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Fármacos Anti-VIH , Farmacorresistencia Viral , Emtricitabina , Infecciones por VIH , VIH-1 , Compuestos Heterocíclicos con 3 Anillos , Oxazinas , Piperazinas , Piridonas , Tenofovir , Humanos , Infecciones por VIH/tratamiento farmacológico , VIH-1/efectos de los fármacos , VIH-1/genética , Emtricitabina/uso terapéutico , Piridonas/uso terapéutico , Piperazinas/uso terapéutico , Tenofovir/uso terapéutico , Compuestos Heterocíclicos con 3 Anillos/uso terapéutico , Fármacos Anti-VIH/uso terapéutico , Oxazinas/uso terapéutico , Compuestos Heterocíclicos de 4 o más Anillos/uso terapéutico , Compuestos Heterocíclicos de 4 o más Anillos/administración & dosificación , Hepatitis B/tratamiento farmacológico , Adenina/análogos & derivados , Adenina/uso terapéutico , Masculino , Femenino , AmidasRESUMEN
BACKGROUND: Although hepatitis B infection is highly endemic in Africa, information on its epidemiology among pregnant women in the region is limited. Therefore, this systematic review provided up-to-date information on the epidemiology of hepatitis B virus (HBsAg) infection among pregnant women in Africa. METHODS: A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews. The Web of Science, Scopus, PubMed, Google Scholar, and African journals online were searched to identify relevant studies published between January 1, 2015, and May 21, 2024, on hepatitis B virus infection in pregnant women living in Africa. The Joanna Briggs Institute tool was used to assess the methodological qualities of the included studies. The random effects model was used to estimate the pooled prevalence of HBV infection. I2 assessed the amount of heterogeneity. Publication bias was assessed using Egger's test and a funnel plot. RESULTS: We included 91 studies from 28 African countries. The pooled prevalence of hepatitis B infection among pregnant women in Africa was 5.89% (95% CI: 5.26-6.51%), with significant heterogeneity between studies (I2 = 97.71%, p < 0.001). Family history of hepatitis B virus infection (AOR = 2.72, 95%CI: 1.53-3.9), multiple sexual partners (AOR = 2.17, 95%CI: 1.3-3.04), and sharing sharp materials were risk factors for hepatitis B infection. CONCLUSION: An intermediate endemic level of hepatitis B virus infection (2-7%) was observed among pregnant women in Africa. To prevent disease transmission, interventions should focus on pregnant women with a family history of hepatitis B infection, multiple sexual partners, and sharing sharp materials.
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Virus de la Hepatitis B , Hepatitis B , Complicaciones Infecciosas del Embarazo , Humanos , Embarazo , Femenino , Hepatitis B/epidemiología , África/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/virología , Prevalencia , Factores de RiesgoRESUMEN
OBJECTIVE: To assess the fibrinogen function in patients with hepatitis B-related cirrhosis and explore the relationship between dysfibrinogenemia and bleeding and thrombotic events. METHODS: Medical records and laboratory data of the patients with hepatitis B-related cirrhosis were collected. Patients were categorized into three groups based on the Child-Pugh score. Fibrinogen activity and antigen, fibrinogen-bound sialic acid (FSA), fibrinogen polymerization and fibrinolysis kinetic analysis, thrombin-antithrombin complex (TAT) and plasmin-α2-antiplasmin complex (PAP) were detected. RESULTS: Eighty patients with seventeen, thirty-eight and twenty-five in Child-Pugh A, B and C, respectively, were included. Seventeen patients experienced bleeding events and eight patients had thrombotic events. Fibrinogen activity and antigen levels were reduced with the severity of cirrhosis. Twenty-two patients exhibited dysfibrinogenemia. The FSA levels in patients with non-dysfibrinogenemia and those with dysfibrinogenemia were increased to 1.25 and 1.37 times of healthy controls, negatively correlated with fibrinogen activity (ρ = -0.393, p = 0.006). Compared to healthy controls, the amount of clot formation was reduced (p < 0.001), the polymerization was delayed (p < 0.001) and the rate of fibrinolysis was reduced (p < 0.001). The TAT levels were significantly increased in the Child-Pugh C patients compared to the Child-Pugh B patients (p = 0.032) while the PAP levels were comparable among 3 groups (p = 0.361). CONCLUSION: Sialylation of fibrinogen is one of the main causes of modifications of fibrinogen in patients with hepatitis B-related cirrhosis. The polymerization and fibrinolysis functions of fibrinogen are impaired. The degree of impaired fibrinolysis function is more severe than that of polymerization function, and may be partly related to the occurrence of thrombotic events.
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Fibrinógeno , Fibrinólisis , Hepatitis B , Cirrosis Hepática , Humanos , Masculino , Femenino , Fibrinógeno/metabolismo , Fibrinógeno/análisis , Persona de Mediana Edad , Cirrosis Hepática/sangre , Cirrosis Hepática/metabolismo , Cirrosis Hepática/complicaciones , Hepatitis B/complicaciones , Hepatitis B/sangre , Hepatitis B/metabolismo , Adulto , AncianoRESUMEN
PURPOSE: This study aims to analyze whether undergoing amniocentesis during pregnancy in women diagnosed with hepatitis B virus (HBV) infection leads to HBV transmission to newborns. METHODS: Retrospective data collection was conducted from June 2019 to November 2022 on expectant mothers positive for hepatitis B surface antigen (HBsAg) who underwent amniocentesis at The Third Affiliated Hospital of Sun Yat-sen University, along with data on their newborns. The study summarized the HBV infection status of newborns born to mothers with different expressions of hepatitis B e antigen (HBeAg), antiviral treatment versus no treatment, and different HBV DNA viral loads before delivery. RESULTS: In this study, 346 expectant mothers tested positive for HBsAg, along with 351 newborns (including 5 sets of twins, with 8 infants (2.28%) testing HBsAg-positive at birth. All newborns received dual immunotherapy and were followed up. At 7-12 months, retesting for HBsAg positivity and HBV DNA positivity among infants revealed that out of the infants born with HBsAg positivity, 7 cases had seroconverted to negative, while the remaining infant, who was positive for both HBsAg and HBeAg at birth, tested positive for both HBsAg and HBV DNA at 7-12 months. Thus, one case of vertical transmission of hepatitis B from mother to child occurred in this study. The proportion of infants born with HBsAg + among newborns born to HBeAg-positive mothers (4 cases, 6.06%) was significantly higher than that among newborns born to HBeAg-negative mothers (4 cases, 1.41%) (P < 0.05). The proportion of infants born with HBsAg + showed no significant difference between newborns born to mothers receiving antiviral therapy (2 cases, 2.90%) and those born to mothers not receiving antiviral therapy (6 cases, 2.13%) (P > 0.05). Among expectant mothers with viral load ≥ 6 log 10 IU/mL before delivery, 3 newborns (30.00%) were manifesting HBsAg positivity at birth, significantly higher than the group with viral load < 6 log 10 IU/mL before delivery (5 cases, 1.47%) (P < 0.05). CONCLUSION: Among HBsAg-positive expectant mothers, only a small number of infants are infected with the hepatitis B virus at birth, the proportion of which is relatively low. Infants born to mothers who are HBeAg-positive or have a viral load ≥ 6 log10 IU/mL have a higher risk of being born positive.
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Amniocentesis , ADN Viral , Antígenos de Superficie de la Hepatitis B , Antígenos e de la Hepatitis B , Virus de la Hepatitis B , Hepatitis B , Transmisión Vertical de Enfermedad Infecciosa , Complicaciones Infecciosas del Embarazo , Carga Viral , Humanos , Femenino , Embarazo , Estudios Retrospectivos , Recién Nacido , Hepatitis B/transmisión , Adulto , Antígenos de Superficie de la Hepatitis B/sangre , Complicaciones Infecciosas del Embarazo/virología , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Virus de la Hepatitis B/genética , Virus de la Hepatitis B/aislamiento & purificación , ADN Viral/sangre , Antígenos e de la Hepatitis B/sangre , Antivirales/uso terapéutico , Masculino , Madres , Adulto JovenRESUMEN
Background: To identify the risk factors and construct a predictive model for early recurrence of hepatitis B virus(HBV-)- related hepatocellular carcinomas(HCCs) after radical resection. Data and methods: A total of 465 HBV-related HCC patients underwent radical resections between January 1, 2012 and August 31, 2018.Their data were collected through the inpatient information management system of the First Affiliated Hospital of University of Science and Technology of China. Survival and subgroup analyses of early recurrence among male and female patients were performed using Kaplan-Meier curves. The independent risk factors associated with early postoperative tumor recurrence were analyzed using multivariate Cox proportional hazards regression model. Based on these independent risk factors, a risk function model for early recurrence was fitted, and a column chart for the prediction model was drawn for internal and external validation. Results: A total of 181 patients developed early recurrences, including 156 males and 25 females. There was no difference in the early recurrence rates between males and females. Tumor diameters>5cm, microvascular invasion and albumin level<35 g/L were independent risk factors for early recurrence. A nomogram for the early recurrence prediction model was drawn; the areas under the curve for the model and for external verification were 0.638 and 0.655, respectively. Conclusion: Tumor diameter>5 cm, microvascular invasion, and albumin level<35 g/L were independent risk factors for early recurrence. The prediction model based on three clinical indicators could predict early recurrence, with good discrimination, calibration, and extrapolation.
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Carcinoma Hepatocelular , Hepatectomía , Neoplasias Hepáticas , Recurrencia Local de Neoplasia , Nomogramas , Humanos , Masculino , Femenino , Carcinoma Hepatocelular/cirugía , Carcinoma Hepatocelular/virología , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/cirugía , Neoplasias Hepáticas/virología , Neoplasias Hepáticas/patología , Recurrencia Local de Neoplasia/patología , Persona de Mediana Edad , Adulto , Factores de Riesgo , Virus de la Hepatitis B , Estudios Retrospectivos , Hepatitis B/complicaciones , China/epidemiología , Anciano , PronósticoRESUMEN
HepB-CpG is a licensed adjuvanted two-dose hepatitis B vaccine for adults, with limited data on exposure during pregnancy. We assessed the risk of pregnancy outcomes among individuals who received HepB-CpG or the 3-dose HepB-alum vaccine ≤28 d prior to conception or during pregnancy at Kaiser Permanente Southern California (KPSC). The pregnancy cohort included KPSC members aged ≥18 y who received ≥1 dose of hepatitis B vaccine (HepB-CpG or HepB-alum) at KPSC outpatient family or internal medicine departments from August 2018 to November 2020. We followed these individuals through electronic health records from the vaccination date until the end of pregnancy, KPSC health plan disenrollment, or death, whichever came first. Among 81 and 125 eligible individuals who received HepB-CpG and HepB-alum, respectively, live births occurred in 84% and 74%, spontaneous abortion occurred in 7% and 17% (adjusted relative risk [aRR] 0.40, 95% CI: 0.16-1.00), and preterm birth occurred in 15% and 14% of liveborn infants (aRR 0.97, 95% CI 0.47-1.99). No major birth defects were identified through 6 months of age. The study found no evidence of adverse pregnancy outcomes for recipients of HepB-CpG in comparison to HepB-alum.
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Vacunas contra Hepatitis B , Hepatitis B , Resultado del Embarazo , Vigilancia de Productos Comercializados , Humanos , Embarazo , Femenino , Adulto , Vacunas contra Hepatitis B/administración & dosificación , Vacunas contra Hepatitis B/efectos adversos , Vigilancia de Productos Comercializados/estadística & datos numéricos , Adulto Joven , Hepatitis B/prevención & control , Adolescente , California/epidemiología , Recién Nacido , Vacunación/efectos adversos , Vacunación/estadística & datos numéricos , Nacimiento Prematuro/epidemiología , Aborto Espontáneo/epidemiología , Adyuvantes Inmunológicos/efectos adversos , Adyuvantes Inmunológicos/administración & dosificación , Nacimiento Vivo/epidemiologíaRESUMEN
BACKGROUND: Most Chinese blood centers have implemented mini pool (MP) HBV nucleic acid testing (NAT) together with HBsAg ELISA in routine blood donor screening for HBV infection since 2015, and a few centers upgraded MP to individual donation (ID) NAT screening recently, raising urgent need for cost-benefit analysis of different screening strategies. In an effort to prevent transfusion-transmitted infections (TTIs) for HBV, cost-benefit analyses of three different screening strategies: HBsAg alone, HBsAg plus MP NAT and HBsAg plus ID NAT were performed in blood donors from southern China where HBV infection was endemic. METHODS: MP-6 HBV NAT and ID NAT were adopted in parallel to screen blood donors for further comparative analysis. On the basis of screening data and the documented parameters, the number of window period (WP) infection, HBV acute infection, chronic hepatitis B infection (CHB) and occult hepatitis B infection (OBI) was evaluated, and the potential prevented HBV TTIs and benefits of these three strategies were predicted based on cost-benefit analysis by an estimation model. RESULTS: Of 132,323 donations, the yield rate for HBsAg-/DNA + screened by ID NAT (0.12%) was significantly higher than that by MP NAT (0.058%, P < 0.05). Furthermore, the predicted transfusion-transmitted HBV cases prevented was 1.25 times more by ID NAT compared to MP-6 NAT. The cost-benefit ratio of the universal HBsAg screening, HBsAg plus ID NAT and HBsAg plus MP NAT were 1:58, 1:27 and 1:22, respectively. CONCLUSIONS: Universal HBsAg ELISA screening in combination with HBV ID NAT or MP-6 NAT strategies was highly cost effective in China. To further improve blood safety, HBsAg plus HBV DNA ID NAT screening should be considered in HBV endemic regions/countries.
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Donantes de Sangre , Análisis Costo-Beneficio , ADN Viral , Antígenos de Superficie de la Hepatitis B , Virus de la Hepatitis B , Hepatitis B , Humanos , China/epidemiología , Virus de la Hepatitis B/genética , Virus de la Hepatitis B/aislamiento & purificación , Virus de la Hepatitis B/inmunología , Hepatitis B/diagnóstico , Hepatitis B/prevención & control , Antígenos de Superficie de la Hepatitis B/sangre , ADN Viral/sangre , Femenino , Masculino , Adulto , Tamizaje Masivo/economía , Tamizaje Masivo/métodos , Técnicas de Amplificación de Ácido Nucleico/métodos , Técnicas de Amplificación de Ácido Nucleico/economía , Persona de Mediana Edad , Pruebas Serológicas/economía , Pruebas Serológicas/métodos , Ensayo de Inmunoadsorción Enzimática/economía , Ensayo de Inmunoadsorción Enzimática/métodos , Adulto JovenRESUMEN
BACKGROUND: Hepatitis B poses a significant global public health challenge, with mother-to-child transmission (MTCT) being the primary method of hepatitis B virus (HBV) transmission. The prevalence of HBV infection in China is the highest in Asia, and it carries the greatest burden globally. OBJECTIVE: This study aims to critically evaluate the existing local strategies for preventing MTCT and the proposed potential enhancements by analyzing the prevalence of hepatitis B among pregnant women and their neonates in Yinchuan. METHODS: From January 2017 to December 2021, 37,557 prenatal screening records were collected. Among them, 947 pregnant women who tested positive for hepatitis B surface antigen (HBsAg) near delivery and their 960 neonates were included in an HBV-exposed group, while 29 pregnant women who tested negative and their 30 neonates were included in an HBV-nonexposed group. HBV markers in maternal peripheral blood and neonatal cord blood were analyzed using the least absolute shrinkage and selection operator (LASSO) regression, logistic regression, chi-square test, t-test, and U-test. Additionally, to further evaluate the diagnostic value of HBsAg positivity in cord blood, we conducted an additional follow-up study on 103 infants who tested positive for HBsAg in their cord blood. RESULTS: The prevalence of HBV among pregnant women was 2.5% (947/37,557), with a declining trend every year (χ²4=19.7; P=.001). From 2018 to 2020, only 33.0% (35/106) of eligible pregnant women received antiviral medication treatment. Using LASSO regression to screen risk factors correlated with HBsAg positivity in cord blood (when log [λ] reached a minimum value of -5.02), 5 variables with nonzero coefficients were selected, including maternal hepatitis B e-antigen (HBeAg) status, maternal hepatitis B core antibody (HBcAb) status, maternal HBV DNA load, delivery method, and neonatal birth weight. Through univariate and multivariate logistic regression, delivery by cesarean section (adjusted odds ratio [aOR] 0.52, 95% CI 0.31-0.87), maternal HBeAg positivity (aOR 2.05, 95% CI 1.27-3.33), low maternal viral load (aOR 2.69, 95% CI 1.33-5.46), and high maternal viral load (aOR 2.69, 95% CI 1.32-5.51) were found to be strongly associated with cord blood HBsAg positivity. In the additional follow-up study, 61 infants successfully completed the follow-up, and only 2 were found to be infected with HBV. The mothers of both these infants had detectable HBV DNA levels and should have received standard antiviral therapy. The results of the hepatitis B surface antibody (HBsAb) positivity rate and titer test indicated a gradual decline in the immunity of vaccinated infants as the interval after vaccination increased. CONCLUSIONS: The clinical relevance of HBV marker detection in cord blood is restricted within the current prevention measures for MTCT. There is an emphasis on the significance of public education regarding hepatitis B and the reinforcement of postnatal follow-up for the prevention of MTCT.
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Hepatitis B , Transmisión Vertical de Enfermedad Infecciosa , Humanos , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Femenino , China/epidemiología , Embarazo , Estudios Transversales , Hepatitis B/epidemiología , Hepatitis B/transmisión , Adulto , Recién Nacido , Prevalencia , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Antígenos de Superficie de la Hepatitis B/sangreRESUMEN
BACKGROUND: Chronic kidney disease patients, especially those on hemodialysis, are at increased risk of developing hepatitis B virus (HBV) infection. Guidelines suggest that all patients with chronic kidney disease patients should be vaccinated against HBV, but these guidelines are sub-optimally implemented. Notably, there is a lack of studies in Ethiopia examining the hepatitis B vaccination status among patients with end-stage renal disease. OBJECTIVE: To assess the vaccination status of hepatitis B and associated factors among people with end-stage renal disease who were on hemodialysis. METHODS: A multi-center cross-sectional observational study was conducted in six randomly selected dialysis centers in Ethiopia, from May 2023 to September 2023. Logistic regression analysis was used to evaluate factors associated with vaccination status. A person is considered to be vaccinated against hepatitis B if he/ she has taken at least one dose of HBV. Vaccination status was determined by patient's recall and verification from medical record. RESULTS: Only 16% of patients with end-stage renal disease on hemodialysis were vaccinated against hepatitis B virus (16.6%; with CI = 12.18, 21.83), of which 30% had received one dose, 57.5% had two doses, 12.5% had three doses, and only five had a booster dose. Post-secondary education (AOR = 5.47; 95% CI = 1.41, 21.2; P < 0.014) and dialysis for more than three years (AOR = 19.75; 95% CI = 4.06, 96.1; P < 0.001) were significant factors associated with having received hepatitis B vaccination. CONCLUSION: Only a small minority of Ethiopian hemodialysis patients have received hepatitis B vaccination. The level of education of patients and the duration of time on dialysis were significant associated factors that affected the vaccination status of patients with end-stage renal disease. So, strong intervention is needed according to the identified factors to raise the vaccination status of patients.
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Vacunas contra Hepatitis B , Hepatitis B , Fallo Renal Crónico , Diálisis Renal , Humanos , Estudios Transversales , Etiopía/epidemiología , Femenino , Masculino , Fallo Renal Crónico/terapia , Fallo Renal Crónico/epidemiología , Vacunas contra Hepatitis B/administración & dosificación , Persona de Mediana Edad , Adulto , Hepatitis B/prevención & control , Hepatitis B/epidemiología , Vacunación/estadística & datos numéricos , Adulto Joven , AncianoRESUMEN
BACKGROUND: Routine screening for viral infections at blood donation is important to avoid transfusion-transmitted infections. It also offers an opportunity to detect an asymptomatic infection. OBJECTIVE: To study changes in serology positivity for viral infections (B and C hepatitis, HTLV-1/2, and HIV) at blood donation in a blood bank from Southern Brazil, comparing two periods of 5 years: the period from 2013 to 2017 with the period from 2018 to 2022. In addition, data on the donor fidelity rate during the studied period were sought. METHODS: Retrospective study using data from 2013 to 2022 from a single blood center electronic database from Curitiba, Southern Brazil. RESULTS: A significant drop in positive serology for all studied viruses was observed: highest in HIV (OR=0.39; 95% CI=0.27-0.57) and lowest in total anti HBc (0.56; 95 CI=0.50-0.63). Anti HBc serology became more commonly seen in women in the period of 2018-2022 when compared to men. No changes in the distribution of positive serology according to donors' ages were observed. Loyalty rates had a median of 70%, with the lowest being 60% in 2013, while the highest was 73% in 2018 and 2022. CONCLUSION: A significant reduction in discarded blood bags due to viral serology was observed when the period of 2013-2017 was compared to 2018-2022 on this blood bank; the highest reduction was observed in HIV serology and the lowest in HBc serology, which became more common in women in the second period. High rates of donor fidelity were observed during the period studied.
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Bancos de Sangre , Donantes de Sangre , Humanos , Donantes de Sangre/estadística & datos numéricos , Brasil/epidemiología , Masculino , Femenino , Estudios Retrospectivos , Adulto , Bancos de Sangre/estadística & datos numéricos , Persona de Mediana Edad , Adulto Joven , Infecciones por VIH/sangre , Infecciones por VIH/diagnóstico , Tamizaje Masivo/métodos , Adolescente , Hepatitis B/sangre , Hepatitis B/diagnóstico , Hepatitis B/epidemiología , Virosis/diagnóstico , Virosis/sangre , Hepatitis C/sangre , Hepatitis C/diagnóstico , Hepatitis C/epidemiología , Pruebas Serológicas/estadística & datos numéricos , Pruebas Serológicas/métodosRESUMEN
Hepatitis B virus (HBV) exploits the endosomal sorting complexes required for transport (ESCRT)/multivesicular body (MVB) pathway for virion budding. In addition to enveloped virions, HBV-replicating cells nonlytically release non-enveloped (naked) capsids independent of the integral ESCRT machinery, but the exact secretory mechanism remains elusive. Here, we provide more detailed information about the existence and characteristics of naked capsid, as well as the viral and host regulations of naked capsid egress. HBV capsid/core protein has two highly conserved Lysine residues (K7/K96) that potentially undergo various types of posttranslational modifications for subsequent biological events. Mutagenesis study revealed that the K96 residue is critical for naked capsid egress, and the intracellular egress-competent capsids are associated with ubiquitinated host proteins. Consistent with a previous report, the ESCRT-III-binding protein Alix and its Bro1 domain are required for naked capsid secretion through binding to intracellular capsid, and we further found that the ubiquitinated Alix binds to wild type capsid but not K96R mutant. Moreover, screening of NEDD4 E3 ubiquitin ligase family members revealed that AIP4 stimulates the release of naked capsid, which relies on AIP4 protein integrity and E3 ligase activity. We further demonstrated that AIP4 interacts with Alix and promotes its ubiquitination, and AIP4 is essential for Alix-mediated naked capsid secretion. However, the Bro1 domain of Alix is non-ubiquitinated, indicating that Alix ubiquitination is not absolutely required for AIP4-induced naked capsid secretion. Taken together, our study sheds new light on the mechanism of HBV naked capsid egress in viral life cycle.
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Cápside , Proteínas de Ciclo Celular , Complejos de Clasificación Endosomal Requeridos para el Transporte , Virus de la Hepatitis B , Ubiquitina-Proteína Ligasas Nedd4 , Ubiquitina-Proteína Ligasas , Ubiquitinación , Liberación del Virus , Complejos de Clasificación Endosomal Requeridos para el Transporte/metabolismo , Humanos , Ubiquitina-Proteína Ligasas/metabolismo , Ubiquitina-Proteína Ligasas/genética , Cápside/metabolismo , Virus de la Hepatitis B/metabolismo , Virus de la Hepatitis B/fisiología , Virus de la Hepatitis B/genética , Ubiquitina-Proteína Ligasas Nedd4/metabolismo , Liberación del Virus/fisiología , Proteínas de Ciclo Celular/metabolismo , Proteínas de Ciclo Celular/genética , Hepatitis B/metabolismo , Hepatitis B/virología , Proteínas de Unión al CalcioRESUMEN
BACKGROUND: While hepatitis B virus (HBV) infection in children has declined dramatically in China due to the vaccination strategy for newborns, HBV infection in high-risk adults is receiving an increasing attention. The number of people who use drugs (PWUD) in China is huge, but their status of HBV infection and vaccination is less reported, especially from large samples. The related knowledge can help decision makers develop the further strategy of HBV prevention and control. METHODS: A seroepidemiological survey was conducted in all four compulsory isolated detoxification centers (CIDCs) and all eight methadone maintenance treatment (MMT) clinics located in Xi'an, China. All PWUD who were undergoing detoxification or treatment in these settings were included. A questionnaire was designed to obtain the information of HBV vaccination history of participants, and sociodemographic and behavioral data of participants were obtained from the registration records of their respective CIDCs or MMT clinics. RESULTS: A total of 4705 PWUD participated in the survey. Positive rates of HBsAg (current infection) and HBsAg or anti-HBc (current/past infection) were 5.50% and 58.02%, notably higher than those reported for the general adult population in the same province during the same period. As age increased, the anti-HBc positive rate increased with statistically significant trend. The all-negative for HBsAg, anti-HBc, and anti-HBs accounted for 28.82%. Only 18.49% were identified by the questionnaire as having received HBV vaccine. The logistic regression found that compared with identified vaccinated PWUD, those unsure if having been vaccinated and those identified non-vaccinated had a significantly higher HBV current/past infection rate, with an increasing trend. CONCLUSION: PWUD are a high-risk adult group of HBV infection in China. Of them, more than half have not received HBV vaccine, and a significant portion are susceptible to HBV. Catch-up vaccination is need for this population to prevent and control HBV transmission.
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Vacunas contra Hepatitis B , Hepatitis B , Vacunación , Humanos , China/epidemiología , Hepatitis B/prevención & control , Hepatitis B/epidemiología , Masculino , Adulto , Femenino , Vacunas contra Hepatitis B/administración & dosificación , Vacunas contra Hepatitis B/inmunología , Persona de Mediana Edad , Vacunación/estadística & datos numéricos , Adulto Joven , Estudios Seroepidemiológicos , Anticuerpos contra la Hepatitis B/sangre , Anticuerpos contra la Hepatitis B/inmunología , Encuestas y Cuestionarios , Adolescente , Antígenos de Superficie de la Hepatitis B/inmunología , Antígenos de Superficie de la Hepatitis B/sangre , Consumidores de Drogas/estadística & datos numéricos , Virus de la Hepatitis B/inmunologíaRESUMEN
Currently, chronic hepatitis B virus infection is still one of the most serious public health problems in the world. Though current strategies are effective in controlling infection and slowing down the disease process, it remains a big challenge to achieve a functional cure for chronic hepatitis B in a majority of patients due to the inability to clear the cccDNA pool. The mammalian target of rapamycin (mTOR) integrates nutrition, energy, growth factors, and other extracellular signals, participating in gene transcription, protein translation, ribosome synthesis, and other biological processes. Additionally, mTOR plays an extremely important role in cell growth, apoptosis, autophagy, and metabolism. More and more evidence show that HBV infection can activate the mTOR pathway, suggesting that HBV uses or hijacks the mTOR pathway to facilitate its own replication. Therefore, mTOR signaling pathway may be a key target for controlling HBV infection. However, the role of the central cytokine mTOR in the pathogenesis of HBV infection has not yet been systematically addressed. Notably, mTOR is commonly activated in hepatocellular carcinoma, which can progress from chronic hepatitis B. This review systematically summarizes the role of mTOR in the life cycle of HBV and its impact on the clinical progression of HBV infection.
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Carcinoma Hepatocelular , Virus de la Hepatitis B , Neoplasias Hepáticas , Transducción de Señal , Serina-Treonina Quinasas TOR , Humanos , Carcinoma Hepatocelular/metabolismo , Carcinoma Hepatocelular/virología , Serina-Treonina Quinasas TOR/metabolismo , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/virología , Virus de la Hepatitis B/fisiología , Hepatitis B/metabolismo , Animales , Hepatitis B Crónica/metabolismoRESUMEN
The Chinese Clinical Practice Guidelines for the prevention and treatment of mother-to-child transmission of hepatitis B virus, developed by the Chinese Society of Infectious Diseases of the Chinese Medical Association in 2019, serves as a valuable reference for standardizing the process of preventing mother-to-child transmission in China. As new evidence emerges, it is crucial that timely and regular updates are made to the clinical practice guidelines so that to optimize guidance for clinical practice and research. To this end, the Infectious Disease Physician Branch of Chinese Medical Doctor Association and the Chinese Society of Infectious Diseases of Chinese Medical Association, in collaboration with multidisciplinary experts, have updated the guidelines based on the latest domestic and international research advancements and clinical practice, in order to provide guidance and reference for clinicians and maternal and child healthcare workers.
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Hepatitis B , Transmisión Vertical de Enfermedad Infecciosa , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Hepatitis B/transmisión , Hepatitis B/prevención & control , China , Femenino , Embarazo , Virus de la Hepatitis B , Complicaciones Infecciosas del Embarazo/prevención & control , Complicaciones Infecciosas del Embarazo/terapia , Complicaciones Infecciosas del Embarazo/virologíaRESUMEN
The prevalence of hepatitis B represents a significant public health concern with a heavy disease burden. In China, there is still a big gap between the current diagnosis and treatment rates of hepatitis B and the goal of eliminating viral hepatitis as a public health threat by 2030 set by the World Health Organization (WHO). In order to achieve the WHO goal and the goal of 2030 Healthy China Outline, the Chinese Preventive Medicine Association organized domestic experts in the fields of clinical medicine, public health and clinical laboratory medicine to develop the Expert Recommendations on Screening, Testing and Management for Hepatitis B Virus Infection in Adults after several rounds of discussion based on comprehensive review of relevant domestic and international guidelines and literatures, the purpose is to facilitate universal screening of hepatitis B virus(HBV)infection in adults and provide practical guidance on disease assessment, treatment and long-term follow-up management of people infected with HBV and vaccination for people susceptible to HBV infection,thus promoting the elimination of the threat of hepatitis B.
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Hepatitis B , Tamizaje Masivo , Humanos , Hepatitis B/diagnóstico , Hepatitis B/prevención & control , Hepatitis B/terapia , Tamizaje Masivo/métodos , Adulto , Virus de la Hepatitis B , China/epidemiologíaRESUMEN
In order to achieve the target of eliminating viral hepatitis as a public health threat by 2030 and to prioritize the role of hepatitis B vaccination in reducing new hepatitis B virus infections, the Chinese Preventive Medicine Association commissioned experts to develop the Expert Recommendations on Hepatitis B Vaccination in Adults to scientifically guide adult hepatitis B vaccination,build the herd immunity in population, and reduce the hepatitis B virus infection rate and incidence of hepatitis B.
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Vacunas contra Hepatitis B , Hepatitis B , Vacunación , Humanos , Vacunas contra Hepatitis B/administración & dosificación , Hepatitis B/prevención & control , AdultoRESUMEN
INTRODUCTION: In Sub-Saharan Africa alone, about 40-65% of Hepatitis B Virus infections among HCWs were a result of percutaneous occupational exposures to contaminated blood and body fluids of patients. Occupational exposure to blood and body fluids among healthcare workers is on the rise in Ghana. However, the relationship between self-reported exposures to blood and body fluids suspected to be contaminated with the hepatitis B virus and actual serological evidence of exposure remains unknown. The aim of the study however was to assess the self-reported exposure to HBV as against the serological evidence of lifetime exposure to HBV and associated factors among Ghanaian HCWs. METHODS: The study was a cross-sectional analytical survey that involved 340 HCWs who were recruited using a simple random sampling procedure from six cadres of staff from five districts in Greater Accra. The participants were surveyed using a validated instrument and 5mls of venous blood was aseptically withdrawn for qualitative detection of Anti-HBc. SPSS version 23.0 was used to analyze the data to obtain proportions, odds ratios and their corresponding confidence intervals with the level of significance set at 0.05. RESULTS: The response rate was 94% with Nurses and Doctors in the majority with a mean age of 35.6 ± 7.2. Self-reported exposure to HBV was 63% whereas lifetime exposure to HBV (Anti-HBc) prevalence was 8.2% (95% CI = 5.0-11.0%). Females were 60% less likely to be exposed to HBV (aOR = 0.4; 95% CI = 0.1-0.9) than their male counterparts. HCWs without training in the prevention of blood-borne infections had almost three times higher odds of being exposed to HBV in their lifetime (aOR = 2.6; 95% CI = 1.0-6.4). CONCLUSIONS: The findings of this study suggest that self-reported exposure to HBV-contaminated biological materials was high with a corresponding high lifetime exposure to HBV. The female gender was protective of anti-HBc acquisition. Apart from direct interventions for preventing occupational exposures to HBV in the healthcare setting, periodic training of all categories of healthcare workers in infection prevention techniques could significantly reduce exposure to the Hepatitis B virus.
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Personal de Salud , Hepatitis B , Exposición Profesional , Autoinforme , Humanos , Estudios Transversales , Ghana/epidemiología , Femenino , Masculino , Personal de Salud/estadística & datos numéricos , Adulto , Hepatitis B/epidemiología , Hepatitis B/transmisión , Exposición Profesional/estadística & datos numéricos , Persona de Mediana Edad , Líquidos Corporales/virología , Virus de la Hepatitis B/inmunología , Virus de la Hepatitis B/aislamiento & purificación , Adulto Joven , Anticuerpos contra la Hepatitis B/sangreRESUMEN
BACKGROUND: The high sensitivity of HBsAg quantitative tests has led to some challenges in the qualitative interpretation of weakly positive specimens. This study aimed to explore the clinical utility of neutralization confirma-tory testing for specimens with low positive hepatitis B surface antigen (HBsAg). METHODS: A retrospective analysis was conducted on outpatient and inpatient cases, from January 2021 to January 2022, at the Zhongshan City People's Hospital, Zhongshan. Confirmatory testing as well as enzyme-linked immunosorbent assay (ELISA) was applied to reanalyze 382 samples with low positive HBsAg detected by chemilumi-nescence microparticle immunoassay (CMIA). A retrospective analysis of hepatitis B serum markers, including e-antigen, e-antibody, and core antibody patterns, was also performed. RESULTS: When the HBsAg value ranged from 0.05 - 0.09 IU/mL, the positivity rate of the confirmatory testing was 34.5%. The HBsAg true positivity levels were all between 0.07 and 0.09. In the range of 0.10 - 0.49, the positivity rate of confirmatory testing was 96.1%. The three methods exhibited a high consistency, when testing samples with relatively high HBsAg values. A receiver operating characteristic (ROC) analysis showed that the optimal sensitivity and specificity were achieved at 0.14 IU/mL. For the HBV e-antigen-positive and negative groups, the positivity rate of confirmatory testing was 100% and 93.8%, with no statistical difference between them. CONCLUSIONS: For specimens with weakly positive, low-value HBsAg, particularly when the hepatitis B surface an-tigen level is less than 0.14 IU/mL, neutralization confirmatory testing can serve as a means for further confirmation.
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Antígenos de Superficie de la Hepatitis B , Hepatitis B , Sensibilidad y Especificidad , Humanos , Antígenos de Superficie de la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/inmunología , Estudios Retrospectivos , Hepatitis B/diagnóstico , Hepatitis B/sangre , Hepatitis B/inmunología , Femenino , Masculino , Persona de Mediana Edad , Ensayo de Inmunoadsorción Enzimática/métodos , Adulto , Pruebas de Neutralización/métodos , Curva ROC , Virus de la Hepatitis B/inmunología , Adulto JovenRESUMEN
Despite recent advances in systemic therapy for hepatocellular carcinoma (HCC), the prognosis of hepatitis B virus (HBV)-induced HCC patients remains poor. By screening a sgRNA library targeting human deubiquitinases, we find that ubiquitin-specific peptidase 26 (USP26) deficiency impairs HBV-positive HCC cell proliferation. Genetically engineered murine models with Usp26 knockout confirm that Usp26 drives HCC tumorigenesis. Mechanistically, we find that the HBV-encoded protein HBx binds to the promoter and induces the production of USP26, which is an X-linked gene exclusively expressed in the testis. HBx consequently promotes the association of USP26 with SIRT1 to synergistically stabilize SIRT1 by deubiquitination, which promotes cell proliferation and impedes cell apoptosis to accelerate HCC tumorigenesis. In patients with HBV-positive HCC, USP26 is robustly induced, and its levels correlate with SIRT1 levels and poor prognosis. Collectively, our study highlights a causative link between HBV infection, deubiquitinase induction and development of HCC, identifying a druggable target, USP26.
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Carcinoma Hepatocelular , Proliferación Celular , Epigénesis Genética , Virus de la Hepatitis B , Neoplasias Hepáticas , Sirtuina 1 , Transactivadores , Proteínas Reguladoras y Accesorias Virales , Carcinoma Hepatocelular/virología , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/metabolismo , Carcinoma Hepatocelular/patología , Humanos , Animales , Neoplasias Hepáticas/virología , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/patología , Virus de la Hepatitis B/genética , Ratones , Sirtuina 1/metabolismo , Sirtuina 1/genética , Transactivadores/metabolismo , Transactivadores/genética , Masculino , Proliferación Celular/genética , Proteínas Reguladoras y Accesorias Virales/metabolismo , Carcinogénesis/genética , Hepatitis B/virología , Hepatitis B/complicaciones , Hepatitis B/genética , Hepatitis B/metabolismo , Línea Celular Tumoral , Ratones Noqueados , Regulación Neoplásica de la Expresión Génica , Enzimas Desubicuitinizantes/metabolismo , Enzimas Desubicuitinizantes/genética , Apoptosis/genética , Cisteína Endopeptidasas/metabolismo , Cisteína Endopeptidasas/genética , Regiones Promotoras Genéticas/genéticaRESUMEN
BACKGROUND: Premature infants have less physiologic reserve and often delayed vaccination compared to full-term infants. The birth dose of hepatitis B vaccine (HepB-BD) is an essential measure to achieve the goal of "zero infections" of hepatitis B virus in all newborns. However, there are few investigations of hepatitis B vaccination of preterm infants, leading to uncertainty of coverage and insufficient knowledge of factors influencing timely vaccination of this important population. METHODS: We obtained hepatitis B vaccine (HepB) vaccination histories of premature infants born during 2019-2021 in three provinces from the respective provincial immunization information systems. Extracted data included date of birth, sex, region, and dates of HepB administration. We conducted descriptive analyses that included basic characteristics of the study subjects, HepB-BD administration, and full-series HepB vaccination. Factors potentially influencing HepB-BD and full series vaccination were analyzed by logistic regression. RESULTS: There were 1623 premature infants included in the analytic data set. Overall HepB-BD coverage was 71.41%; coverage among premature infants born to mothers with unknown hepatitis B surface antigen (HBsAg) status was 69.57%; coverage was higher at county-level-and-above hospitals (72.02%) than hospitals below county level (61.11%). Full-series HepB coverage was 94.15%; full-series coverage among preterm infants weighing less than 2000 g at birth was 76.92%. Logistic regression showed that the HepB-BD vaccination rate was positively associated with being born to an HBsAg-positive mother and being preterm with high birth weight. Regression analysis for factors influencing full-series HepB coverage showed that being born prematurely was positively associated with full-series coverage and being premature with a very low birth weight was negatively associated with full-series coverage. CONCLUSIONS: HepB-BD coverage levels in three provinces of China were less than the target of 90%, especially among premature infants born to mothers with unknown HBsAg status and at hospitals below the county level. Screening of pregnant women should be a universal normal standard. Hepatitis B vaccination training should be strengthened in hospitals to improve the HepB-BD vaccination rate of premature infants and to effectively prevent mother-to-child transmission of hepatitis B virus.