Nonlinear Relationship Between Macrocytic Anemia and Decompensated Hepatitis B Virus Associated Cirrhosis: A Population-Based Cross-Sectional Study

Background: Mean corpuscular volume (MCV) is major used as an indicator for the differential diagnosis of anemia. Macrocytic anemia in decompensated cirrhosis is common. However, the relationship between macrocytic anemia and decompensated hepatitis B virus (HBV) associated cirrhosis has not been fully addressed.Methods: In this cross-sectional study, a total of 457 patients diagnosed decompensated HBV associated cirrhosis who met all inclusion criteria from 2011 to 2018 were analyzed. Association between macrocytic anemia and the liver damaged (Model for End Stage Liver Disease (MELD) score) were examined using multiple logistic regression analyses and identified using smooth curve fitting.Results: Compared with normocytic anemia, MCV and MELD are significantly positively correlated in macrocytic anemia (p < 0.001). A non-linear relationship of MCV and MELD association was found though the piecewise linear spline models in patients with decompensated HBV associated cirrhosis. MCV positive correlated with MELD when the MCV was greater than 98.2 fl (regression coefficient = 0.008, 95% CI 0.1, 0.4).Conclusion: Macrocytic anemia may be a reliable predictor for mortality because it is closely related to the degree of liver damage in patients with decompensated HBV associated cirrhosis.

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Macrocytic anemia is associated with the severity of liver impairment in patients with hepatitis B virus-related decompensated cirrhosis: a retrospective cross-sectional study

BMC Gastroenterology ◽

10.1186/s12876-018-0893-9 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

Jian Yang ◽

Bin Yan ◽

Lihong Yang ◽

Huimin Li ◽

Yajuan Fan ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Macrocytic Anemia ◽

Cross Sectional Study ◽

Decompensated Cirrhosis ◽

Sectional Study ◽

Cross Sectional ◽

Liver Impairment ◽

B Virus

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A CROSS-SECTIONAL STUDY TO COMPARE HEPATITIS B IMMUNITY IN HIV INFECTED AND UNINFECTED KENYAN CHILDREN FOLLOWING PRIMARY IMMUNIZATION AGAINST THE HEPATITIS B VIRUS.

10.26226/morressier.58fa1769d462b80290b51b9b ◽

2017 ◽

Author(s):

Joseph Mbuthia

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Cross Sectional Study ◽

Primary Immunization ◽

Sectional Study ◽

Cross Sectional ◽

B Virus

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Hepatitis B virus infection among men who have sex with men and transgender women living with or at risk for HIV: a cross sectional study in Abuja and Lagos, Nigeria

BMC Infectious Diseases ◽

10.1186/s12879-021-06368-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Olusegun A. Adeyemi ◽

Andrew Mitchell ◽

Ashley Shutt ◽

Trevor A. Crowell ◽

Nicaise Ndembi ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Condomless Sex ◽

B Virus ◽

Hbv Prevalence ◽

Sex With Men ◽

Living With Hiv

Abstract Background Despite the development of a safe and efficacious hepatitis B vaccine in 1982, the hepatitis B virus (HBV) remains a public health burden in sub-Saharan Africa. Due to shared risk factors for virus acquisition, men who have sex with men (MSM) and transgender women (TGW) living with HIV are at increased risk of HBV. We estimated the prevalence of HBV and associated factors for MSM and TGW living with or without HIV in Nigeria. Methods Since March 2013, TRUST/RV368 has recruited MSM and TGW in Abuja and Lagos, Nigeria using respondent driven sampling. Participants with HIV diagnosis, enrollment as of June 2015, and available plasma were selected for a cross-sectional study and retrospectively tested for hepatitis B surface antigen and HBV DNA. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with prevalent HBV infection. Results A total of 717 MSM and TGW had a median age of 25 years (interquartile range [IQR]: 21–27), 5% self-reported HBV vaccination, 61% were living with HIV, 10% had prevalent HBV infection and 6% were HIV-HBV co-infected. HIV mono-infected as compared to HIV-HBV co-infected had a higher median CD4 T cell count [425 (IQR: 284–541) vs. 345 (IQR: 164–363) cells/mm3, p = 0.03] and a lower median HIV RNA viral load [4.2 (IQR: 2.3–4.9) vs. 4.7 (IQR: 3.9–5.4) log10copies/mL, p < 0.01]. The only factor independently associated with HBV was self-report of condomless sex at last anal intercourse (OR: 2.2, 95% CI: 1.3, 3.6). HIV infection was not independently associated with HBV (OR: 1.0, 95% CI: 0.7–1.6). Conclusion HBV prevalence was moderately high but did not differ by HIV in this cohort of MSM and TGW. Recent condomless sex was associated with elevated HBV risk, reinforcing the need to increase communication and education on condom use among key populations in Nigeria. Evaluating use of concurrent HIV antiretroviral therapy with anti-HBV activity may confirm the attenuated HBV prevalence for those living with HIV.

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Hepatitis B virus infection and its associated factors among medical waste collectors at public health facilities in eastern Ethiopia: a facility-based cross-sectional study

BMC Infectious Diseases ◽

10.1186/s12879-021-05918-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Degu Abate Mengiste ◽

Abebe Tolera Dirbsa ◽

Behailu Hawulte Ayele ◽

Tewodros Tesfa Hailegiyorgis

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Cross Sectional Study ◽

Medical Waste ◽

Health Facilities ◽

Sectional Study ◽

Cross Sectional ◽

Eastern Ethiopia ◽

B Virus ◽

History Of

Abstract Background The risk of hepatitis B virus infection among medical waste handlers who undergo collection, transportation, and disposal of medical wastes in the health institutions is higher due to frequent exposure to contaminated blood and other body fluids. There is limited evidence on the seroprevalence of hepatitis B among medical waste handlers in eastern Ethiopia. The study was aimed at studying the seroprevalence of Hepatitis B Virus and associated risk factors among medical waste collectors at health facilities of eastern Ethiopia. Methods A facility-based cross-sectional study was conducted among randomly selected medical waste collectors from public health facilities in eastern Ethiopia from March to June 2018. A pre-tested and well-structured questionnaire was used to collect data on socio-demographic characteristics and hepatitis B infection risk factors. A2.5ml venous blood was also collected, centrifuged and the serum was analyzed for hepatitis B surface antigen using the instant hepatitis B surface antigen kit. Descriptive summary measures were done. Chi-square and Fisher exact tests were used to assess the risk of association. Multivariate logistic regression was conducted with 95% CI and all value at P-value < 0.05 was declared statistically significant. Results From a total of 260 (97.38%) medical waste collectors participated, HBV was detected in 53 (20.4%) of the participants [95%CI; 15.8, 25.6]. No significant differences were observed in the detection rates of HBV with respect to socio-demographic characteristics. In both bivariate and multivariable logistic regression analysis, being unvaccinated (AOR = 6.35; 95%CI = [2.53–15.96], P = 0.001), history of blood transfusion (receiving) (AOR; 3.54; 95%CI; [1.02–12.24], P = 0.046), history of tattooing (AOR = 2.86; 95%CI = [1.12–7.27], p = 0.03), and history of multiple sexual partner (AOR = 10.28; 95%CI = [4.16–25.38], P = 0.001) remained statistically significantly associated with HBsAg positivity. Conclusion This cross-sectional study identified that HBV infection is high among medical waste collectors in eastern Ethiopia. Immunization and on job health promotion and disease prevention measures should be considered in order to control the risk of HBV infection among medical waste collectors in eastern Ethiopia.

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Screening for hepatitis B virus prior to initiating tocilizumab and tofacitinib in patients with rheumatologic diseases: a cross-sectional study

The Journal of Rheumatology ◽

10.3899/jrheum.210257 ◽

2021 ◽

pp. jrheum.210257

Author(s):

Amir M. Mohareb ◽

Naomi J. Patel ◽

Xiaoqing Fu ◽

Arthur Y. Kim ◽

Zachary S. Wallace ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Positive Hbsag ◽

Rheumatologic Diseases ◽

American College Of Rheumatology ◽

B Virus ◽

Hbv Screening

Objective Hepatitis B virus (HBV) can reactivate among rheumatology patients initiating tocilizumab or tofacitinib. HBV screening is recommended by the Centers for Disease Control and Prevention (CDC), the American Association for the Study of Liver Diseases (AASLD), and the Canadian Rheumatology Association but is not explicitly recommended by the American College of Rheumatology. Methods We conducted a cross-sectional study to characterize HBV screening practices for adult rheumatology patients initiating tocilizumab or tofacitinib before December 31, 2018, in the Greater Boston area. We classified appropriate HBV screening patterns prior to tocilizumab or tofacitinib (i.e., HBV surface antigen [HBsAg], total core antibody [anti- HBcAb], and surface antibody [HBsAb]) as: complete (all 3 tested), partial (any 1 or 2 tests), or none. We determined the frequency of inappropriate HBV testing (HBeAg, anti-HBcAb IgM, or HBV DNA without a positive HBsAg or total anti-HBcAb) and used multivariable regression to assess factors associated with complete HBV screening. Results Among 678 subjects initiating tocilizumab, 194 (29%) completed appropriate HBV screening, 307 (45%) had partial screening, and 177 (26%) had none. Among 391 subjects initiating tofacitinib, 94 (24%) completed appropriate HBV screening, 195 (50%) had partial screening, and 102 (26%) had none. Inappropriate testing was performed in 22% of subjects. Race was associated with complete HBV screening (white versus non-white, OR 0.74; 95%CI: 0.57-0.95) while prior immunosuppression was not (csDMARDs, OR 1.05, 95%CI: 0.72-1.55; bDMARDs, OR 0.73, 95%CI: 0.48- 1.12). Conclusion Patients initiating tocilizumab or tofacitinib are infrequently screened for HBV despite recommendations from AASLD and CDC.

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