scholarly journals Models to Predict Hepatitis B Virus Infection Among Patients With Cancer Undergoing Systemic Anticancer Therapy: A Prospective Cohort Study

2018 ◽  
Vol 36 (10) ◽  
pp. 959-967 ◽  
Author(s):  
Jessica P. Hwang ◽  
Anna S. Lok ◽  
Michael J. Fisch ◽  
Scott B. Cantor ◽  
Andrea Barbo ◽  
...  
Keyword(s):  
United States ◽  
Cohort Study ◽  
Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
Anticancer Therapy ◽  
The United States ◽  
Hbv Infection ◽  
Patients With Cancer ◽  
Screening Strategies ◽  
B Virus

Purpose Most patients with cancer are not screened for hepatitis B virus (HBV) infection before undergoing anticancer therapy, and optimal screening strategies are unknown. We sought to develop selective HBV screening strategies for patients who require systemic anticancer therapy. Methods This prospective cohort study included adults age ≥ 18 years with solid or hematologic malignancies who received systemic anticancer therapy at a comprehensive cancer center during 2013 and 2014. Patients underwent hepatitis B surface antigen, hepatitis B core antibody, and hepatitis B surface antibody testing, and completed a 19-question modified Centers for Disease Control and Prevention (CDC) HBV survey. Multivariable models that predict chronic or past HBV infection were developed and validated using bootstrapping. Results A total of 2,124 patients (mean age, 58 ± 13 years) completed the risk survey and HBV testing. Of these, 54% were women; 77% were non-Hispanic white, 11% Hispanic, 8% black, and 4% Asian; and 20% had a hematologic malignancy and 80% a solid tumor. Almost 12% were born outside the United States. The prevalence was 0.3% for chronic HBV infection and 6% for past HBV infection. Significant predictors of positive hepatitis B surface antigen or hepatitis B core antibody tests were as follows: men who had sex with men, black or Asian race, birthplace outside the United States, parent’s birthplace outside the United States, household exposure to HBV, age ≥ 50 years, and history of injection drug use. The area under the receiver operating characteristic curve of the model on the basis of these seven predictors was 0.79 (95% CI, 0.73 to 0.82). The modified CDC survey and brief tools with fewer than seven questions yielded similar false-negative rates (0% and 0% to 0.7%, respectively). Conclusion An internally validated risk tool performed as well as the modified CDC survey; however, more than 90% of patients who completed the tool would still require HBV testing. Universal HBV testing is more efficient than risk-based screening.

scholarly journals 1066. Immune Escape Mutant Detection Using Commercially Available Methods for Hepatitis B Surface Antigen Serological Testing

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S562-S562
Author(s):  
Robert Gish ◽  
Vincent Streva
Keyword(s):  
Hepatitis B ◽  
Immune Escape ◽  
Hepatitis B Surface Antigen ◽  
Panel Member ◽  
The United States ◽  
Hbv Infection ◽  
Hepatitis B Vaccination ◽  
Review Panel ◽  
B Virus ◽  
Escape Mutants

Abstract Background Although overall infection rates of Hepatitis B virus (HBV) in the United States (US) remain stable, as many as 2.2 million persons are still chronically infected with Hepatitis B Virus (HBV)1. Persons who inject drugs (PWID) are at a higher risk of HBV infection and since 2009 three states (KY, TN, WV) have reported up to a 114% increase in cases of acute HBV infection due to higher infection rates among a non-Hispanic white populations (30–39 years), and injection drug users2. Hepatitis B vaccination is recommended as primary prevention for adults who are at increased risk for HBV infection, including PWID. However, data from the National Health Interview Survey indicate that hepatitis B vaccination coverage is low among adults in the general population3, and it is likely to be lower among injection drug users. Hepatitis B Surface Antigen (HBsAg) is the first serological marker to appear after HBV exposure and infection; this marker is included in the recommended panel for acute hepatitis diagnosis and accurate detection is necessary for early and accurate diagnosis. Serological testing challenges exist for HBsAg due to the high degree of genetic variability which can further be exacerbated by endogenous and exogenous pressures. The immuno-dominant region may have one or more mutations described as immune escape mutations which can decrease or abrogate HBsAg binding to antibodies used in immunoassays. Although the prevalence of these mutations is not well documented in the United States, international studies have shown that up to 79% of HBV-reactivated patients (vs 3.1% of control patients; p< 0.001) carry HBsAg mutations localized in immune-active HBsAg regions4. Methods A study was conducted using a panel of 10 unique recombinant HBsAg immune escape mutants. Panel members were tested by commercially available HBsAg serological immunoassays. Results It was found that although commercially available HBsAg immunoassays are the primary diagnostic tool for HBV diagnosis, not all HBsAg immune escape mutants are detected, with some method detecting as few as 5 out of 10 of these mutant samples. Figure 1 Conclusion Improvement is needed in commercially available methods for the accurate detection of HBsAg. Disclosures Robert Gish, MD, Abbott (Consultant)AbbVie (Consultant, Advisor or Review Panel member, Speaker’s Bureau)Access Biologicals (Consultant)Antios (Consultant)Arrowhead (Consultant)Bayer (Consultant, Speaker’s Bureau)Bristol Myers (Consultant, Speaker’s Bureau)Dova (Consultant, Speaker’s Bureau)Dynavax (Consultant)Eiger (Consultant, Advisor or Review Panel member)Eisai (Consultant, Speaker’s Bureau)Enyo (Consultant)eStudySite (Consultant, Advisor or Review Panel member)Exelixis (Consultant)Fujifilm/Wako (Consultant)Genentech (Consultant)Genlantis (Consultant)Gilead (Consultant, Advisor or Review Panel member, Speaker’s Bureau)GLG (Consultant)HepaTX (Consultant, Advisor or Review Panel member)HepQuant (Consultant, Advisor or Review Panel member)Intercept (Consultant, Speaker’s Bureau)Ionis (Consultant)Janssen (Consultant)Laboratory for Advanced Medicine (Consultant)Lilly (Consultant)Merck (Consultant)Salix (Consultant, Speaker’s Bureau)Shionogi (Consultant, Speaker’s Bureau)Viking (Consultant)

scholarly journals Hepatitis B Virus: Advances in Prevention, Diagnosis, and Therapy

2020 ◽  
Vol 33 (2) ◽  
Author(s):  
Mindie H. Nguyen ◽  
Grace Wong ◽  
Edward Gane ◽  
Jia-Horng Kao ◽  
Geoffrey Dusheiko
Keyword(s):  
United States ◽  
Hepatitis B Virus ◽  
Natural History ◽  
Hepatitis B ◽  
Linkage To Care ◽  
The United States ◽  
Hbv Infection ◽  
Care Providers ◽  
Curative Therapy ◽  
B Virus

SUMMARY Currently, despite the use of a preventive vaccine for several decades as well as the use of effective and well-tolerated viral suppressive medications since 1998, approximately 250 million people remain infected with the virus that causes hepatitis B worldwide. Hepatitis C virus (HCV) and hepatitis B virus (HBV) are the leading causes of liver cancer and overall mortality globally, surpassing malaria and tuberculosis. Linkage to care is estimated to be very poor both in developing countries and in high-income countries, such as the United States, countries in Western Europe, and Japan. In the United States, by CDC estimates, only one-third of HBV-infected patients or less are aware of their infection. Some reasons for these low rates of surveillance, diagnosis, and treatment include the asymptomatic nature of chronic hepatitis B until the very late stages, a lack of curative therapy with a finite treatment duration, a complex natural history, and a lack of knowledge about the disease by both care providers and patients. In the last 5 years, more attention has been focused on the important topics of HBV screening, diagnosis of HBV infection, and appropriate linkage to care. There have also been rapid clinical developments toward a functional cure of HBV infection, with novel compounds currently being in various phases of progress. Despite this knowledge, many of the professional organizations provide guidelines focused only on specific questions related to the treatment of HBV infection. This focus leaves a gap for care providers on the other HBV-related issues, which include HBV’s epidemiological profile, its natural history, how it interacts with other viral hepatitis diseases, treatments, and the areas that still need to be addressed in order to achieve HBV elimination by 2030. Thus, to fill these gaps and provide a more comprehensive and relevant document to regions worldwide, we have taken a global approach by using the findings of global experts on HBV as well as citing major guidelines and their various approaches to addressing HBV and its disease burden.

Adoption of Hepatitis B Virus-Infected Foreign-Born Children

PEDIATRICS ◽  
1990 ◽  
Vol 85 (5) ◽  
pp. 890-891
Author(s):  
RONALD J. SOKOL
Keyword(s):  
United States ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
South America ◽  
The United States ◽  
Hbv Infection ◽  
Foreign Born ◽  
B Virus ◽  
High Incidence ◽  
Central South

To the Editor.— Hostetter et al1 confirmed recent reports2-5 of the relatively high incidence of hepatitis B virus (HBV) infection among foreign-born children who are adopted in the United States. Approximately 5% to 15% of adopted infants from Asia, India, and Central/South America are found to have active HBV infection or to be asymptomatic carriers.1-5 Although some information is provided to prospective parents by adoption agencies discussing the possibility of a number of diseases (including HBV infection) in the foreign-born infants, few parents, in our experience, felt that they were adequately informed about the true risk and the potential social and medical consequences of HBV infection before the placement of the child in their home.

Hepatitis B Immunization in Infants of Hepatitis B Surface Antigen-Negative Mothers

PEDIATRICS ◽  
1993 ◽  
Vol 92 (5) ◽  
pp. 717-719 ◽  
Author(s):  
GAETANO CHIRICO ◽  
CESARE BELLONI ◽  
ANTONELLA GASPARONI ◽  
ROSA MARIA CERBO ◽  
GIORGIO RONDINI ◽  
...  
Keyword(s):  
United States ◽  
High Risk ◽  
Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
The United States ◽  
American Academy Of Pediatrics ◽  
B Virus ◽  
Selective Strategy ◽  
High Risk Populations ◽  
Vaccine Availability

The American Academy of Pediatrics (AAP) Committee on Infectious Diseases and the Immunization Practices Advisory Committee of the Centers for Disease Control have recently pointed out that the selective strategy of immunization against hepatitis B virus (HBV) of high-risk populations has not resulted in the limitation of the diffusion of the disease. In fact, in spite of vaccine availability for more than 10 years, about 200 000 to 300 000 new cases of infection occur in the United States each year. Therefore, the AAP recommended the "universal hepatitis B immunization" strategy as a means to control the disease.1,2 In Italy, where about 400 000 new cases of infection are expected each year, the vaccination has been extended to all newborns, regardless of mother's serologic status (and, for the first 12 years, to all 12-year-old adolescents), with a law promulgated in May 1991.

scholarly journals 2303. Chronic Hepatitis B Virus Infection and Risk of Herpes Zoster: A Cohort Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S789-S789
Author(s):  
Haesuk Cheong ◽  
Bomi Kim ◽  
Eun Jeong Joo ◽  
YooSoo Chang ◽  
Seungho Yoo
Keyword(s):  
Cohort Study ◽  
Herpes Zoster ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
Hbv Infection ◽  
Chronic Hepatitis B Virus ◽  
B Virus ◽  
Hbsag Seropositivity ◽  
Incident Cases

Abstract Background No cohort studies have evaluated the effect of hepatitis B virus (HBV) infection on the risk of herpes zoster. We investigated the association of HBV infection with the development of herpes zoster. Methods We performed a cohort study of 224,691 non-cirrhotic adult men and women free of herpes zoster at baseline who underwent serologic testing for hepatitis B surface antigen (HBsAg) and were followed annually or biennially for a median of 4.2 years. Incident cases of herpes zoster were ascertained using the Korean Health Insurance and Review Agency (HIRA) database. A Cox proportional hazard model was used to estimate the adjusted hazard ratio (aHR) with 95% confidence interval (CI) for incident herpes zoster according to HBsAg seropositivity status. Results During 830,073.4 person-years of follow-up, 11,061 cases of incident herpes zoster were identified. HBsAg seropositivity was inversely associated with the development of herpes zoster. After adjustment for possible confounders, the multivariable-adjusted hazard ratios (95% CI) for herpes zoster comparing HBsAg-positive to HBsAg-negative participants was 0.83 (0.75–0.93). Conclusion In a large cohort of Korean adults, HBsAg seropositivity was associated with lower risk of herpes zoster, suggesting that HBV seems to inhibit the reactivation of varicella-zoster virus. Disclosures All authors: No reported disclosures.

scholarly journals Blood donor testing for hepatitis B virus in the United States: is there a case for continuation of hepatitis B surface antigen detection?

Transfusion ◽  
2018 ◽  
Vol 58 (9) ◽  
pp. 2166-2170 ◽  
Author(s):  
Roger Y. Dodd ◽  
Megan L. Nguyen ◽  
David E. Krysztof ◽  
Edward P. Notari ◽  
Susan L. Stramer
Keyword(s):  
United States ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Surface Antigen ◽  
Blood Donor ◽  
Hepatitis B Surface Antigen ◽  
The United States ◽  
Antigen Detection ◽  
B Virus

How Far we are towards Eradication of HBV Infection

2015 ◽  
Vol 24 (4) ◽  
pp. 473-479 ◽  
Author(s):  
Mihai Voiculescu
Keyword(s):  
Immune Response ◽  
Hepatitis B Virus ◽  
T Cell ◽  
Hepatitis B ◽  
T Cell Receptors ◽  
Hepatitis B Surface Antigen ◽  
Hbv Infection ◽  
Major Health Problem ◽  
Cell Receptors ◽  
B Virus

Hepatitis B virus (HBV) infection is a major health problem with an important biological and a significant socio-economic impact all over the world. There is a high pressure to come up with a new and more efficient strategy against HBV infection, especially after the recent success of HCV treatment. Preventing HBV infection through vaccine is currently the most efficient way to decrease HBV-related cirrhosis and liver cancer incidence, as well as the best way to suppress the HBV reservoir. The vaccine is safe and efficient in 80-95% of cases. One of its most important roles is to reduce materno-fetal transmission, by giving the first dose of vaccine in the first 24 hours after birth. Transmission of HBV infection early in life is still frequent, especially in countries with high endemicity.Successful HBV clearance by the host is immune-mediated, with a complex combined innate and adaptive cellular and humoral immune response. Different factors, such as the quantity and the sequence of HBV epitope during processing by dendritic cells and presenting by different HLA molecules or the polymorphism of T cell receptors (TOL) are part of a complex network which influences the final response. A new potential therapeutic strategy is to restore T-cell antiviral function and to improve innate and adaptive immune response by immunotherapeutic manipulation.It appears that HBV eradication is far from being completed in the next decades, and a new strategy against HBV infection must be considered. Abbreviations: ALT: alanine aminotransferase; APC: antigen presenting cells; cccDNA: covalently closed circular DNA; HBIG: hepatitis B immunoglobulin; HbsAg: hepatitis B surface antigen; HBV: hepatitis B virus; HCC: hepatocellular carcinoma; CTL: cytotoxic T lymphocyte; IFN: interferon; NUC: nucleos(t)ide analogues; pg RNA: pre genomic RNA; TLR: toll-like receptors; TOL: T cell receptors.

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