Prevalensi HBsAg Positif Antara Donor Darah Sukarela Dengan Donor Darah Pengganti Di UTD PMI Provinsi Lampung Tahun 2019-2020

ABSTRACT: PREVALENCE OF POSITIVE HBsAg BETWEEN VOLUNTARY BLOOD DONATIONS AND REPLACEMENT BLOOD DONATIONS AT PMI UTD LAMPUNG PROVINCE 2019-2020 Background: The risk of transmission of HBV infection through blood transfusion depends on many things, including the prevalence of disease in the community, the recipient's immune status, the number of donors per unit of blood, and the effectiveness of the screening used. The main disease transmission will occur during the window period, which is a period immediately after infection in which the donor's blood has been infected but the screening result is still negative.Objective: To determine the prevalence of positive HBsAg between voluntary blood donations and replacement blood donations at the PMI UTD in Lampung Province in 2019-2020. Methodology: The type of research used in this research is quantitative descriptive with cross-sectional design. The sample used in this study were blood donors at UTD PMI Lampung Province in 2019-2020.Results: The prevalence of voluntary blood donation with positive HBsAg in 2019 was obtained as many as 70 people (33.65%) while the prevalence of replacement blood donors with positive HBsAg in 2019 was obtained as many as 8 people (16%). Then, the prevalence of positive HBsAg voluntary blood donors in 2020 was found to be 138 people (66.35%) while the prevalence of positive HBsAg blood donors in 2020 was 42 people (84%).Conclusion: There is a difference in the prevalence of both voluntary blood donors and replacement blood donors between 2019 and 2020. and the prevalence of HBsAg positive in blood donors is different every year. Keywords: Blood Transfusion, Volunteer, Replacement, HBsAg INTISARI: PREVALENSI HBsAg POSITIF ANTARA DONOR DARAH SUKARELA DENGAN DONOR DARAH PENGGANTI DI UTD PMI PROVINSI LAMPUNG TAHUN 2019-2020 Latar Belakang: Risiko penularan pada infeksi HBV melalui transfusi darah bergantung pada banyak hal, antara lain yaitu adanya prevalensi penyakit pada masyarakat, status imun resipien, jumlah donor tiap unit darah dan keefektifan skrining yang di gunakan. Penularan penyakit yang utama akan timbul pada saat window period, yaitu suatu periode segera terjadi setelah terinfeksi dimana darah donor sudah terinfeksi tetapi hasil skrining masih negative.Tujuan: Mengetahui Prevalensi HBsAg Positif Antara Donor Darah Sukarela Dengan Donor Darah Pengganti Di UTD PMI Provinsi Lampung Tahun 2019-2020.Metodologi: Jenis penelitian yang digunakan dalam penelitian ini adalah deskriptif kuantitatif dengan desain cross sectional. Sampel yang digunakan pada penelitian ini adalah pendonor darah di UTD PMI Provinsi Lampung tahun 2019-2020.Hasil: Prevalensi donor darah sukarela dengan HBsAg positif pada tahun 2019 didapatkan sebanyak 70 orang (33,65%) sementara prelavensi donor darah pengganti dengan HBsAg positif pada tahun 2019 didapatkan sebanyak 8 orang (16%). Lalu, prevalensi donor darah sukarela dengan HBsAg positif pada tahun 2020 didapatkan sebanyak 138 orang (66,35%) sementara untuk prevalensi donor darah pengganti dengan HBsAg positif pada tahun 2020 didapatkan sebanyak 42 orang (84%).Kesimpulan: Terdapat perbedaan prevalensi baik donor darah sukarela maupun donor darah pengganti antara tahun 2019 dengan tahun 2020. Dan prevalensi HBsAg Positif pada donor darah berbeda-beda setiap tahun. Kata Kunci : Donor Darah, Sukarela, Pengganti, HBsAg

Evaluation of Seroprevalence of Hepatitis B Virus and Hepatitis C Virus in Reference Center Hospital in Turkey's Southeast Anatolia Among Patients Referred for Major or Minimally Invasive Surgery: Last Decade Experience in a Previously High Prevalence Area

Background: There is a high worldwide prevalence of chronic Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infections, among the significant causes of liver-related morbidity and mortality. Objectives: We aimed to determine the prevalence of HBV and HCV in a referral center hospital in Southeast Anatolia among patients that applied for major or minimally invasive surgery. Methods: In a tertiary referral state hospital for general purposes, patients undergoing surgical procedures and serologic examinations for HBV and HCV were included in the study between January 2011 and September 2020. Results: In the general population, hepatitis B surface antigen (HBsAg) and anti-HBs were examined in 220,724 patients, and anti-HCV was examined in 186,017 patients. The mean age was 42.3 ± 20.2 years with a 51.8% male distribution. The frequency of positive HBsAg and anti-HCV in all patients was 9.4 and 0.9%, respectively. On the other hand, the frequency of positive HBsAg and anti-HCV was 4.2 and 0.7%, respectively, among patients admitted for a surgical procedure. The mean age was 46.1 ± 21.1 years with a slightly male predominance (54 vs. 46%). In this group, the frequency of positive HBsAg was higher in males (5.1%) while the lowest was in the 1 - 10 age range (0.4%) and the highest in the 41 - 50 age range (5.7%). Between 2011 and 2019, the prevalence of HBsAg positivity decreased from 6.4 to 4.0%, while anti-HCV positivity was similar in both genders, and its frequency increased with age. Conclusions: Between 2011 and 2020, the overall prevalence of HBV and HCV decreased in the Southeast Anatolia Region of Turkey.

Incidence and Influencing Factors of New Hepatitis B Infections and Spontaneous Clearance: A Large-Scale, Community-Based Study in China

Background: Hepatitis B surface antigen (HBsAg) is widely used in hepatitis B screening, and HBsAg seroclearance indicates hepatitis B eradication. Few studies have explored the incidence of and determinants for spontaneous seroclearance using a long-term follow-up cohort study. Our research aimed to examine the incidence of and influencing factors for hepatitis B virus infection and spontaneous clearance of HBsAg from a large-scale cohort in China.Methods: A total of 151,926 resident individuals in Tongxiang underwent HBsAg screening at least thrice in a 7-year period. Serum samples collected at baseline and follow-up examinations were tested for HBsAg. Cox proportional hazard models were used to analyze determinants of HBsAg seroclearance and persistent HBsAg presence.Results: Among the 151,926 participants, new hepatitis B infections occurred in 4,497 participants, yielding an incidence rate of 571.38 per 100,000 person-years. The incidence rate for males was higher than that for females. In the multivariate Cox regression analysis, female gender, alcohol drinking history, hepatitis family history and middle-age group were predictors for persistent positive HBsAg status.Conclusions: The incidence rate of new hepatitis B infections was 571.38 per 100,000 person-years. Male and aged people in this community cohort have a higher infection rate. Alcohol drinking and hepatitis family history were risk factor leading to chronic infection. Female and middle-aged people were prone to persistent positive HBsAg status.

919. Rates of False-Positive Hepatitis B Surface Antigen Is Low in Cancer Patients

Background Accurate interpretation of hepatitis B virus (HBV) laboratory testing is paramount in avoiding inaccurate diagnosis and incorrect management that could lead to unnecessary and overtreatment. This is particularly relevant in patients with cancer where universal testing is recommended in order to avoid HBV reactivation. Hepatitis B surface antigen testing (HBsAg) positivity indicates chronic or acute HBV infection. The rates and outcomes of a false-positive HBsAg have not been established for patients with cancer. Methods Three hundred and ninety-seven patients with any type of cancer and positive HBsAg seen at MD Anderson Cancer Center from January 2016 – January 2021 were retrospectively reviewed in this study approved by the institutional review board. Cases of false-positive HBsAg were defined as those patients with a positive HBsAg but negative HBsAg quantitative, negative HBV core antibody (total Ig), and undetectable HBV DNA within 30 days of positive HBsAg testing. Serum samples from patients were tested for HBsAg using Vitros Enhanced Chemiluminescent Immunoassay (Ortho-Clinical Diagnostics, Raritan, NJ, USA). Data collection includes demographics, past medical history, underlying cancer and its stage, prior cancer treatment, risk factors for HBV, co-infections (hepatitis C, HIV), symptoms, liver function tests, anti-HBV treatment, and interruptions on cancer treatment. Results Out of 397 patients with a positive HBsAg, 33 were excluded as they did not meet the diagnostic criteria or have insufficient HBV data. Of them, 3 cases (0.8%) were identified as false positive HBsAg. All 3 patients were female, white, and had progressive malignancy (Table 1). No prior history of liver disease or liver function abnormalities were noted with these 3 patients. Initially, antiviral treatment was started on 1 patient which was discontinued shortly after confirmation of false-positive HBsAg. All 3 patients had additional workup and evaluation by an HBV specialist. In 2 patients, cancer treatment was canceled or delayed. Conclusion Although uncommon, cancer patients with false-positive HBsAg need further workup to avoid overtreatment and unnecessary interruptions in cancer care Disclosures Jessica P. Hwang, MD, MPH , Merck (Grant/Research Support)

Viral Hepatitis and Hepatocellular Carcinoma: State of the Art

Viral hepatitis is one of the main causes leading to hepatocellular carcinoma (HCC). The continued rise in incidence of HCC suggests additional factors following infection may be involved. This review examines recent studies investigating the molecular mechanisms of chronic hepatitis and its association with hepatocarcinogenesis. Hepatitis B virus patients with genotype C display an aggressive disease course leading to HCC more than other genotypes. Furthermore, hepatitis B excretory antigen (HBeAg) seems to be a more sensitive predictive tumor marker exhibiting a six-fold higher relative risk in patients with positive HBsAg and HBeAg than those with HBsAg only. Single or combined mutations of viral genome can predict HCC development in up to 80% of patients. Several mutations in HBx-gene are related with higher HCC incidence. Overexpression of the core protein in HCV leads to hepatocellular lipid accumulation associated with oncogenesis. Reduced number and decreased functionality of natural killer cells in chronic HCV individuals dysregulate their surveillance function in tumor and viral cells resulting in HCC. Furthermore, high T-cell immunoglobulin and mucin 3 levels supress CD8+ T-cells, which lead to immunological dysregulation. Hepatitis D promotes HCC development indirectly via modifications to innate immunity, epigenetic alterations and production of reactive oxygen species with the LHDAg being the most highly associated with HCC development. Summarizing the results, HBV and HCV infection represent the most associated forms of viral hepatitis causing HCC. Further studies are warranted to further improve the prediction of high-risk patients and development of targeted therapeutics preventing the transition from hepatic inflammation–fibrosis to cancer.

Pre-Existing HBV and HCV Infections Do Not Affect COVID-19-Related Outcomes: An Observational Retrospective Study

Background: A better understanding of the interaction between SARS-CoV-2 infection and HBV or HCV hepatitis is very important. Objectives: We aimed at determining the prevalence and the impact of pre-existing HBV and HCV infections in patients with COVID-19. Methods: We conducted a retrospective study and included all the subjects positive for SARS-CoV-2 from March to May 2020. We evaluated the prevalence of chronic HBV and HCV infections and performed a matched cohort analysis to compare COVID-19-related outcomes between patients with and without infections due to HBV or HCV. Results: Among 606 subjects, 12 cases (2%) had positive HBsAg, and 6 cases (0.99%) presented detectable HCV RNA. We recognized 80 individuals positive for SARS-CoV-2 with negative markers for HBV and HCV suitable for the matched analysis. No statistical differences in mechanical ventilation and mortality rates were found (P = 0.27 and P = 0.80, respectively). Moreover, individuals with viral hepatitis were more likely to be admitted to the Intensive Care Unit in comparison to those without HBV or HCV infections (29% vs. 15%). The median time of virus clearance was 27.5 days, with no difference between the two groups. Conclusions: In our cohort, the pre-existing viral liver infection did not have any impact on the clinical and virological evolution of COVID-19.

Hepatitis B Surface Antigen level and its Correlation with Age, Gender, and Liver Biomarkers

Background: Measuring the concentration of hepatitis B surface antigen (HbsAg) in HBV patients can be determined with immunoassay techniques. This study aimed to measure the HbsAg titers in chronic HBV patients and to assess its correlation with patients' ages, gender, and with the levels of liver enzymes and total serum bilirubin. Materials and Method: Fifty-eight chronic hepatitis B infected patients were enrolled in this study. Age and gender of the patients were recorded. HbsAg concentration was tested with automated Immunoanalyzer. The patients were also tested for ALT, AST, ALP, and TSB by automated chemistry analyzer. Results: All the chronic HBV patients have positive HBsAg titers above the negative cutoff (0.05U/L) with mean concentration equal to 3099.7U/L, and a range of 0.25-6005.2 U/L. The highest mean HbsAg concentration was in age group 50-59, while the least was in age group ≥60. There was weak negative insignificant correlation between HbsAg concentrations and ages of patients. Thirty one of the patients were males and 27 were females. The means of HbsAg concentrations between males and females were statistically not significant. The mean ALT concentration was 60.038U/L, for AST was 40.728U/L, for ALP was 113.722 U/L, and for TSB was 1.168mg/dl. The values of correlation coefficients (R) between HBsAg titers and the concentrations of ALT, AST, ALP, and TSB were 0.13, 0.11, 0.12, and 0.14, respectively. Conclusions: The HBsAg titers are positive among all chronic HBV patients, with a mean titer of 3099.7U/L and all of the values are below 10000.0U/L. The mean titers increase gradually with age to reach the peak in age group 50-59 years old then decline The age, gender, serum ALT, serum AST, serum ALP, and TSB all have weak insignificant correlations with HBsAg titers among chronic HBV patients. The serum ALT is the most commonly elevated liver biomarker in chronic HBV patients.

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

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.

Incidence of hepatitis B and hepatitis C in Pediatric ward in General hospital, Bhopal (M.P)

To determine the incidence of HBV and HCV in pediatric ward in Rajeev Gandhi General Hospital and College, Bhopal. (M.P.) Viral hepatitis caused by HCV and HBV represents a major public health problem in India. These viruses share common modes of transmission, as parenteral route. Hospital base study of pediatric cases admitted to hospital during a period from March 2019 to February 2020. Pediatric cases were studied for the incidence of HBsAg and HCV Ab by ELISA, Rapid technique. The positive result was confirmed with line immuno-assay. The study showed positive HBsAg in 12 patients and HCV in 2 cases out 25 cases represented with acute hepatitis from a total of 1762 pediatric cases were submitted in this study, with incidence rate of 0.68% and 0.11% respectively.: The incidence of HBV and HCV are low, therefore active program need to be applied to control the spread of infection among the population.

Hepatitis B Envelope Antigen in Children and Adults with Hepatitis B Infection in Tertiary Health Facility in North East Nigeria During the Period 2000-2015

Introduction: Worldwide, most people living with chronic HBV infection are in in low- and middle-income countries. Most of the burden of disease from HBV infection comes from infections acquired before the age of 5 years. Materials and Methods: Records of Hepatitis B surface and envelope antigen results of children and adults in Federal Teaching Hospital, Gombe between May 2000 and May 2015 were analyzed Results: 22,862 individuals were tested for Hepatitis B surface antigen. 19.5% (4456) tested positive. 24.7 % (3146) and 12.9% (1310) of males and females respectively were HBsAg positive. HBsAg Peak prevalence of 21.8% was in the age group 26-46 (2533) and the lowest prevalence in infancy (3.5%). Amongst males, the 19-25year age group had the peak prevalence of 28.6% and in females the age group 5-9 years constituted the highest (20.3%). 36% (1602/4456) of HBsAg positive children and adults were tested for HBeAg. 26.2% (420/1602) of individuals with HBsAg carriage were HBeAg. More males (307/1105) than females (113/495) were HBeAg positive but not statistically significant. (P=0.034). Prevalence of HBeAg was highest in infants (50%) and children 1-4 years (50%) age group and thereafter declined with increasing age. Females of the younger age group <1year, 1-4 years and 5-9 years and older age group, 56-65 and >65 years, compared to their male carriers of HBsAg had higher prevalence of HBeAg but these were not statistically significant. Conclusion: A fifth of HBsAg carriers were HBeAg positive and HBeAg positivity decreased with increasing age. Hepatitis B vaccination in Nigeria requires urgent strengthening. Keywords: Hepatitis, HBsAg, HBeAg Children, Adults, Nigeria.