Immunisation of infants at risk of perinatal transmission of hepatitis B: retrospective audit of vaccine uptake

Abstract Background The paucity of hepatitis B virus (HBV) DNA measurement in low-/middle-income countries hinders the identification of HBV-infected pregnant women at risk of perinatal transmission. This study evaluates the validity of an algorithm selecting HBeAg-positive women and HBeAg-negative women with alanine aminotransferase (ALT) ≥40 IU/L as a predictor of high HBV DNA level. Methods All women with reactive samples for hepatitis B surface antigen (HBsAg) were assessed with an SD BIOLINE HBeAg rapid test and HBV DNA quantification was performed. Validities of HBeAg and of the algorithm to identify HBV DNA >2 thresholds (5.3 and 7.3 log10 IU/mL) were evaluated. Results For the 515 HBsAg-positive women, median age was 29 years, 92 (17.9%) were HBeAg positive, 47 (9.1%) were HBeAg negative with ALT ≥40 IU/L, and 144 (28.0%) had an HBV DNA >5.3 log10 IU/mL. Sensitivity and specificity of HBeAg were 61.8% and 99.2% for HBV DNA >5.3 log10 IU/mL and 81.3% and 96.7% for HBV DNA >7.3 log10 IU/mL. For the algorithm, sensitivity and specificity were 79.2% and 93.3% for HBV DNA level >5.3 log10 IU/mL and 92.7% and 88.1% for HBV DNA >7.3 log10 IU/mL. The AUCs for the algorithm (0.92 and 0.94 for HBV DNA >5.3 and 7.3, respectively) were significantly greater (P < .001) than the AUCs for HBeAg (0.81 and 0.89 for HBV DNA >5.3 and 7.3, respectively). Conclusions An algorithm using HBeAg and ALT level could be an effective strategy to identify HBV-infected pregnant women at risk of perinatal transmission in countries where HBV DNA quantification is not routinely available.

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Post-vaccination serological test results of infants at risk of perinatal transmission of hepatitis B using an intensified follow-up programme in a London centre

Vaccine ◽

10.1016/j.vaccine.2013.04.083 ◽

2013 ◽

Vol 31 (31) ◽

pp. 3174-3178 ◽

Cited By ~ 11

Author(s):

Cheuk Y.W. Tong ◽

Carol Robson ◽

Yin Wu ◽

Rozanna Issa ◽

Timothy Watts ◽

...

Keyword(s):

At Risk ◽

Hepatitis B ◽

Serological Test ◽

Perinatal Transmission ◽

Test Results ◽

Post Vaccination

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A Retrospective Audit of Hepatitis B Management in the GU Clinic.

10.26226/morressier.5731a407d462b8028d88ca12 ◽

2016 ◽

Author(s):

Elizabeth Nicol

Keyword(s):

Hepatitis B ◽

Retrospective Audit

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Hepatitis B virus infection, knowledge and vaccine uptake among hairdressers in Ikorodu, Lagos State

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1442 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

B A Aina ◽

O A Olutoye

Keyword(s):

Risk Perception ◽

Hepatitis B ◽

Occupational Risk ◽

Vaccine Uptake ◽

Beauty Salon ◽

B Virus ◽

Level Of Knowledge ◽

Transmission Prevention ◽

Hbsag Screening ◽

Hbv Transmission

Abstract Background Hepatitis B is a major public health concern. Hepatitis B virus (HBV) continues to thrive in developing countries including Nigeria. Occupationally exposed persons like people working in women's beauty salon are at high risk of HBV infection and may play a critical role in the disease transmission via contaminated needles and sharps. The aim of this study therefore was to estimate HBV infection, knowledge level, occupational risk perception and vaccine uptake among people working in women's beauty salons. Also to get them screened and encourage those that are negative to get vaccinated to curb the spread of this infection. Methods This was a cross-sectional study carried out on 199 people working in women's beauty salons in Ikorodu Local government area of Lagos State. HBsAg screening using a rapid diagnostic test kit was carried out for all respondents to determine their infection status. Questionnaire which assessed their knowledge level and occupational risk perception were completed by trained interviewers and data was analysed using SPSS software. Results The result of this study showed that only 2.01% respondents tested positive for the HBsAg screening. Majority of the respondents (69.3%) have poor knowledge about HBV transmission, prevention and vaccine. While most (78.9%) of the respondents don't know their occupational risk of exposure to HBV, 9.0% rated themselves at high risk of occupational exposure. Significant association was observed between level of knowledge and risk perception (P < 0.001). The level of vaccine uptake was very poor as only 1 out of 199 respondents has taken 3 doses of HBV vaccine, 60.9%(120) have not been vaccinated. Conclusions The respondents exhibited poor level of knowledge about HBV transmission, prevention, vaccination and went about their occupation without adequate protection form HBV. Key messages Screening of people working in women beauty salon is highly imperative to identify those with infection so that they can be treated on time while those that are negative should be vaccinated. Due to the potential roles of people working in women’s beauty salon in HBV transmission, education programs and vaccine coverage policy should be adopted for people in this occupation.

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Reduced doses of hepatitis B immune globulin in the prevention of perinatal transmission of hepatitis B

Journal of Medical Virology ◽

10.1002/jmv.1890210402 ◽

1987 ◽

Vol 21 (4) ◽

pp. 301-309 ◽

Cited By ~ 1

Author(s):

Tsang-Ming Ko ◽

Fon-Jou Hsieh ◽

Chih-Liang Yaung ◽

Ding-Shinn Chen ◽

Kai-Hsin Lin ◽

...

Keyword(s):

Hepatitis B ◽

Immune Globulin ◽

Perinatal Transmission ◽

Hepatitis B Immune Globulin

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Prevention of Hepatitis B Virus Infections

PEDIATRICS ◽

10.1542/peds.75.2.362 ◽

1985 ◽

Vol 75 (2) ◽

pp. 362-364

Author(s):

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Hepatitis B Surface Antigen ◽

Far East ◽

Perinatal Transmission ◽

Perinatal Infection ◽

Virus Infections ◽

B Virus ◽

Sexual Contacts ◽

Hepatitis B Virus Infections

Infants born to mothers who are hepatitis B surface antigen (HBsAg) positive are frequently infected with hepatitis B virus (HBV). Many of these newborns will become chronic carriers of HBV and will subsequently develop chronic liver disease. Recent studies have demonstrated that perinatal transmission can be prevented by immunization of the newborn. Recommendations for the management of infants at risk are presented. PERINATAL TRANSMISSION OF HBV INFECTIONS Perinatal infection of infants by mothers who are HBsAg positive is most likely to occur if mothers are also hepatitis Be antigen positive. About 90% of infants whose mothers are positive for both markers will become infected and most will become permanent carriers.1 Infants whose mothers are HBeAg negative or who have antibody to HBeAg are at lesser risk, but can still be infected.2 Infected infants usually will not become HBsAg positive until several weeks after birth. Although clinical jaundice or acute hepatitis are rare in infected infants, elevations in transaminase levels are frequent.3 It is estimated that about one in four infants who become chronic carriers following perinatal infection will develop cirrhosis or hepatocellular carcinoma later in life. As they are persistent carriers, later in life they may transmit infection to other family members, to sexual contacts, or to others by transfusions or inoculation of their blood. Infection of female infants may eventually result in transmission of HBV to their own infants. Indeed, transmission from mother to infant is a major method of perpetuation of this virus in hyperendemic areas, eg, the Far East.

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Southern African guidelines for the safe use of pre-exposure prophylaxis in men who have sex with men who are at risk for HIV infection

Southern African Journal of HIV Medicine ◽

10.4102/sajhivmed.v13i2.136 ◽

2012 ◽

Vol 13 (2) ◽

Cited By ~ 2

Author(s):

Southern African HIV Clinicians Society Consensus Committee

Keyword(s):

At Risk ◽

Renal Function ◽

Hiv Prevention ◽

Hepatitis B ◽

Hiv Infection ◽

Creatinine Clearance ◽

Fixed Dose ◽

Sex With Men ◽

Exposure Prophylaxis ◽

Hiv Negative

Background. The use of oral antiretrovirals to prevent HIV infection among HIV-negative men who have sex with men (MSM) has been shown to be safe and efficacious. A large, randomised, placebo-controlled trial showed a 44% reduction in the incidence of HIV infection among MSM receiving a daily oral fixed-dose combination of tenofovir disoproxil fumarate and emtricitabine (Truvada) in combination with an HIV prevention package. Improved protection was seen with higher levels of adherence. Aim. The purpose of this guideline is to: (i) explain what pre-exposure prophylaxis (PrEP) is; (ii) outline current indications for its use; (iii) outline steps for appropriate client selection; and (iv) provide guidance for monitoring and maintaining clients on PrEP. Method. PrEP is indicated for HIV-negative MSM who are assessed to be at high risk for HIV acquisition and who are willing and motivated to use PrEP as part of a package of HIV prevention services (including condoms, lubrication, sexually transmitted infection (STI) management and risk reduction counselling). Recommendations. HIV testing, estimation of creatinine clearance and STI and hepatitis B screening are recommended as baseline investigations. Daily oral Truvada, along with adherence support, can then be prescribed for eligible MSM. PrEP should not be given to MSM with abnormal renal function, nor to clients who are unmotivated to use PrEP as part of an HIV prevention package; nor should it be commenced during an acute viral illness. Three-monthly follow-up visits to assess tolerance, renal function, adherence and ongoing eligibility is recommended. Six-monthly STI screens and annual creatinine levels to estimate creatinine clearance are recommended. Hepatitis B vaccination should be provided to susceptible clients. Gastro-intestinal symptoms and weight loss are common side-effects, mostly experienced for the first 4 - 8 weeks after initiating PrEP. There is a risk of the development of antiretroviral resistance among those with undiagnosed acute HIV infection during PrEP initiation and among those with sub-optimal adherence who become HIV infected while on PrEP. Risk compensation (increasing sexual behaviours that can result in exposure to HIV) while on PrEP may become a concern, and clinicians should continue to support MSM clients to continue to use condoms, condom-compatible lubrication and practice safer sex. Research is ongoing to assess optimum dosing regimens, potential long-term effects and alternative PrEP medications. Recommendations for the use of PrEP among other at-risk individuals, and the components of these recommendations, will be informed by future evidence. S Afr J HIV Med 2012;13(2):40-55.

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