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 Cost-effectiveness of Hepatitis B Virus Infection Screening and Treatment or Vaccination in 6 High-risk Populations in the United States

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Harinder S Chahal ◽  
Marion G Peters ◽  
Aaron M Harris ◽  
Devon McCabe ◽  
Paul Volberding ◽  
...  
Keyword(s):  
United States ◽  
Cost Effectiveness ◽  
Hepatitis B Virus ◽  
High Risk ◽  
Hepatitis B ◽  
The United States ◽  
Inactive Disease ◽  
Progression Rate ◽  
B Virus ◽  
High Risk Populations

Abstract Background Two million individuals with chronic hepatitis B (CHB) in the United States are at risk for premature death due to liver cancer and cirrhosis. CHB can be prevented by vaccination and controlled with treatment. Methods We created a lifetime Markov model to estimate the cost-effectiveness of strategies to prevent or treat CHB in 6 high-risk populations: foreign-born Asian/Pacific Islanders (API), Africa-born blacks (AbB), incarcerated, refugees, persons who inject drugs (PWID), and men who have sex with men (MSM). We studied 3 strategies: (a) screen for HBV infection and treat infected (“treatment only”), (b) screen for HBV susceptibility and vaccinate susceptible (“vaccination only”), and (c) screen for both and follow-up appropriately (“inclusive”). Outcomes were expressed in incremental cost-effectiveness ratios (ICERs), clinical outcomes, and new infections. Results Vaccination-only and treatment-only strategies had ICERs of $6000–$21 000 per quality-adjusted life-year (QALY) gained, respectively. The inclusive strategy added minimal cost with substantial clinical benefit, with the following costs per QALY gained vs no intervention: incarcerated $3203, PWID $8514, MSM $10 954, AbB $17 089, refugees $17 432, and API $18 009. Clinical complications dropped in the short/intermediate (1%–25%) and long (0.4%–16%) term. Findings were sensitive to age, discount rate, health state utility in immune or susceptible stages, progression rate to cirrhosis or inactive disease, and tenofovir cost. The probability of an inclusive program costing <$50 000 per QALY gained varied between 61% and 97% by population. Conclusions An inclusive strategy to screen and treat or vaccinate is cost-effective in reducing the burden of hepatitis B virus among all 6 high-risk, high-prevalence populations.

scholarly journals Heterosexual Transmission of Hepatitis B and Implications for Vaccine Prevention Strategies

1991 ◽  
Vol 2 (suppl a) ◽  
pp. 13-17 ◽  
Author(s):  
Miriam J Alter
Keyword(s):  
United States ◽  
Hepatitis B Virus ◽  
High Risk ◽  
Virus Infection ◽  
Hepatitis B ◽  
Risk Groups ◽  
The United States ◽  
Hepatitis B Virus Infection ◽  
B Virus ◽  
Homosexual Activity

Since 1985, cases of hepatitis B virus infection attributable to heterosexual activity have increased by 38%, whereas those attributable to homosexual activity have declined by 62%, Heterosexual activity now accounts for 26% of cases and has replaced homosexual activity in importance as a risk factor for hepatitis B. For heterosexuals, the number of recent (ie, in the preceding four to six months) and lifetime sex partners, as well as a history of other sexually transmitted diseases (eg. syphilis) appear to be significantly associated with increased hepatitis B virus infection. Of equal concern is the rising number of cases among parenteral drug users in the United States and some minority groups, including blacks, Hispanics and Asians. Hepatitis B prevention by administering hepatitis B vaccine to high risk groups before exposure to infection has not been successful, and at least 30% of hepatitis B cases in the United States have no identifiable risk factors. Thus, participation in the current programs which target only high risk groups is not possible. The ideal immunization strategy is integration of hepatitis B vaccine in to the routine childhood immunization schedule.

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.

Letter to the Editor

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 242-243
Author(s):  
Neal A. Halsey ◽  
Caroline B. Hall
Keyword(s):  
United States ◽  
Hepatitis B ◽  
American Academy ◽  
Immune Globulin ◽  
Drug Administration ◽  
Hepatitis B Surface Antigen ◽  
The United States ◽  
Reference Standard ◽  
American Academy Of Pediatrics ◽  
Hepatitis B Immune Globulin

Dr Vegnente et al raise an important point regarding the different concentrations of antibodies to hepatitis B surface antigen (anti-HBsAg) in preparations of hepatitis B immune globulin (HBIg) prepared by manufacturers outside the United States. The American Academy of Pediatrics (AAP) recommendations were based on products manufactured in the United States (US). These products have been standardized to contain anti-HBsAg concentrations equivalent to or exceeding the potency of anti-HBsAg in a reference standard hepatitis B immune globulin (human) prepared by the Food and Drug Administration (FDA).

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

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 Treatment of children with chronic hepatitis B virus infection in the United States: Patient selection and therapeutic options

Hepatology ◽  
2010 ◽  
Vol 52 (6) ◽  
pp. 2192-2205 ◽  
Author(s):  
Maureen M. Jonas ◽  
Joan M. Block ◽  
Barbara A. Haber ◽  
Saul J. Karpen ◽  
W. Thomas London ◽  
...  
Keyword(s):  
United States ◽  
Chronic Hepatitis ◽  
Hepatitis B Virus ◽  
Virus Infection ◽  
Hepatitis B ◽  
Patient Selection ◽  
The United States ◽  
Hepatitis B Virus Infection ◽  
Chronic Hepatitis B Virus ◽  
B Virus
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