Deoxycholic acid liganded HBs contributes to HBV maturation

Understanding the underlying mechanism of HBV maturation and subviral particle production is critical to control HBV infection and develop new antiviral strategies. Here, we demonstrate that deoxycholic acid (DCA) plays a central role in HBV production. HBV infection increased DCA levels, whereas elimination of DCA-producing microbiome decreased HBV viral load. DCA can bind to HBs antigen via LXXLL motif at TM1 and TM2 region to regulate HBs-HBc interaction and the production of mature HBV. Plasma DCA levels from patients undergoing antiviral therapy were significantly higher in those with positive HBV viral load. These results suggest that intestinal DCA-producing microbiome can affect the efficiency of antiviral therapy and provide a potential novel strategy for HBV antiviral therapy.

Determination of the prevalence of the HBs antigen and evaluation of the vaccination status against Hepatitis B among the staff of the Dschang district hospital in West Cameroon

Hepatitis B infection is a major global health problem. Sub–saharan Africa is particularly affected. The aim of this study was to determine the prevalence of HBs antigen (HBs Ag) and to assess the hepatitis B vaccine status among medical and paramedical staff at Dschang District Hospital. A descriptive cross-sectional study was conducted at Dschang District Hospital from November 2018 to June 2019. All medical and paramedical staff of the Dschang District Hospital were included, regardless of sex or age, vaccinated and unvaccinated. We assessed the level of knowledge of hepatitis B, investigated hepatitis B markers like HBs antigen (HBs Ag), HBc antibody (HBc Ab), HBs antibody (HBs Ab); we performed HBs Ab assay, investigated hepatitis B risk factors, and low hepatitis B immunization factors, among an average of 171 health personnel aged 36.48 ± 9.58. Of these, 94.7 % said they knew hepatitis B. The prevalence of hepatitis B was 7%. Nursing and paramedical professions were the main concerned by the HBs Ag positivity. The risk factors found in HBs Ag carriers were unprotected sex, scarification and blood exposure accident. There was an association between HBs antigen portage and unprotected sex (P=0.021), blood exposure accident (P=0.021) and piercing (P=0.004). However, there was no association between HBs Ag carrying and age group (P=0.779), sex (P=0.248) and marital status (P=0.779). On the basis of the statements, without a certificate, 57% of the staff said they had already been vaccinated against hepatitis B; of these, 89% had received at least 3 doses of vaccine, of which 53.3% had acquired immunity from HBV. Advanced age (over 40 years) and overweight were associated with a low response to hepatitis B vaccine. In addition, sex and smoking were not associated with low hepatitis B seroprotection. In conclusion, this study found that the prevalence of HBs Ag is still high in our context and low hepatitis B seroprotection in the study population. Hence the need for awareness-raising, systematic screening and vaccination of health personnel, training of vaccinators and monitoring of the vaccination chain.

OCCURRENCE OF HEPATITIS B AND HEPATITIS C AND THEIR DUAL INFECTIONS: A GREAT PUBLIC HEALTH CONCERN

Introduction-Viral hepatitis is one of the major public health concern worldwide. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are of great concern due to their association with cirrhosis and hepatocellular carcinoma. Aims & Objectives-i)To determine the frequency of Hepatitis B surface antigen and anti-HCV antibodies in patients coming to a tertiary care teaching hospital ii)To estimate the occurrence of co-infection with hepatitis B virus and hepatitis C virus iii) To analyse the risk factors associated with hepatitis B, hepatitis C and their co-infections. Method- This prospective study included serum samples which were subjected to detection of HBs antigen and anti-HCV antibodies using rapid immunochromatographic card tests, which were further confirmed by Enzyme Linked Immunosorbent Assay (ELISA). Results- Out of total of 12,502 cases, the seropositivity of HBs antigen and anti-HCV antibodies was found to be 3.6% (452 /12,502) and 6.1% (758 /12,502) respectively. The frequency of co-infection (HBs antigen and anti-HCV antibodies) was found to be 0.8% (99 /12,502). Male to female ratio for hepatitis B, hepatitis C and co-infection was 2.1:1, 1.6:1and 2.3:1, respectively. The commonest risk factor associated with seropositivity of HBV was intravenous drug use, followed by blood / blood components transfusion. Hepatitis C infection was most commonly seen with blood / blood components transfusion, followed by intravenous drug use. Conclusions: Counseling and health education regarding the safe injection practices, safe sexual practices , screening of blood / blood products and vaccination against HBV are the essential steps to combat viral hepatitis.

Significance of Hepatitis B Virus Diagnosis by Real-time Polymerase Chain Reaction over Serological Markers in Hepatitis B Virus Patients

Hepatitis B virus (HBV) is the leading cause of viral hepatitis, as currently over 2 billion people have HBV infection worldwide. Nucleic acid assay and quantitative hepatitis B surface antigen (HBsAg) have been developed for diagnostic and therapeutic monitoring of patients with HBV infection. These tests might also show correlation between HBV DNA and HBs serostatus. The study aimed to find and analyze the frequency and impact of HBsAg seropositivity among patients revealed HBV DNA negative level through quantitative estimation of both seromarkers. Real-time polymerase chain reaction (RT-PCR) and Elecsys assays were used for quantitative estimation of HBV DNA and HBs antigen, respectively. A total of 256 blood samples were used from patients referred for either diagnostic purpose and/or HBV viral load monitoring after antiviral therapy. Blood profile analysis showed 12.26% HBs antigen seropositivity among patients revealed negative for nucleic acid assay for HBV DNA. Positive HBs antigen titers ranged from 1000–50,000 COI, with seronegative anti-HBs antibody test for all samples tested positive for HBs antigen. This study delineated that negative or undetectable quantitation of HBV DNA level does not exclude HBV infection; as the level might fluctuate in different phases of HBV replication. This gives an impression and raising a question about significance of replacing test for HBsAg with quantitation of HBV DNA PCR assay. Thus, the study refers to a special HBV profile outside the classical pattern.

Characteristics of an Outpatient Cohort with HBeAg-Negative Chronic Hepatitis B

Introduction: Patients with hepatitis Be antigen negative chronic hepatitis B (HBeAg-negative CHB) and patients inactive carriers (IC) have similar laboratory and serologic characteristics and are not always easy to distinguish. Aim: To characterize hepatitis Be antigen (HBeAg) negative chronic hepatitis B cohort based on their laboratory and virology evaluations at one point of time. Material and Methods: A prospective non-randomized study was conducted on 109 patients with HBeAg negative chronic hepatitis B treated as outpatients at the Clinic for infectious disease and febrile conditions. All patients underwent laboratory and serology testing, quantification of HBV DNA and HBs antigen (qHBsAg). Results: 56 patients were inactive carriers (IC) and 53 patients had HBeAg-negative CHB (AH). The mean values of ALT, HBV DNA and qHBsAg in IC were 29,13 U/L; 727,95 IU/ml and 2753,73 IU/ml respectively. In the AH group the mean values of ALT, HBV DNA and quantitative HBsAg were 50,45 U/L; 7237363,98 IU/ml and 12556,06 IU/ml respectively. The serum value of ALT was more influenced by qHBsAg than HBV DNA in both IC and AH groups (R=0.22 vs R=0.15) (p>0.05). Conclusion: patients with inactive and active HBeAg-negative CHB have similar laboratory and serology profile. It is necessary to combine analysis of ALT, HBV DNA and qHBsAg for better discrimination between patients IC and patient swith HBeAg- negative CHB. Key words: chronic hepatitis B, inactive carriers, ALT, HBeAg, HBV DNA, quantitative HBsAg BACKGROUND: Patients with hepatitis Be antigen-negative chronic hepatitis B (HBeAg-negative CHB), and patients' inactive carriers (IC) have similar laboratory and serologic characteristics and are not always easy to distinguish. AIM: To characterise hepatitis Be antigen (HBeAg) negative chronic hepatitis B cohort based on their laboratory and virology evaluations at one point of time. METHODS: A prospective non-randomized study was conducted on 109 patients with HBeAg negative chronic hepatitis B treated as outpatients at the Clinic for Infectious Diseases and Febrile Conditions. All patients underwent laboratory and serology testing, quantification of HBV DNA and HBs antigen (qHBsAg). RESULTS: A group of 56 patients were inactive carriers (IC), and 53 patients had HBeAg-negative CHB (AH). The mean values of ALT, HBV DNA and qHBsAg in IC were 29.13 U/L; 727.95 IU/ml and 2753.73 IU/ml respectively. In the AH group, the mean values of ALT, HBV DNA and quantitative HBsAg were 50.45 U/L; 7237363.98 IU/ml and 12556.06 IU/ml respectively. The serum value of ALT was more influenced by qHBsAg than HBV DNA in both IC and AH groups (R = 0.22 vs R = 0.15) (p > 0.05). CONCLUSION: patients with inactive and active HBeAg-negative CHB have similar laboratory and serology profile. It is necessary to combine analysis of ALT, HBV DNA and qHBsAg for better discrimination between patient's IC and patient with HBeAg-negative CHB.