBsAg- and/or HBV-DNA-positive than indigenous Dutch participants. In indigenous Dutch participants, risk factors for anti-HBc positivity were older age and having received a blood product before 1990. In FGMs, being of Asian origin was a risk factor. In second-generation migrants, having a foreign-born partner and injecting drug use were risk factors. FGMs are the main target group for secondary HBV prevention in The Netherlands.

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Seroprevalence of Hepatitis B Virus among antenatal clinic attendees in Gamawa Local Government Area, Bauchi State, Nigeria

10.21203/rs.2.10126/v1 ◽

2019 ◽

Author(s):

Garba Umar Mustapha ◽

Abdulrasul Ibrahim ◽

Muhammad Shakir Balogun ◽

Chukwuma David Umeokonkwo ◽

Aisha Indo Mamman

Keyword(s):

Hepatitis B Virus ◽

Local Government ◽

Hepatitis B ◽

Pregnant Women ◽

Surface Antigen ◽

Hepatitis B Surface Antigen ◽

Local Government Area ◽

Hbv Infection ◽

Risk Of Death ◽

B Virus

Abstract Background: Hepatitis B is a potentially life-threatening liver infection and a major global health problem. It causes chronic infection and puts people at high risk of death from cirrhosis and liver cancer. WHO estimated 257 million people are living with hepatitis B virus (HBV) infection and in 2015 alone HBV resulted in to 887,000 deaths globally. We determined the prevalence and associated factors of hepatitis B virus infection among Antenatal Care (ANC) attendees in Gamawa Local Government Area, Bauchi State. Methods: We conducted a descriptive cross-sectional, health facility-based study between March and April 2018. We used systematic random sampling technique to recruit 210 pregnant women aged 15-49 years. With a structured questionnaire, we interviewed the respondents and collected blood sample to test for hepatitis B surface antigen. We calculated frequencies, means, proportions, and tested for associations using Epi Info 7.2 and Microsoft Excel. Results: The mean age of respondents was 24.5 ± 6.0 years; 53.3% of whom were younger than 25 years. All were married, 87.1% had no formal education and up to 90.5% were employed. Overall, 6.7% tested positive for HBsAg; women aged ≥35 years had the highest prevalence (10.5%). None with tertiary education tested positive and women married before 18 years had 6.5% prevalence. Conclusions: The prevalence of HBsAg among pregnant women in Gamawa LGA was 6.7% which is quite lower than the national prevalence reported. We recommended improved surveillance of HBV infection and screening of women attending ANC. Keywords: Hepatitis B virus, Hepatitis B Surface antigen, Prevalence, Pregnancy, Health facilities, Hepatitis B

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Hepatitis B Virus Reactivation by Immunosuppressive Therapy in Patients with Autoimmune Diseases: Risk Analysis in Hepatitis B Surface Antigen-negative Cases

The Journal of Rheumatology ◽

10.3899/jrheum.110289 ◽

2011 ◽

Vol 38 (10) ◽

pp. 2209-2214 ◽

Cited By ~ 32

Author(s):

MASARU KATO ◽

TATSUYA ATSUMI ◽

TAKASHI KURITA ◽

TOSHIO ODANI ◽

YUICHIRO FUJIEDA ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Autoimmune Diseases ◽

Immunosuppressive Therapy ◽

Surface Antigen ◽

Hepatitis B Surface Antigen ◽

Hbv Dna ◽

Core Antigen ◽

Hbv Reactivation ◽

B Virus

Objective.To evaluate the risk of reactivation of resolved hepatitis B virus (HBV) by immunosuppressive therapy in patients with autoimmune diseases.Methods.Thirty-five patients with autoimmune diseases were included in our study; all were hepatitis B surface antigen (HBsAg)-negative and antibody against hepatitis B core antigen-positive. They were followed for 8–124 weeks and clinical outcomes were analyzed, including serum levels of HBV-DNA and aminotransferase every 4 weeks during their immunosuppressive therapy for underlying autoimmune diseases. If HBV-DNA was detected during the immunosuppressive therapy, HBsAg, antibody against HBsAg (anti-HBs), hepatitis B e antigen (HBeAg), and antibody against HBeAg were also monitored every 4 weeks.Results.HBV-DNA was detected in 6 out of 35 patients. Anti-HBs titer was significantly lower in the patients in whom HBV-DNA was detected compared with the others at baseline: 2.83 (range 0.24–168.50) mIU/ml vs 99.94 (range 0.00–5342.98) mIU/ml, respectively (p = 0.036). Outcomes of the 6 patients with HBV reactivation were as follows: HBV-DNA turned negative in 2 patients without nucleic acid analog (NAA) and 1 with NAA; 2 died due to bacterial sepsis; and 1 died due to autoimmune hemolytic anemia. Significant elevation of aminotransferase was found in only 1 patient, but HBsAg converted to positive in 2 patients and HBeAg converted to positive in 1 patient.Conclusion.Reactivation of resolved HBV can occur during standard immunosuppressive therapy for autoimmune diseases. The low titer of baseline anti-HBs may carry its risk.

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