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World Journal of Gastroenterology Sep 2015Accompanying the increased use of biological and non-biological antirheumatic drugs, a greater number of cases of hepatitis B virus (HBV) reactivation have been reported... (Review)
Review
Accompanying the increased use of biological and non-biological antirheumatic drugs, a greater number of cases of hepatitis B virus (HBV) reactivation have been reported in inactive hepatitis B surface antigen (HBsAg) carriers and also in HBsAg-negative patients who have resolved HBV infection. The prevalence of resolved infection varies in rheumatic disease patients, ranging from 7.3% to 66%. Through an electronic search of the PubMed database, we found that among 712 patients with resolved infection in 17 observational cohort studies, 12 experienced HBV reactivation (1.7%) during biological antirheumatic therapy. Reactivation rates were 2.4% for etanercept therapy, 0.6% for adalimumab, 0% for infliximab, 8.6% for tocilizumab, and 3.3% for rituximab. Regarding non-biological antirheumatic drugs, HBV reactivation was observed in 10 out of 327 patients with resolved infection from five cohort studies (3.2%). Most of these patients received steroids concomitantly. Outcomes were favorable in rheumatic disease patients. A number of recommendations have been established, but most of the supporting evidence was derived from the oncology and transplantation fields. Compared with patients in these fields, rheumatic disease patients continue treatment with multiple immunosuppressants for longer periods. Optimal frequency and duration of HBV-DNA monitoring and reliable markers for discontinuation of nucleoside analogues should be clarified for rheumatic disease patients with resolved HBV infection.
Topics: Antirheumatic Agents; Antiviral Agents; Hepatitis B; Hepatitis B virus; Humans; Immunocompromised Host; Prevalence; Recurrence; Rheumatic Diseases; Risk Assessment; Risk Factors; Virus Activation
PubMed: 26420955
DOI: 10.3748/wjg.v21.i36.10274 -
Journal of Immigrant and Minority Health Dec 2021Hepatitis B (HBV) is endemic in Haiti, therefore Haitian immigrants should be screened to identify and link affected individuals to care. Current screening approaches...
Hepatitis B (HBV) is endemic in Haiti, therefore Haitian immigrants should be screened to identify and link affected individuals to care. Current screening approaches are ineffective. We assessed the acceptability and feasibility of home-based screening among Haitian immigrants using community health workers (CHWs). We recruited participants exiting a pragmatic trial evaluating strategies to improve care delivery (NCT02970136). Participants completed an acceptability questionnaire. Blood drawn by CHWs at participants' homes or community sites was tested for hepatitis B surface antigen, hepatitis B surface antibody and hepatitis B core antibody. Of 60 participants, 59 found screening acceptable; 53 had blood drawn. Of those, 45.3% had HBV previously, 49.1% remained susceptible and 5.7% were vaccinated. Respondents cited various reasons community members might find screening unacceptable. The high prior HBV rate highlights the need for effective outreach programs. Home-based HBV screening was both acceptable and feasible among Haitian immigrants.
Topics: Emigrants and Immigrants; Feasibility Studies; Haiti; Hepatitis B; Humans; Mass Screening
PubMed: 33686574
DOI: 10.1007/s10903-021-01165-z -
Viruses Dec 2023Despite the outstanding progress that has been made in the prevention, detection, and management of hepatitis B during the past decades, hepatitis B remains a problem... (Review)
Review
Despite the outstanding progress that has been made in the prevention, detection, and management of hepatitis B during the past decades, hepatitis B remains a problem among healthcare personnel (HCP) in many countries. We reviewed studies on all aspects of hepatitis B in HCP published from 2017 through April 2023. They revealed wide variations on the prevalence of infection among HCP, ranging from 0.6% in Europe to >8.7% in Africa, almost always in association with very low vaccination rates. Many studies found a significant association between HCP's knowledge about hepatitis B and hepatitis B vaccines, their vaccination status, and practices. This research also discloses global inequities regarding vaccination policies against hepatitis B, free-of-charge vaccinations, and access to post-exposure prophylaxis (PEP). Strategies to prevent and manage accidental exposures are needed in order to reduce the burden of hepatitis B on HCP, while written policies for all aspects of infection prevention, protective equipment, and PEP should be available. Lastly, HCP should be accordingly educated. These are all imperative given the decline of routine vaccinations in the COVID-19 era, particularly in countries with fragile vaccination programs, and the disruptions of interventions for hepatitis B that are expected to provide a pool of virus transmission to future generations.
Topics: Humans; Health Personnel; Hepatitis B; Vaccination; Hepatitis B Vaccines; Delivery of Health Care
PubMed: 38140695
DOI: 10.3390/v15122454 -
Mathematical Biosciences and... Apr 2023New stochastic and deterministic Hepatitis B epidemic models with general incidence are established to study the dynamics of Hepatitis B virus (HBV) epidemic...
New stochastic and deterministic Hepatitis B epidemic models with general incidence are established to study the dynamics of Hepatitis B virus (HBV) epidemic transmission. Optimal control strategies are developed to control the spread of HBV in the population. In this regard, we first calculate the basic reproduction number and the equilibrium points of the deterministic Hepatitis B model. And then the local asymptotic stability at the equilibrium point is studied. Secondly, the basic reproduction number of the stochastic Hepatitis B model is calculated. Appropriate Lyapunov functions are constructed, and the unique global positive solution of the stochastic model is verified by Itô formula. By applying a series of stochastic inequalities and strong number theorems, the moment exponential stability, the extinction and persistence of HBV at the equilibrium point are obtained. Finally, using the optimal control theory, the optimal control strategy to eliminate the spread of HBV is developed. To reduce Hepatitis B infection rates and to promote vaccination rates, three control variables are used, for instance, isolation of patients, treatment of patients, and vaccine inoculation. For the purpose of verifying the rationality of our main theoretical conclusions, the Runge-Kutta method is applied to numerical simulation.
Topics: Humans; Incidence; Hepatitis B; Hepatitis B virus; Computer Simulation; Epidemics
PubMed: 37322965
DOI: 10.3934/mbe.2023483 -
The American Journal of Tropical... Dec 2020Hepatitis B virus (HBV) vaccination patterns and the understanding of its risks among healthcare workers (HCWs) is a critical step to decrease transmission. However, the...
Hepatitis B virus (HBV) vaccination patterns and the understanding of its risks among healthcare workers (HCWs) is a critical step to decrease transmission. However, the depth of this understanding is understudied. We distributed surveys to HCWs in 12 countries in Africa. Surveys had nine multiple-choice questions that assessed HCWs' awareness and understanding of HBV. Participants included consultants, medical trainees, nurses, students, laboratory personnel, and other hospital workers. Surveys were completed anonymously. Fisher's exact test was used for analysis, with a -value of < 0.05 considered significant; 1,044 surveys were collected from Kenya, Egypt, Sudan, Tanzania, Ethiopia, Uganda, Malawi, Madagascar, Nigeria, Cameroon, Ghana, and Sierra Leone. Hepatitis B virus serostatus awareness, vaccination rate, and vaccination of HCWs' children were 65%, 61%, and 48%, respectively. Medical trainees had higher serostatus awareness, vaccination rate, and vaccination of their children than HCWs in other occupations (79% versus 62%, < 0.001; 74% versus 58%, < 0.001; and 62% versus 45%, = 0.006, respectively). Cost was cited as the most frequent reason for non-vaccination. West African countries were more aware of their serostatus but less often vaccinated than East African countries (79% versus 59%, < 0.0001 and 52% versus 60%, = 0.03, respectively). West African countries cited cost as the reason for non-vaccination more than East African countries (59% versus 40%, = 0.0003). Our study shows low HBV serostatus awareness and vaccination rate among HCWs in Africa, and reveals gaps in the perception and understanding of HBV prevention that should be addressed to protect HCWs and improve their capacity to control HBV infection.
Topics: Adult; Africa; Female; Health Expenditures; Health Knowledge, Attitudes, Practice; Health Personnel; Hepatitis B; Hepatitis B Vaccines; Humans; Laboratory Personnel; Male; Medical Staff; Nurses; Students, Medical; Students, Nursing; Vaccination Coverage
PubMed: 33025875
DOI: 10.4269/ajtmh.20-0521 -
Saudi Journal of Gastroenterology :... 2019Hepatitis B virus (HBV) infection remains a public health problem worldwide. In this review, we aim to assess the current situation of the HBV care pathway in the... (Review)
Review
Hepatitis B virus (HBV) infection remains a public health problem worldwide. In this review, we aim to assess the current situation of the HBV care pathway in the Kingdom of Saudi Arabia (KSA), identify gaps/barriers therein, and recommend initiatives to be taken to improve the management of such patients. Towards this end, a literature search was conducted in PubMed and free Internet searches. Interviews with individuals and focus group discussions were held with HBV experts in KSA. Although significant improvements have been made in the past 30 years in KSA in terms of the decline in prevalence (currently estimated to be around 1.3%), the morbidity and mortality related to the disease have not shown a parallel decline. This makes HBV an important public health concern. Furthermore, poor disease awareness, low diagnosis rates, and nonadherence to therapy amplify the disease burden. There are several mandated national screening structures present; however, established protocols for those who test positive and subsequent linkage-to-care are inadequate. In the absence of a virologic cure, a concerted effort should be made to provide safe and effective lifelong treatment. This review provides recommendations to reduce the HBV disease burden in the Saudi population.
Topics: Awareness; Cost of Illness; Diagnostic Screening Programs; Female; Hepatitis B; Hepatitis B virus; Humans; Immunization Programs; Male; Medication Adherence; Morbidity; Prevalence; Saudi Arabia
PubMed: 30720000
DOI: 10.4103/sjg.SJG_421_18 -
PloS One 2022Hepatitis B is a major global public health threat. According to China's National Notifiable Disease Reporting System (NNDRS), Gannan Tibetan Autonomous Prefecture... (Review)
Review
Hepatitis B is a major global public health threat. According to China's National Notifiable Disease Reporting System (NNDRS), Gannan Tibetan Autonomous Prefecture (Gannan) had the highest incidence of hepatitis B in Gansu Province during 2004 to 2016. We evaluated NNDRS hepatitis B case reports from Gannan to determine accuracy of diagnosis and to understand factors associated with inaccuracy. We reviewed medical records with hepatitis B diagnosis hospitalized in seven county hospitals in Gannan between January 1, 2016 and July 31, 2017. Using national "Classification and Diagnostic Procedures for Hepatitis B," we independently reclassified the diagnoses. We determined the positive predictive value (PPV) of reported hepatitis B cases. We investigate clinicians' understanding of the diagnostic and reporting criteria for hepatitis B by questionnaire. We reviewed and re-categorized 400 inpatients reported. Sixteen cases had been reported as acute hepatitis B, but on re-categorization, none were acute hepatitis B cases. PPVs for chronic hepatitis B and unclassified hepatitis B cases were 66% and 15% respectively; 327 (82%) of the reported hepatitis B cases were inaccurately classified; 261 were carriers, 59 were reported previously, and 7 did not have hepatitis B. The actual incidence of hepatitis B in Gannan in 2016 was estimated to be 19/100,000, significantly below the reported incidence of 106/100,000. Among reported cases, 81% had been tested for Alanine aminotransferase, 52% for hepatitis C antibody, 80% with liver ultrasound, 32% for hepatitis A antibody, and 7% for hepatitis B virus (HBV) DNA. Not all cases were tested for anti-HBc IgM or hepatitis E antibody or had a liver biopsy. In the knowledge test, 56% of clinicians accurately diagnosed three simulated cases of acute hepatitis B, and 17% correctly diagnosed two simulated cases chronic hepatitis B; 22% knew that "a client with only HBsAg positivity need not be reported." The falsely high incidence in Gannan was due to diagnostic and reporting inaccuracies. We recommend that clinicians and laboratorians receive additional training in hepatitis B diagnostic criteria and reporting standards, including appropriate use of IgM anti-HBc tests. Hepatitis B surveillance data should be periodically reviewed and evaluated for accuracy.
Topics: Alanine Transaminase; China; Hepatitis B; Hepatitis B Antibodies; Hepatitis B Surface Antigens; Hepatitis B, Chronic; Humans; Immunoglobulin M; Surveys and Questionnaires
PubMed: 36122331
DOI: 10.1371/journal.pone.0274798 -
Clinical Infectious Diseases : An... Jun 2016Chronic hepatitis B virus (HBV) infection is estimated to affect >350 million people worldwide and represents a significant cause of morbidity and mortality related to...
Chronic hepatitis B virus (HBV) infection is estimated to affect >350 million people worldwide and represents a significant cause of morbidity and mortality related to cirrhosis and hepatocellular carcinoma. Mother-to-child transmission (MTCT) of HBV remains an important source of incident cases of HBV. Current barriers to eradication of incident HBV infections via MTCT include underutilization of immunoprophylaxis with hepatitis B vaccination and hepatitis B immune globulin in certain endemic regions as well as failure of immunoprophylaxis.
Topics: Adult; Female; Hepatitis B; Hepatitis B Vaccines; Hepatitis B virus; Humans; Infectious Disease Transmission, Vertical; Pregnancy; Pregnancy Complications, Infectious; Young Adult
PubMed: 27190321
DOI: 10.1093/cid/ciw092 -
Genes Oct 2022Adenoviral vaccines have been at the front line in the fight against pandemics caused by viral infections such as Ebola and the coronavirus disease 2019. This has... (Review)
Review
Adenoviral vaccines have been at the front line in the fight against pandemics caused by viral infections such as Ebola and the coronavirus disease 2019. This has revived an interest in developing these vectors as vaccines and therapies against other viruses of health importance such as hepatitis B virus (HBV). Current hepatitis B therapies are not curative; hence, chronic hepatitis B remains the major risk factor for development of liver disease and death in HBV-infected individuals. The ability to induce a robust immune response and high liver transduction efficiency makes adenoviral vectors attractive tools for anti-HBV vaccine and therapy development, respectively. This review describes recent developments in designing adenoviral-vector-based therapeutics and vaccines against HBV infection.
Topics: Humans; COVID-19; Genetic Vectors; Hepatitis B virus; Hepatitis B, Chronic; Hepatitis B; Viral Vaccines
PubMed: 36360178
DOI: 10.3390/genes13111941 -
Annual Review of Virology Sep 2021Chronic hepatitis B virus (HBV) infection is the leading cause of liver cirrhosis and hepatocellular carcinoma, estimated to be globally responsible for ∼800,000... (Review)
Review
Chronic hepatitis B virus (HBV) infection is the leading cause of liver cirrhosis and hepatocellular carcinoma, estimated to be globally responsible for ∼800,000 deaths annually. Although effective vaccines are available to prevent new HBV infection, treatment of existing chronic hepatitis B (CHB) is limited, as the current standard-of-care antiviral drugs can only suppress viral replication without achieving cure. In 2016, the World Health Organization called for the elimination of viral hepatitis as a global public health threat by 2030. The United States and other nations are working to meet this ambitious goal by developing strategies to cure CHB, as well as prevent HBV transmission. This review considers recent research progress in understanding HBV pathobiology and development of therapeutics for the cure of CHB, which is necessary for elimination of hepatitis B by 2030.
Topics: Antiviral Agents; Hepatitis B; Hepatitis B virus; Hepatitis B, Chronic; Humans; Virus Replication
PubMed: 34586871
DOI: 10.1146/annurev-virology-091919-062728