A bird’s eye view: Sexual health adviser coordination of contact tracing for hepatitis B

2021 ◽  
Vol 32 (5) ◽  
pp. 476-478
Author(s):  
Sam King ◽  
Martin Murchie ◽  
Jenny Dalrymple
Keyword(s):  
Hepatitis B ◽  
Sexual Health ◽  
Index Case ◽  
Hepatitis B Surface Antigen ◽  
Contact Tracing ◽  
Health Board ◽  
Natural Immunity ◽  
Retrospective Audit ◽  
Sexual Contacts ◽  
Disproportionate Burden

An National Health Service sexual health adviser led service to facilitate management of new cases of hepatitis B from all settings across a large Scottish health board was initiated in 2012. Sexual health advisers contacted testing clinicians to support referral into appropriate services and facilitate identification, testing and vaccination of sexual partners, family and household contacts. A retrospective audit of contact tracing outcomes was conducted between September 2012 and December 2019. From a total of 1344 people diagnosed with hepatitis B, 2248 household and sexual contacts were identified. A documented outcome was established for 1741 (78%) of contacts, equalling 1.3 per index case. 257 (11%) of traced contacts were hepatitis B surface antigen positive, 162 (7%) had natural immunity and 1222 (54%) were vaccinated, either before or after contact tracing. This suggests a multi-agency approach to contact tracing for hepatitis B can achieve good outcomes. Further work is required to reduce the disproportionate burden of hepatitis B among ethnic minority subpopulations in Scotland.

Prevention of Hepatitis B Virus Infections

PEDIATRICS ◽  
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.

scholarly journals Estimation of the Secondary Attack Rate for Delta Hepatitis Coinfection among Injection Drug Users

1993 ◽  
Vol 4 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Christiane Poulin ◽  
Theresa Gyorkos ◽  
Lawrence Joseph
Keyword(s):  
Nova Scotia ◽  
Hepatitis B ◽  
Confidence Interval ◽  
Rural Area ◽  
Attack Rate ◽  
Injection Drug Users ◽  
Drug Users ◽  
Index Case ◽  
Injection Drug ◽  
Contact Tracing

The secondary attack rate for delta hepatitis coinfection was estimated among a cluster of injection drug users (IDUs). The infections occurred during an epidemic of hepatitis B in a rural area of Nova Scotia in 1988 and 1989. Six IDUs formed a cluster of delta hepatitis coinfections, representing the first reported outbreak of delta hepatitis in Canada. Contact-tracing was used to identify a cluster of 41 IDUs potentially exposed to delta hepatitis. The index case of delta hepatitis coinfection was presumed to have led to five secondary cases. The secondary attack rate was estimated to be 13.2% (95% confidence interval 0.044 to 0.281). The estimated secondary attack rate may be a useful predictor of disease due to delta hepatitis coinfection in similar IDU populations.

How can we improve hepatitis B testing and management in primary care? A cross-sectional survey of GPs in England, 2015–2017

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697241
Author(s):  
Z Amin ◽  
K Beebeejaun ◽  
L Letley ◽  
B Mahange ◽  
K Harrington ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
Treatment Options ◽  
Hbv Infection ◽  
Contact Tracing ◽  
Cross Sectional Survey ◽  
Cross Sectional

BackgroundChronic hepatitis B (HBV) infection can lead to life-threatening liver disease. In the UK, approximately 180,000 people are carriers. The disease is underdiagnosed and undertreated.AimAs part of a nurse-led intervention aimed at improving HBV contact-tracing and management, we ascertained GPs’ understanding of HBV and their perceived barriers and enablers to HBV diagnosis.MethodIn 2015, we asked 1324 GPs across 2 England regions about HBV-related knowledge and practice, using a questionnaire. We reported the proportion of GPs answering each question, with 95% confidence intervals (95% CI).Results254 GPs (18%) replied. Of those, 189(74%, 95%CI 68–79%) correctly identified hepatitis B surface antigen as a marker of current HBV infection, and 154 (61%, 95% CI = 54 to 66%) recognised IgM anti-HBc as a marker for differentiating acute from chronic cases. 219 GPs (86%, 95% CI = 81 to 90%) believed HBV knowledge among patients to be one of the main enablers to improved testing uptake and 208 (82%, 95% CI = 77 to 86%) identified lack of HBV knowledge among patients as a barrier to testing. Of all GP responders, 227 (89%, 95% CI = 85 to 93%) reported HBV training and education would be beneficial, and 185 (73%, 95% CI = 67 to 78%) reported knowledge of treatment options as a knowledge gap.ConclusionGPs perceive gaps in knowledge among patients and healthcare professionals as a factor potentially contributing to the under-ascertainment of chronic hepatitis B in England. Improving HBV awareness and knowledge among patients, their contacts, and increasing HBV-focused training for GPs, particularly in the interpretation of laboratory results and the treatment options, can improve case ascertainment and chronic HBV management in primary care.

Analysis of chlamydia contacts and the look-back interval at a UK sexual health clinic

2021 ◽  
Vol 32 (6) ◽  
pp. 533-537
Author(s):  
Catherine Turner ◽  
Sally E Howlett ◽  
Hannah Loftus
Keyword(s):  
Sexual Health ◽  
Sexual Intercourse ◽  
Index Case ◽  
Contact Tracing ◽  
Health Clinic ◽  
Significant Difference ◽  
Look Back ◽  
The Look ◽  
The Relationship ◽  
Current Guidelines

Guidance on contact tracing in Chlamydia trachomatis (CT) is limited. CT contacts data over 12 months (1 December 2018–29 November 2019) at a UK sexual health clinic were analysed to determine the appropriateness of the currently recommended six-month ‘look-back’ interval. Age and sex of CT contacts were associated with clinical outcomes. Subgroups of 100 CT positive/negative contacts (each N = 100) were randomly selected. The relationship between time since sexual intercourse with the index case (Last Sexual Intercourse; LSI) and CT positivity was examined; suitability of varying look-back intervals was explored. Of 891 CT contacts (mean age = 25.0 years, 66.2% men), 66.9% tested positive for CT. Positive CT contacts were significantly younger (23.8 ± 6.8 years vs. 27.4 ± 9.1, p < 0.001) and more often women (36.4% vs. 28.5%, p = 0.018) than negative contacts. In the subgroups, the Mann–Whitney U test revealed no significant difference between the LSI of positive and negative contacts ( p = 0.081). 95% of positive CT contacts ( N = 82) were captured within a hypothetical three-month look-back interval. While most CT positive contacts were captured within three months, they appeared to remain proportionately represented beyond this point. Although this supports current guidelines, further research should investigate whether CT contacts involved in longer look-back intervals may require disproportionately greater resources to trace.

scholarly journals Does a clinical guideline change chlamydia testing? Report from the Waikato Chlamydia Project

2012 ◽  
Vol 4 (1) ◽  
pp. 45 ◽  
Author(s):  
Jane Morgan ◽  
Andre Donnell ◽  
Anita Bell
Keyword(s):  
Health Care ◽  
New Zealand ◽  
Sexual Health ◽  
Care Delivery ◽  
Guideline Implementation ◽  
Contact Tracing ◽  
Health Board ◽  
Local Data ◽  
District Health ◽  
Chlamydia Testing

BACKGROUND AND CONTEXT: Waikato District Health Board was one of three districts chosen to implement a national chlamydia management guideline, with the aim of optimising testing and treatment. Previous New Zealand studies suggest any test increases associated with such an intervention may be short-lived. ASSESSMENT OF PROBLEM: District-wide chlamydia test volumes were compared for three periods, before (June–Nov 2008), during (June–Nov 2009) and after (June–Nov 2010) guideline implementation by age, gender and ethnicity. Crude estimates of population test uptake were calculated. Azithromycin pharmacy claim volumes were assessed as a measure of treatment. RESULTS: Chlamydia test uptake for women was already high, with 23% of 15- to 24-year-old women tested during the period from June to November 2008. Although tests from under-25-year-olds increased during implementation in 2009, the change was not significant and was not sustained in 2010, p=0.06. Similarly, there were no significant sustained changes by gender or ethnicity following implementation. STRATEGIES FOR IMPROVEMENT: This includes a continued emphasis on optimal chlamydia case finding and treatment by focusing on those at greater risk of infection. Efforts to improve partner notification should be instigated which may in turn better engage men around sexual health. LESSONS: Local data should be used to identify local issues. There is a need to determine whether <25 years is the optimal age threshold for targeted chlamydia testing in New Zealand and to ensure appropriate resources, training and support are in place for primary care nurses who play a pivotal role in sexual health care delivery. Keywords: Chlamydia trachomatis; mass screening; practice guidelines; primary health care; contact tracing

scholarly journals Prevalence and associated risk factors for hepatitis B and C viruses among refugee populations living in Mahama, Rwanda: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257917
Author(s):  
Innocent Kamali ◽  
Dale A. Barnhart ◽  
Jean d’Amour Ndahimana ◽  
Kassim Noor ◽  
Jeanne Mumporeze ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
Household Contact ◽  
Contact Tracing ◽  
Cross Sectional ◽  
Adjusted Risk ◽  
History Of ◽  
Age And Sex

Introduction As part of the integration of refugees into Rwanda’s national hepatitis C elimination agenda, a mass screening campaign for hepatitis B (HBV) and hepatitis C (HCV) was conducted among Burundian refugees living in Mahama Camp, Eastern Rwanda. This cross-sectional survey used data from the screening campaign to report on the epidemiology of viral hepatitis in this setting. Methods Rapid diagnostic tests (RDTs) were used to screen for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV) among people of ≥15years old. We calculated seroprevalence for HBsAg and anti-HCV by age and sex and also calculated age-and-sex adjusted risk ratios (ARR) for other possible risk factors. Results Of the 26,498 screened refugees, 1,006 (3.8%) and 297 (1.1%) tested positive for HBsAg and Anti-HCV, respectively. HBsAg was more prevalent among men than women and most common among people 25–54 years old. Anti-HCV prevalence increased with age group with no difference between sexes. After adjusting for age and sex, having a household contact with HBsAg was associated with 1.59 times higher risk of having HBsAg (95% CI: 1.27, 1.99) and having a household contact with anti-HCV was associated with 3.66 times higher risk of Anti-HCV (95% CI: 2.26, 5.93). Self-reporting having HBV, HCV, liver disease, or previously screened for HBV and HCV were significantly associated with both HBsAg and anti-HCV, but RDT-confirmed HBsAg and anti-HCV statuses were not associated with each other. Other risk factors for HBsAg included diabetes (ARR = 1.97, 95% CI: 1.08, 3.59) and family history of hepatitis B (ARR = 1.32, 95% CI: 1.11, 1.56) and for anti-HCV included heart disease (ARR = 1.91, 95% CI: 1.30, 2.80) and history of surgery (ARR = 1.70, 95% CI: 1.24, 2.32). Conclusion Sero-prevalence and risks factors for hepatitis B and C among Burundian were comparable to that in the Rwandan general population. Contact tracing among household members of identified HBsAg and anti-HCV infected case may be an effective approach to targeted hepatitis screening given the high risk among self-reported cases. Expanded access to voluntary testing may be needed to improve access to hepatitis treatment and care in other refugee settings.

IL10 Promotorpolymorphismen beeinflussen die Hepatitis B Surface Antigen und die Hepatitis A spezifische Immunantwort

2015 ◽  
Vol 41 (08) ◽  
Author(s):  
E Reuss ◽  
N Evers ◽  
N Dietrich ◽  
J Vollmar ◽  
PM Schneider ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Surface Antigen ◽  
Hepatitis A ◽  
Hepatitis B Surface Antigen

Effects of Vancomycin on Platelets, Plasma Proteins and Hepatitis B Surface Antigen

1975 ◽  
Vol 34 (01) ◽  
pp. 083-093 ◽  
Author(s):  
Barry S Coller ◽  
W. B Lundberg ◽  
Harvey R Gralnick
Keyword(s):  
Hepatitis B ◽  
Factor Viii ◽  
Surface Antigen ◽  
Plasma Proteins ◽  
Hepatitis B Surface Antigen ◽  
Infusion Site ◽  
Vancomycin Therapy ◽  
Intravenous Injections ◽  
Low Concentrations ◽  
High Doses

SummaryThe antibiotic vancomycin shares many similarities with ristocetin, an agent noted for its effects on platelets and plasma fibrinogen. Vancomycin did not aggregate platelets as ristocetin, but platelets were incorporated into precipitates induced by vancomycin. Fibrinogen and factor VIII were precipitated from plasma at low concentrations of vancomycin. The precipitated fibrinogen remained clottable. Hepatitis B surface antigen was selectively precipitated from serum and could be recovered from the precipitate. Rabbits receiving bolus intravenous injections of high doses of vancomycin developed hypofibrinogenemia and thrombocytopenia within minutes and often went on to die. Studies with 125I-vancomycin revealed little stable binding of the antibiotic to platelets or fibrinogen. A relationship is suggested between the potent protein precipitating effects and phlebitis at the infusion site commonly associated with vancomycin therapy.

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