Analyses of blood donor samples from eight provinces in Lao PDR suggest considerable variation concerning HBV exposure and carriage

Introduction Hepatitis B is endemic in Lao PDR and about 9% of the adult population is chronically infected. In this study, we investigated regional, occupational, age and sex-related differences in hepatitis B epidemiology in Lao blood donors. Methods 5017 voluntary blood donors from 8 different provinces were tested for hepatitis B markers by ELISA. Predictors for the prevalence of hepatitis B surface antigen (HBsAg) and antibodies against the core antigen (anti-HBc) were assessed by bivariate and multivariable analyses. Results In total, 41% of the participants were positive for anti-HBc; the HBsAg prevalence was estimated at 6.9% among all participants (9.2% among first-time donors and 3.9% among repeat donors). Among first-time donors, HBsAg positivity was associated independently with being male (p<0.001), being from the North (p<0.001) and being soldier (p<0.001). Participants were more likely to be anti-HBc positive when they were male (p<0.001), from the Northern provinces (p<0.001) and older than 20 years (p<0.01). Conclusion In conclusion, our study confirmed an overall high HBsAg and anti-HBc prevalence in Lao PDR, albeit with considerable regional variation. The identification of a sizeable number of HBsAg positives among repeat donors warrants a thorough investigation of current blood screening, record keeping, donor identification and counselling practises.

Trend of HBsAg Seroprevalence Among Blood Donors in a Nigerian Teaching Hospital: A Five-Year Retrospective Study

World Health Organization (WHO) classified Nigeria as a hyper-endemic hepatitis B surface antigen (HBsAg) positive nation with prevalence ≥ 8%. This study intends to add information that could strengthen established database to improve awareness and prevention of hepatitis B virus (HBV) infection. We aimed to evaluate seroprevalence and trend of HBsAg among blood donors in Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Ogun State, Nigeria over a five-year period. Data from records of 7,102 individuals aged ≥ 20 years old who donated blood to blood bank in this hospital from January 2012 to December 2016 were analysed for gender, age, number of donors per year and HBsAg status. Data analysis was done with Statistical Package for Social Sciences software. P ≤ 0.05 was considered statistically significant. Males were in the majority (6,547 [92.2%]). Age 30–39 years old was the major group (3,052 [43.0%]). Pooled HBsAg seroprevalence was 486 (6.8%). Females had the highest HBsAg seroprevalence across board with highest rate of 10 (19.6%) in year 2012 and pooled prevalence of 73 (13.2%). Age group of ≥ 50 years old had highest HBsAg seroprevalence 39 (8.5%) while age group of 20–29 years old had least 128 (5.8%). Stratified HBsAg positivity decreased steadily from year 2012 to year 2016. This location was HBV intermediate-endemic. There were age, gender and yearly seroprevalence of HBsAg related trends which could be leveraged upon in finding effective preventive measures against the disease. We recommend mass vaccination by government against HBV infection in addition to provision of sensitive blood investigational equipment.

Prevalence of HBsAg among reproductive age couples in Chongqing: A population-based, cross-sectional study

Hepatitis B is a leading cause of death worldwide. Here, we performed a large, population-based, cross-sectional study in Chongqing, China from 2011 to 2016 to assess the prevalence of HBsAg among couples of reproductive age, to predict subsequent trends, and to provide evidence for the WHO goal of "the elimination of viral hepatitis as a public health threat by 2030". A total of 386,286 couples aged 20 to 49 years were enrolled in the study. Approximately 14.35% of couples were HBsAg positive, including 95.00% with discordant HBsAg positivity. HBsAg prevalence was higher in men than in women. Among different occupations, the two categories of “houseworker” (female 6.73%, male 9.99%) and “unemployed” (female 6.64%, male 9.94%) showed the highest HBsAg positivity. In different regions, the lowest prevalence appeared in southeastern Chongqing (female 4.87%, male 7.71%). In 2030, the HBsAg positivity rate is expected to be 2.79%, 7.27% and 5.13% in females, males, and the whole population, respectively. According to the trends, this rate would drop to less than 2% in 2034, 2078 and 2051. In conclusion, the HBsAg prevalence in Chongqing is still relatively high compared with that in other parts of western China, especially among reproductive-age men. HBsAg-positive couples should be taken as an important unit of care. Vaccination is necessary before pregnancy if no antibody is found. More attention should be given to people without stable jobs. HBsAg-positive rate will decrease perceptibly by 2030 and will reach the level of low in epidemic areas by 2050.

Association of hepatitis B virus infection and allergy with the risk of gastrointestinal cancer

Purpose To investigate the association of hepatitis B virus infection and allergy with gastrointestinal carcinogenesis, to provide a basis for risk factor identification among gastrointestinal cancer(GICA) risk populations, and for studies concerning the CICA etiology. Methods Clinical data of 2,375 GICA patients hospitalized from 2009 to 2020 were retrospectively analyzed, with 48,496 non-oncologic patients in the departments of psychiatry, neurology and cardiology as controls, totaling 50,871 patients. The data were processed using R software and SPSS22.0 for 1:4 propensity score matching. Results Overall, HBsAg positivity rate was 3.3% for 50,871 patients. A total of 11,872 patients completed the 1:4 propensity score matching, including 2,375 patients with GICA and 9,497 controls. HBsAg positivity was 4.5% in the GICA group and 3.2% in the control group, showing a significant inter-group difference (P = 0.002, OR = 1.427, 95% CI: 1.138–1.789). The incidence of GICA among patients with a history of allergies was significantly lower at 5.9% (139/2352) than among those without such history at 17.1% (4,592/26,785), also showing a significant inter-group difference (P < 0.001, OR = 3.294, 95% CI: 2.767–3.921). Besides, the incidence of allergies among HBsAb-positive patients was 9.0% (923/10,246), which was high than that among HBsAb-negative patients 7.6% (732/9,591), with a significant inter-group difference between the two groups (P < 0.001). Conclusion HBV infection is positively associated with gastrointestinal carcinogenesis. HBsAb positivity is also positively correlated with allergy, while allergy is negatively correlated with gastrointestinal carcinogenesis. The exact mechanism underlying these associations deserves further clarification. In addition, HBsAg positivity rate in Southwest China is approximately 3.3%.

Utilization of HBV Surface Antigen Positive Grafts in Liver Transplantation: A Matched Study Based on a National Registry Cohort

Background and purposeDonor shortage has become worldwide limitation in liver transplantation. Use of HBsAg+ donors could be an alternative source of donor organs. This study aims to prove the safety and efficacy of liver transplantation using HBsAg+ liver grafts and its long-term outcome.MethodsThis was a retrospective study of adults liver transplantation registered in the database of the China Liver Transplant Registry between January 2015 and September 2018. By propensity score matching (1:1), 503 eligible patients who received HBsAg+ liver grafts were compared with 503 matched patients who received HBsAg- liver grafts.ResultsThe 1-, 3- and 4-year patient survival rates were 81.52%, 72.04% and 70.03% in HBsAg+ donor group, that were comparable to 83.93%, 77.27% and 75.52% in HBsAg- donor group (p=0.222). The 1-, 3- and 4-year graft survival rates were also comparable between the two groups (81.49%, 71.45% and 70.24% vs. 83.62%, 77.11% and 75.32%, respectively, p=0.243). Most main complications were not increased in HBsAg+ donor group except for the retaining of HBsAg positivity after liver transplantation. Furthermore, transplanting HBsAg+ liver grafts did not result in inferior outcomes either in HBsAg+ or HBsAg- recipients. The risk of tumor recurrence after liver transplantation was neither increased in hepatocellular carcinoma patients. ConclusionsThe outcomes of using HBsAg+ liver grafts were comparable with those of HBsAg- liver grafts. Our study provided strong evidence for the safe use of HBsAg+ grafts to expand the donor liver pool.

An Interesting Case of Isolated False-Reactive Hepatitis B Surface Antigen

The standard serologic markers used to diagnose hepatitis B infection include hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), total hepatitis B core antibody (anti-HBc), and IgM antibody to hepatitis B core antigen (IgM anti-HBc). Different markers or combinations of markers are used to identify different phases of HBV infection and determine whether a patient has acute or chronic infection or immunity due to prior infection or vaccination or is seronegative and susceptible to future infection. Isolated HBsAg seropositivity is a peculiar serological pattern that requires investigation. Herein, we present a case of an asymptomatic female without a history of liver disease or evident risk factors for hepatitis, who underwent screening for infectious disease prior to resection of basal cell carcinoma involving her eyelid. The patient’s laboratory testing showed positivity for HBsAg and the HIV 1/2 screen. To investigate, we performed serial dilutions, utilized heterophilicantibody blocking tubes, and repeated analysis using a different commercial assay (Abbott Architect i2000), all in support of a false-positive result attributed to a heterophilic antibody. Hence, we demonstrate that heterophilic antibody interference can result in isolated HBsAg positivity and recommend considering this form of interference in the differential where there is low clinical suspicion for viral infection.

Efficacy and Safety of Telbivudine in Preventing Mother-to-Child Transmission of Hepatitis B Virus

Background: To define the best timing for the treatment of high maternal viral DNA levels in order to block the mother-to-child transmission (MTCT).Methods: From a total of 820 HBsAg-positive pregnant women, 229 who satisfied the selection criteria were enrolled for the final analysis. These patients were divided into thress groups: Group A: 62 patients received telbivudine (LdT) (600 mg/day, orally) treatment before pregnant; Group B: 101 patients received LdT treatment at 24-28 weeks of gestation; and Group C: 66 patienst with high viral load received LdT at the third trimester. All infants born to the enrolled women were vaccinated with 100 IU of hepatitis B immune globulin (HBIG) and 10 μg of hepatitis B vaccine within 2 hours of birth. The second and third does of recombinant HBV vaccine were administered at 1 and 6 months of age, respectively.Results: LdT can effectively reduce serum HBV DNA and normalize ALT levels before delivery (p<0.001). The HBsAg positivity rate in infants in Groups A, B and C after delivery was 1.6%, 7.9% and 3.0%, respectively. The serum HBV DNA positivity rate in infants in Groups A, B and C after delivery was 4.8%, 5.0% and 0%, respectively. After 28 weeks of follow up, all infants remained HBV DNA and/or HBSag negative. No serious adverse events were found in the mothers or their infants treated with LdT.Conclusions: Telbivudine (LdT) given at the 28-32 weeks of gestation can effectively reduce mother-to-child transmission in HBV-infected women with good safety.

2018 annual dialysis data report of the JSDT Renal Data Registry: patients with hepatitis

According to the annual survey of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) conducted at the end of 2018, a total of 339,841 patients were receiving dialysis (hereinafter, dialysis patients) in Japan. This survey included an investigation of individual test results for hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody (HCV-Ab), HCV-RNA, and serum alanine aminotransferase (ALT) (glutamic pyruvic transaminase [GPT]). The survey revealed that among dialysis patients in Japan, the prevalence of HBsAg positivity was 1.38% and the prevalence of HCV-Ab positivity was 4.7% at the end of 2018, both of which were markedly lower than the corresponding rates documented in 2007 (9.8% and 4.7%, respectively). The proportion of HCV-RNA-positive patients among all HCV-Ab-positive patients was 37.5%, which was also markedly lower than the percentage recorded in 2007 (64.0%). The prevalence of HBsAg positivity tended to increase as the dialysis vintage increased. The prevalence of HCV-Ab positivity was also not correlated with the dialysis vintage during the first 30 years of dialysis; however, it tended to increase as the dialysis vintage increased beyond the 30th year. Trial registration University hospital Medical Information Network (UMIN) Clinical Trials Registry, UMIN000018641. The JRDR was approved by the ethics committee of the JSDT (approval number 1-3) and was registered on August 8, 2015 (accessed June 2, 2020).

HBV Infection Statuses Indicate Different Risks of Synchronous and Metastasis Liver Metastasis in Colorectal Cancer

Background: Previous studies on the effect of HBV infection on CRLM are contrary. This study identified more specific and different impacts of HBV on CRLM.Methods: A total of 3132 CRC patients were analyzed retrospectively and followed up for five years. All patients were divided into three groups: group A, HBsAg positive with HBV infection; group B, HBsAg negative with HBV infection; and group C, no HBV infection. The risk factors for SYN-CRLM, MET-CRLM, 5-year OS, and LDFS were analyzed.Results: A total of 829 patients had CRLM. SYN-CRLM was found in 425 patients. The incidence of SYN-CRLM was 16.95%, 11.60% and 13.50% (P <0.03) in groups A, B, and C, respectively. HBsAg-positive HBV infection increased the risk of SYN-CRLM (P<0.01), with a worse prognosis in group A (P<0.05). MET-CRLM was found in 404 patients. The incidence of MET-CRLM in groups A, B, and C, was 16.51%, 11.53% and 16.50% (P=0.02). HBsAg-negative HBV infection decreased the incidence of MET-CRLM (P=0.02) with a better 5-year LDFS (P=0.01), but was not related to 5-year OS (P=0.15).Conclusion: HBsAg positivity infection increased the risk of SYN-CRLM with poor prognosis. HBsAg-negative infection reduced the risk of MET-CRLM with better LDFS after surgery.