THE ANALYSYS OF LEVEL OF BLOOD-BORNE AND SEXUALLY TRANSMITTED VIRUSES INFECTIONS OF THE PRISONERS IN THE CONTEXT OF HBV PREVENTION

The aim of the article is to analyze the level of viral infections transmitted through sexual contact and blood-borne infections in Polish penal institutions and detention centers. The description of the issue presented in the study is primarily aimed at signaling the issue and at trying to indicate possible preventive solutions. It seems inevitable to confront the actual living conditions and situations in the prison environment with the scale of the problem of HIV and HBV/HCV infections. Therefore, the authors consider it necessary to monitor the situation and familiarize the interested specialists in the field of probation with the problem in order to encourage reflection on the possible introduction of preventive measures.

Common concerns, barriers to care, and the lived experience of individuals with hepatitis B: a qualitative study

Background An estimated between 257 and 292 million people live with chronic HBV globally. While much is known about the causes, and epidemiology of HBV, little is understood about the quality of life and impact of HBV on those living with the infection. Methods A random sample of HBV-related email queries sent to the Hepatitis B Foundation, a U.S.-based non-profit organization, over a 12-month period in 2018–2019 were retrieved, tabulated, and analyzed qualitatively to highlight information needs and explore the experiences of people living with HBV and their families and loved ones. Codebook development was informed by the literature and through line-by-line reading of a sub-sample of queries. Data analysis was facilitated by NVivo12 software. Data were coded independently by two members of the research team and intercoder reliability was assessed to assure coding accuracy throughout the coding phase. Results A total of 338 queries from people around the globe were identified and analyzed. The analysis revealed three thematic groups: 1) health-specific challenges associated with diagnosis and treatment, 2) emotional needs related to experiences with HBV stigma, discrimination, fear, social isolation, and distress and 3) informational needs related to HBV prevention and transmission, and interpretation of laboratory tests. Conclusions People living with HBV are in need of information to manage their disease and prevent its spread. Analysis of queries uncovered significant misconceptions about HBV transmission and treatment. Additionally, the emotional and psychological impact of an HBV diagnosis on those living with the infection is significant. There is a clear need for patient and community education to expand knowledge and awareness of HBV globally to achieve 2030 WHO HBV elimination goals.

Knowledge, attitudes, and practices towards hepatitis B virus prevention among nursing students at a selected campus in Rwanda

Introduction: Hepatitis B virus continues to be among the significant global challenges, and its prevention is doubtable among nursing students due to the lack of knowledge or exposure to risky behaviors in their clinical practices. This study was conducted to assess nursing students at a selected campus in Rwanda about their knowledge, attitudes, and practices towards hepatitis B prevention.Methods: A cross-sectional study design was used to conduct this study. Non-probability sampling, including convenience and snowball techniques, was used to determine the representation at all levels at a selected Campus from May to July 2018. Statistical Package for the Social Sciences (SPSS) version 26 was used for data entry. Descriptive and inferential statistics using Binary logistic regression were used to analyze the data. Institutional Review Board (IRB) of the University of Rwanda approved the study, andparticipants' rights were protected.Results: Among 171 study participants, only 140 returned the completed questionnaires, which translates to a response rate of 82.4%. Among the students who participated in this study, most were males, 75 (53.5%). The respondents' mean age was 25 years old, and the maximum age was 43. Most of the participants were from level 1 52(37.1%). The findings revealed that nursing students have adequateknowledge and practices towards HBV prevention at 65% and 71%, respectively. However, their attitudes regarding HBVprevention were negative because 96% scored at most four questions right.Conclusion: Knowledge and practices regarding HBV prevention among nursing students were quite adequate. However, a significant proportion of nursing students do not have good attitudes. These findings highlight the need to increase knowledge about HBV among nursing students in clinical orientation meetings before starting their clinical placements and introducing infection prevention and control training when they are already in clinical settings. Keywords: Hepatitis B virus, knowledge, attitudes, practices, nursing students, Rwanda

Common Concerns, Barriers to Care, and the Lived Experience of Individuals with Hepatitis B: A Qualitative Study

Background & Aims: An estimated between 257 and 292 million people live with chronic HBV globally. While much is known about the causes, and epidemiology of HBV, little is understood about the quality of life and impact of HBV on those living with the infection. Approach and Results: A random sample of HBV-related email queries sent to the Hepatitis B Foundation, a U.S.-based non-profit organization, over a 12-month period in 2018-2019 were retrieved, tabulated, and analyzed qualitatively to highlight information needs and explore the experiences of people living with HBV and their families and loved ones. Codebook development was informed by the literature and through line-by-line reading of a sub-sample of queries. Data analysis was facilitated by NVivo12 software. Data were coded independently by two members of the research team and intercoder reliability was assessed to assure coding accuracy throughout the coding phase. A total of 338 queries from people around the globe were identified and analyzed. The analysis revealed three thematic groups: 1) health-specific challenges associated with diagnosis and treatment, 2) emotional needs related to experiences with HBV stigma, discrimination, fear, social isolation, and distress and 3) informational needs related to HBV prevention and transmission, and interpretation of laboratory tests.Conclusions: People living with HBV are in need of information to manage their disease and prevent its spread. Analysis of queries uncovered significant misconceptions about HBV transmission and treatment. Additionally, the emotional and psychological impact of an HBV diagnosis on those living with the infection is significant. There is a clear need for patient and community education to expand knowledge and awareness of HBV globally to achieve 2030 WHO HBV elimination goals.

Global prevalence and phylogeny of hepatitis B virus (HBV) drug and vaccine resistance mutations

ABSTRACTIntroductionVaccination and anti-viral therapy with nucleos(t)ide analogues (NAs) are key approaches to reducing the morbidity, mortality and transmission of hepatitis B virus (HBV) infection. However, the efficacy of these interventions may be reduced by the emergence of drug resistance-associated mutations (RAMs) and/or vaccine escape mutations (VEMs). We have assimilated data on the global prevalence and distribution of HBV RAMs/VEMs from publicly available data and explored the evolution of these mutations.MethodsWe analysed sequences downloaded from the Hepatitis B Virus Database, and calculated prevalence of 41 RAMs and 38 VEMs catalogued from published studies. We generated maximum likelihood phylogenetic trees and used treeBreaker to investigate the distribution of selected mutations across tree branches. We performed phylogenetic molecular clock analyses using BEAST to estimate the age of mutations.ResultsRAM M204I/V had the highest prevalence, occurring in 3.8% (109/2838) of all HBV sequences in our dataset, and a significantly higher rate in genotype C sequence at 5.4% (60/1102, p=0.0007). VEMs had an overall prevalence of 1.3% (37/2837) and had the highest prevalence in genotype C and in Asia at 2.2% (24/1102; p=0.002) and 1.6% (34/2109; p=0.009) respectively. Phylogenetic analysis suggested that most RAM/VEMs arose independently, however RAMs including A194T, M204V and L180M formed clusters in genotype B. We show evidence that polymorphisms associated with drug and vaccine resistance may have been present in the mid 20th century suggesting that they can arise independently of treatment/ vaccine exposure.DiscussionHBV RAMs/VEMs have been found globally and across genotypes, with the highest prevalence observed in genotype C variants. Screening for the genotype and for resistant mutations may help to improve stratified patient treatment. As NAs and HBV vaccines are increasingly being deployed for HBV prevention and treatment, monitoring for resistance and advocating for better treatment regimens for HBV remains essential.

HBV Prevention and Treatment in Countries of Central Asia and the Caucasus

The countries of Central Asia and the Caucasus are linked by travel and trade, which is promoted by visa-free mobility across borders. Unfortunately, this migrant mobility has given rise to the transmission of various infections within this region. Overlaps in culture, tradition, and behavior among these countries provide opportunities to share experiences that have proven effective in controlling transmission. Here we present a review of hepatitis B virus (HBV) prevalence, prevention and treatment across Central Asia and the Caucasus. Overall, owing to effective measures, while HBV prevalence has been steadily declining in the region, certain gaps still exist regarding the generation and availability of HBV infection data.

Trends in Hepatitis B Surveillance Among Pregnant Women in New York City, 1998-2015

Objective Infants born to women with hepatitis B virus (HBV) infection are at high risk for chronic HBV infection and premature death. We examined epidemiologic trends among women with HBV infection who gave birth in New York City (NYC) to inform public health prevention activities. Methods We obtained data on HBV-infected women residing and giving birth in NYC during 1998-2015 from the NYC Perinatal HBV Prevention Program. We obtained citywide birth data from the NYC Office of Vital Statistics. We calculated the incidence of births to HBV-infected women per 100 000 live births and stratified by maternal race, birthplace, and age. We calculated annual percentage change (APC) in incidence of births to HBV-infected women by using joinpoint regression. Results Of 29 896 HBV-infected women included in the study, 28 195 (94.3%) were non–US-born, of whom 16 600 (58.9%) were born in China. Overall incidence of births to HBV-infected women per 100 000 live births increased from 1156 in 1998 to 1573 in 2006 (APC = 3.1%; P < .001) but declined to 1329 in 2015 (APC = –1.4%; P = .02). Incidence among US-born women declined from 1998 to 2015 (330 to 84; APC = –7.3%; P < .001) and among non–US-born women increased from 1998 to 2007 (1877 to 2864; APC = 3.6%; P < .001) but not thereafter. Incidence among women born in China increased from 1998 to 2006 (13 275 to 16 480; APC = 1.8%; P = .02) but decreased to 12 631 through 2015 (APC = –3.3%; P < .001). Conclusions The incidence of births to HBV-infected women in NYC declined significantly among US-born women but not among non–US-born women, highlighting the need for successful vaccination programs worldwide.

Hepatitis B virus perceptions and health seeking behaviors among pregnant women in Uganda: implications for prevention and policy

Background With most countries in sub-Saharan Africa (SSA) lagging behind schedule to implement a comprehensive viral hepatitis elimination strategy, several barriers to accurate information and hepatitis B virus (HBV) services still exist, that are unique to different regions. In an obstetric population of a high HBV burden SSA setting without antenatal HBV services, we systematically evaluated perceptions and prevention behavioral intentions in relation to HBV and liver cancer. Methods Eligible consenting pregnant women were recruited from public health care facilities in the central and northern regions of Uganda, between October 2016 and December 2017. Standardized procedures and instruments based on the health belief model and theory of planned behavior were used to collect data on socio-demographic characteristics, HBV perceptions and behavioral intentions. Descriptive analysis using Chi-square tests was done to obtain distribution of respondents by levels of perceived risk of HBV and liver cancer for themselves, their child under 5 years and their spouse. Modified Poisson regression analyses were used to evaluate relationships between perception variables and different behavioral outcomes (intention to screen, vaccinate and treat HBV). Results Perceived risk (PRR = 0.95(0.90–1.00), p = 0.055) was inversely associated with intention to screen for HBV. Conversely, perceived self-efficacy showed a consistent association with intention to screen for HBV (PRR = 1.18(1.10–1.23) p = 0.005), to vaccinate (PRR = 1.20(1.05–1.36) p = 0.006) and to seek treatment for HBV (PRR = 1.40(1.18–1.67) p < 0.001). Women from the north, compared to the central region (PRR = 1.76 (1.13–2.72) p = 0.012), and those who self-identified as Catholic (PRR = 1.85 (0.99–3.56) p = 0.056), and as Protestant, (PRR = 2.22 (1.22–4.04) p = 0.002), were more likely to have higher perceived self-efficacy, compared to Muslims. Age and education were not related to perceived self-efficacy. Conclusion Women in both regions hold incorrect perceptions of HBV and liver cancer risk, with women from the central reporting higher perceived risk than those from the north. High perceived self-efficacy influenced intention to participate in HBV prevention. Programs and policies geared towards enhancing HBV prevention in this sub-population may consider socio-cultural factors observed to influence prevention behaviors. These findings may guide HBV interventions aimed at improving capacity to seek HBV prevention services, thereby promoting HBV micro-elimination in this sub-population.