Search

Chronic hepatitis B virus (HBV) infection is a significant global public health concern, and the clearance of HBV is closely linked to the activity of HBV‐specific T cells, which is regulated by various co‐suppressor molecules. Cytotoxic T lymphocyte‐associated antigen 4 (CTLA‐4) is among these co‐suppressor molecules which induces T cell exhaustion by competitively inhibiting CD28 and dampening the function of HBV‐specific T cells. CTLA‐4 also plays a role in the regulation of T helper (Th) cell differentiation and influences cytokine release. In addition, CTLA‐4 can impact glucose metabolism in hepatocellular carcinoma through its interaction with T regulatory (Treg) cells. This review aims to provide a comprehensive overview of the existing literature related to the role of CTLA‐4 in HBV patients across different subsets of T cells. Additionally, we propose a discussion on the possible mechanisms through which CTLA‐4 may contribute to HBV infection, as well as the development of HBV‐induced cirrhosis and hepatocellular carcinoma. [ABSTRACT FROM AUTHOR]

ObjectiveTo analyze the changing trends of the disease burden of viral hepatitis B (HB) and its risk factors among Chinese residents from 1990 to 2019, to provide a reference for HB prevention and control. MethodsData on the disease burden of HB and its risk factors among Chinese residents from 1990 to 2019 were collected from the Global Burden of Disease Study 2019 (GBD 2019). Descriptive statistics were performed using standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs) rate of HB. Joinpoint regression model was used to analyze the trends of disease burden of HB attributable to smoking, alcohol consumption, drug abuse, and high body mass index (BMI) among Chinese residents from 1990 to 2019. ResultsDuring the 30-year period among Chinese residents there were significant decreasing trends in the HB standardized rate (1/100 000) of incidence (2 725.98 to 1 397.31), prevalence (12 239. 53 to 6 566.12), mortality (24.67 to 8.07), and DALYs (793.38 to 247.71), with average annual percentage changes (AAPC) of – 2.29%, – 2.13%, – 3.82%, and – 3.98%, respectively (P < 0.001 for all), and although declining more rapidly in a global comparison, these standardized rates were still higher than those in the total world population. The values of APPC were significantly higher negatively in the female population than in the male population for HB standardized of incidence (– 2.49% vs. – 2.14%), prevalence (– 2.26% vs. – 2.04%), mortality (– 4.82% vs. – 3.48%), and DALYs (– 5.15% vs. – 3.63%) rates (all P < 0.001), indicating that there was still a higher disease burden of HB in the male Chinese population. During this period, the standardized mortality rate and DALYs rate of HB attributable to smoking, drinking alcohol, drug use, and high BMI showed a significant decreasing trend (both P < 0.01), with the AAPC of – 62.20%, – 62.01%, – 44.44%, and – 18.18% for the mortality rate and – 63.90%, – 63.54%, – 47.71%, and – 18.76% for the DALYs rate. ConclusionAlthough the disease burden of viral hepatitis B among Chinese residents has decreased from 1990 to 2019, it is still higher than that of the world population, and male residents who smoke, consume alcohol, take drugs and have high body mass index still need to pay more attention.

Vaccination against viral hepatitis B is an effective method of protection against this infection. There is multiple decrease in the hepatitis B incidence. However, there was increase in chronic hepatitis B by 42.5%, 15 cases of acute viral hepatitis B in children and 2 deaths from this infection were registered according to the state report “On the sanitary and epidemiological wellbeing of the population of the Russian Federation for 2022”. The criteria for evaluating protection against viral hepatitis B are the anti-HBs level and the duration of post-vaccination immunity.Objective. The aim of the study is to evaluate the duration of postvaccination immunity in temporal aspect in children and adolescents vaccinated against viral hepatitis B.Methods. Prospective open-label study was conducted to assess post-vaccination immunity against viral hepatitis B in 143 children and adolescents. The study of anti-HBs was implemented via the immunoenzyme test system “Vectohep B-HBs-antigen”. Microsoft Office Excel 2010 package and the Prism9 program (GraphPad, USA) were used for statistical analysis.Results. It has been shown that hepatitis B vaccine provides 100% seroconversion. However, decrease in anti-HBs levels was revealed already 6 months after vaccination in 15.07% of cases of seronegative individuals, after 1 year their number has increased up to 28.77% of cases. On average, every fourth person had low protective level of anti-HBs. Almost two-thirds of adolescents became seronegative by the age of 14.Conclusion. Vaccination against viral hepatitis B ensures the maximum production of anti-HBs 1 month after the completed vaccination in 100% of cases. Antibody level begins to decrease 6 months after the third completed vaccination against hepatitis B, and in 14 years, 72.74% of those immunized become seronegative. All of these dictates the need to consider a booster dose in adolescents at the age of 14 years.

A patient co-infected with COVID-19 and viral hepatitis B can be at more risk of severe complications than the one infected with a single infection. This study develops a comprehensive stochastic model to assess the epidemiological impact of vaccine booster doses on the co-dynamics of viral hepatitis B and COVID-19. The model is fitted to real COVID-19 data from Pakistan. The proposed model incorporates logistic growth and saturated incidence functions. Rigorous analyses using the tools of stochastic calculus, are performed to study appropriate conditions for the existence of unique global solutions, stationary distribution in the sense of ergodicity and disease extinction. The stochastic threshold estimated from the data fitting is given by: ℛS0 = 3.0651. Numerical assessments are implemented to illustrate the impact of double-dose vaccination and saturated incidence functions on the dynamics of both diseases. The effects of stochastic white noise intensities are also highlighted. [ABSTRACT FROM AUTHOR]

Weiling Zhou,1 Qian Gao,1 Lianjing Wang,2 Weijing Li,2 Cuiying He,2 Yanting Li,3 Lei Feng,1 Wei Liu,2 Lihong Liu,2 Yuan Wang1 1Department of Endocrine and Metabolic Diseases, The Fourth Hospital of Hebei Medical University, Shijiazhuang, HeBei Province, 050000, People’s Republic of China; 2Department of Hematology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, HeBei Province, 050000, People’s Republic of China; 3Department of Glandular Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, HeBei Province, 050000, People’s Republic of ChinaCorrespondence: Lihong Liu, Department of Hematology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, HeBei Province, 050000, People’s Republic of China, Email liulihong111222@163.com Yuan Wang, Department of Endocrine and Metabolic Diseases, The Fourth Hospital of Hebei Medical University, Shijiazhuang, HeBei Province, 050000, People’s Republic of China, Email wyuan1111122222@163.comBackground: Diffuse large B-cell lymphoma (DLBCL) involving the breast, spleen, and bone in a male patient with hepatitis B virus (HBV) infection is extremely rare in clinical practice.Case Presentation: We report a case of DLBCL involving the breast, spleen, and bone (triple expression of Bcl-2+, Bcl-6+, and 70% positive C-mcy) in a male patient with HBV admitted to our hospital. The patient was treated with EPOCH× 4, lenalidomide+EPOCH× 2 chemotherapy, intermittent methotrexate intrathecal injections to prevent central invasion, and autologous stem cell transplantation (ASCT). The patient is currently in complete remission, and the follow-up time was 43 months.Conclusion: A patient with DLBCL involving the breast, spleen, and bone can be treated with a combination of multiple regimens. If the patient’s economic conditions permit it, ASCT can be considered.Keywords: breast, viral hepatitis B, diffuse large B-cell lymphoma, triple expression, autologous stem cell transplantation

The aim of the work is to assess the prevalence of hepatitis B virus drug resistance mutations and immune escape mutations in pregnant women in the Republic of Guinea. Materials and methods. Blood plasma samples obtained from 480 pregnant women from different regions of the Republic of Guinea with laboratory-confirmed viral hepatitis B were studied. Nucleotide sequences for genotype identification and mutation detection were obtained using nested-PCR followed by Sanger sequencing, based on overlapping pairs of primers spanning the complete genome of the virus. Results and discussion. In the examined group, the viral genotype E was the most prevalent (92.92%) compared with subgenotypes A1 (1.67%), A3 (1.46%), D1 (0.63%), D2 (1.04%) and D3 (2.29%). Among the examined HBV-infected pregnant women, 188 (39.17%) had undetectable HBsAg. Drug resistance mutations were detected in 33 individuals, which amounted to 6.88%. The following mutations were found: S78T (27.27%), L80I (24.24%), S202I (15.15%), M204I/V (42.42%). The presence of polymorphic variants not described as drug resistant has also been shown in positions associated with the development of drug resistance to tenofovir, lamivudine, telbivudine and entecavir (L80F, S202I, M204R). When analyzing the MHR and the region of a determinant, mutations were detected in 318 (66.25%) of pregnant women. In 172 of them, which amounted to 54.09%, multiple mutations were found. The amino acid substitutions in 13 positions associated with HBsAg-negative hepatitis B and/or potentially affecting HBsAg antigenicity were identified. Conclusion. The high prevalence of immune escape and drug resistance mutations potentially associated with false-negative result of HBsAg screening, prophylaxis failure, and virological failure of therapy that has been identified among treatment naive pregnant women imposes a serious problem.

Background: Hepatitis B is the most common chronic viral infection and a significant contributor to morbidity and death globally. Based on the mother's hepatitis B e antigen (HBeAg) status, the probability of perinatal HBV infection in children delivered to mothers with HBV ranges from 10% to 85%.Aim: to determine the prevalence of hepatitis B virus infection among women of childbearing age in the eastern region of Algeria and investigate risk factors for infection to recommend ways to reduce the disease's impact on neonatal morbidity and mortality.Methods: We conducted a cross-sectional study in Sétif, Algeria, from 2005 to 2007 to assess the prevalence of Hepatitis B Surface Antigen among women of childbearing age. This study is the first and only one in Algeria. Data on risk factors, obstetrics, and sociodemographic were gathered using structured questionnaire; they were subsequently tested using an enzymelinked immunosorbent assay for HBsAg. The data collected were entered and processed using Epi info 3.3.2 software. Infection prevalence, sociodemographic, clinical, obstetric and risk factors variable frequency distributions were calculated. The student's t-test and Fisher's exact test were applied, at a significance level of 5%.Results: There are834 women of childbearing age's medical records were examined for this study. 1% of HBsAg test findings were positive. Positive HBsAg didn't significantly correlate with any other variables, including age, place of residence, municipality, marital status, occupation, parity, current pregnancy, reason for current consultation, transmission risk factors (blood transfusion, recent piercing, dental care, shared personal hygiene equipment, injection with multiple use equipment, tattoo, scarification, partner characteristics). However, history of jaundice has a significant protective effect against HBsAg positive.Conclusion: Although our results classify the two municipalities studied as low prevalence areas (< 2%). Prenatal HBsAg screening is strongly advised.

Abstract Background At present, there are a variety of antiviral drugs for HBV in clinical practice, but there is no standard scheme for transcatheter arterial chemoembolization(TACE) combined with antiviral drugs. The aim of this study was to investigate whether TACE must be combined with antiviral therapy in patients of HBV-related hepatocellular carcinoma(HCC). Meanwhile, the efficacy and safety of TACE combined with entecavir and TACE combined with tenofovir in the treatment of HBV-related HCC were compared. Method This study included 536 patients with HBV-related HCC who underwent TACE in Union Hospital from March 2017 to March 2020, and they met the criteria. They were divided into three groups: control group (N = 212): TACE alone; Entecavir group (N = 220): TACE combined with entecavir; and Tenofovir group (N = 228): TACE combined with tenofovir. We conducted a retrospective study to analyze the efficacy and safety of the three groups of patients. Results Objective response rate(ORR): 29.2% in control group, 54.1% in entecavir group, and 63.2% in tenofovir group (P

Chronic hepatitis B virus infection is not only an important global public health problem but also an important challenge in our country. Although there are some vaccines for hepatitis B and its prevalence is increasing year by year, there are still many patients in need of treatment. Neutralizing antibody as an important treatment for HIV is also promising in the field of hepatitis B cure. Current studies on neutralizing antibodies related to hepatitis B virus mainly include G12, Bc1.187, H017, H019, BX-182, KR127 and 2H5-A14, among which H017 and H019 combined application and 2H5-A14 have achieved quite good results in immune tolerance and neutralization activity in animal experiments. This article reviews the research progress of neutralizing antibodies related to hepatitis B virus to explore the possible development direction and application prospect in the future.

Abstract Introduction To monitor Sweden’s progress towards the WHO goal of eliminating viral hepatitis, we estimated the prevalence, notification rate, and liver-related morbidity and mortality for diagnosed hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in 2015 and 2018. Methods We identified cases of hepatitis B and C within the National System for Notifiable Diseases and obtained data on treatment and whether the case was deceased or not. We calculated prevalence, notification rates per 100,000, and proportion of newly diagnosed cases of hepatitis with liver disease at the time of diagnosis, and proportion of all deceased cases who died from liver disease. We calculated Poisson 95% confidence intervals (CIs) around the notification rates and Wilson 95% CIs around prevalence and mortality estimates. Results In 2015 and 2018, the prevalence of diagnosed HBV infections was 0.20% [95% CI: 0.19–0.20] and 0.21% [0.20–0.21]. Notification rates per 100,000 for HBV infections were 13.02 [12.32–13.76] and 7.71 [7.18–8.27]. HBV liver-related morbidity was 2.65% [1.90–3.68] and 2.16% [1.35–3.43]. HBV liver-related mortality was 20.00% [14.81–26.44] and 17.95% [13.20–23.94]. In 2015 and 2018, the prevalence of diagnosed HCV-infections was 0.24% [0.24–0.25] and 0.18% [0.18–0.19]. Notification rates per 100,000 for HCV infections were 15.92 [15.14–16.73] and 13.05 [12.36–13.77]. HCV liver–related morbidity was 8.14% [6.89–9.60] and 3.90% [2.99–5.08]. HCV liver–related mortality was 27.08% [24.54–29.77] and 26.90% [24.12–29.88]. Conclusions All indicators decreased or remained stable between 2015 and 2018, indicating progress in the elimination of viral hepatitis, especially for HCV infection.

Screening technologies aimed at identifying such transfusion transmissible infections (TTI) as hepatitis B and C, HIV-1,2 and syphilis have been developing and this has resulted in increased safety of applied hemotherapy. Our research goal was to analyze detection of infectious markers in donors of the FMBA Blood Center over five years. We examined 167,389 samples of donor blood taken from 53,093 donors of blood and its components by the FMBA Blood Center over the period from 2015 to 2019. Over the whole analyzed period, we detected 1453 infectious-positive samples taken from 1235 donors. Average long-term quantity of detected hepatitis C markers equaled 78.6 ± 9.4; hepatitis B, 49.8 ± 8.2; syphilis, 66.2 ± 16.8; HIV, 52.8 ± 13.2. We also analyzed detected of TTI markers in long-term dynamics and established an ascending trend in a number of syphilis markers (the growth rate was 3.2), hepatitis B (the growth rate was 2.5), and a descending trend in hepatitis C markers (the decrease rate was 3.3) as well as HIV markers (the decrease rate was 1.7). This decrease rate in detection of HIV markers (fall by 1.7) occurred both among first-time and regular donors. At the same time, we revealed growing detection of syphilis markers both among first-time donors where it grew by 3.6 and among regular ones, by 1.4. Frequency of infection markers was higher among first-time donors than among regular ones as per syphilis markers, 2.351 (95 % CI: 1.862–2.938), p < 0.00001; hepatitis B markers, 2.111 (95 % CI: 1.622–2.763), p < 0.00001; hepatitis C markers, 2.107 (95 % CI: 1.708–2.609), p < 0.00001; and HIV, 2.471 (95 % CI: 1.9–3.238), p < 0.00001. Over the last 5 years, there was a descending trend in detection of transfusion transmissible infections among donors regarding HIV and viral hepatitis C excluding tests aimed at detecting syphilis and viral hepatitis B markers.

Background: At present, there are a variety of antiviral drugs for HBV in clinical practice, but there is no standard scheme for transcatheter arterial chemoembolization(TACE) combined with antiviral drugs. The aim of this study was to investigate whether TACE must be combined with antiviral therapy in patients of HBV-related hepatocellular carcinoma(HCC). Meanwhile, the efficacy and safety of TACE combined with entecavir and TACE combined with tenofovir in the treatment of HBV-related HCC were compared. Method: This study included 536 patients with HBV-related HCC who underwent TACE in Union Hospital from March 2017 to March 2020, and they met the criteria. They were divided into three groups: control group (N = 212): TACE alone; Entecavir group (N = 220): TACE combined with entecavir; and Tenofovir group (N = 228): TACE combined with tenofovir. We conducted a retrospective study to analyze the efficacy and safety of the three groups of patients. Results: Objective response rate(ORR): 29.2% in control group, 54.1% in entecavir group, and 63.2% in tenofovir group (P < 0.05). Disease control rate(DCR): 63.7% in control group, 80.9% in entecavir group, and 88.1% in tenofovir group (P < 0.05). Median overall survival(mOS): control group, 12.2 months; entecavir group, 17.3 months; tenofovir group, 22.5 months (p < 0.05). Median progression-free survival (mPFS): control group, 9.3 months; entecavir group, 15.5 months; tenofovir group, 16.6 months (p < 0.05). At 6 months, there was an increase in creatinine(Cr) and a decrease in glomeruar filtration rate(GFR) in tenofovir group, which were statistically different from control and entecavir groups (p < 0.05). Conclusion: TACE combined with entecavir and TACE combined with tenofovir had higher ORR and DCR, longer OS and PFS than TACE alone. The OS of TACE combined with tenofovir was higher than that of TACE combined with entecavir. TACE combined with tenofovir is a safe strategy, but we cannot completely ignore the impact of tenofovir on renal function. [ABSTRACT FROM AUTHOR]

Retrospective data showed that when we administered ledipasvir/sofosbuvir (LDV/SOF) to patients with hepatitis B and C coinfection, there was a modest reduction in hepatitis B surface antigen (HBsAg). Therefore, we hypothesize that similar HBsAg reduction can be seen in hepatitis B virus (HBV) monoinfected subjects. Primary and secondary efficacy endpoints are the decline in HBsAg and HBV DNA at Week 12 from baseline, respectively. We conducted an open‐label Phase 2 pilot study to evaluate the safety, tolerability, and antiviral activity of LDV and/or SOF for HBV. Eligible subjects were either suppressed on antivirals (Group B) or inactive chronic HBV (Group A, C, D). Group A and B received LDV/SOF. Group C and D received SOF 400 mg and LDV 90 mg, respectively. All subjects completed the study, and all related adverse events (AEs) were mild. No discontinuations due to AEs or hepatitis flare occurred. At Week 12, HBsAg decline (log10 IU/ml) was similar between Group A (0.399) and B (0.400), less in Group C (0.207), and none in Group D, and there was HBV DNA decline in the inactive chronic HBV groups. LDV and SOF are safe and well tolerated when given to chronic hepatitis B subjects and have modest antiviral activity, particularly when given in combination. [ABSTRACT FROM AUTHOR]

Introduction: To monitor Sweden's progress towards the WHO goal of eliminating viral hepatitis, we estimated the prevalence, notification rate, and liver-related morbidity and mortality for diagnosed hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in 2015 and 2018. Methods: We identified cases of hepatitis B and C within the National System for Notifiable Diseases and obtained data on treatment and whether the case was deceased or not. We calculated prevalence, notification rates per 100,000, and proportion of newly diagnosed cases of hepatitis with liver disease at the time of diagnosis, and proportion of all deceased cases who died from liver disease. We calculated Poisson 95% confidence intervals (CIs) around the notification rates and Wilson 95% CIs around prevalence and mortality estimates. Results: In 2015 and 2018, the prevalence of diagnosed HBV infections was 0.20% [95% CI: 0.19–0.20] and 0.21% [0.20–0.21]. Notification rates per 100,000 for HBV infections were 13.02 [12.32–13.76] and 7.71 [7.18–8.27]. HBV liver-related morbidity was 2.65% [1.90–3.68] and 2.16% [1.35–3.43]. HBV liver-related mortality was 20.00% [14.81–26.44] and 17.95% [13.20–23.94]. In 2015 and 2018, the prevalence of diagnosed HCV-infections was 0.24% [0.24–0.25] and 0.18% [0.18–0.19]. Notification rates per 100,000 for HCV infections were 15.92 [15.14–16.73] and 13.05 [12.36–13.77]. HCV liver–related morbidity was 8.14% [6.89–9.60] and 3.90% [2.99–5.08]. HCV liver–related mortality was 27.08% [24.54–29.77] and 26.90% [24.12–29.88]. Conclusions: All indicators decreased or remained stable between 2015 and 2018, indicating progress in the elimination of viral hepatitis, especially for HCV infection. [ABSTRACT FROM AUTHOR]

ObjectiveTo examine the prevalence of hepatitis B virus (HBV) infection among migrant workers in Luohu district of Shenzhen city for providing evidences to HBV infection prevention in the workers. Methods A questionnaire survey and serum hepatitis B surface antigen (HBsAg) and antibody (anti-HBs) detections with enzyme-linked immunosobent assay (ELISA) were conducted among 5 493 migrant workers in Shenzheng city′s Luohu demonstration zone for comprehensive prevention and control of hepatitis B (HB) when the workers had their physical examinations between April 2019 and June 2020. Results For all the workers, the positive rate was 6.54% and 60.37% for serum HBsAg and anti-HBs; the positive rate of both HBsAg and anti-HBs differed significantly by age, education, occupation, registered residence, and history of HBV vaccination. The results of binary logistic regression analysis on significant influencing factors of serum HBsAg and anti-HBs identified with univariate analysis demonstrated that inoculation of HBV vaccine is a protective factor against HBsAg positive; while, with the education of junior high school and lower and aged 30 – 49 years are risk factors for HBsAg positive; the results also indicated that the workers having received HBV vaccination, aged less than 30 years, and with a registered residence in East China were more likely to be serum anti-HBs positive compared to other migrant workers. ConclusionThe prevalence of HBV infection decreased in comparison to that ten years ago among migrant workers in Shenzhen city′s Luohu demonstration zone for comprehensive HBV infection prevention and treatment but the prevention of HBV infection still needs to be strengthened in the unvaccinated migrant workers younger than 20 years and in those from southwest, northeast and northwest region of China.

Introduction. The achievement of the goal of the World Health Organization to eliminate viral hepatitis B by 2030 seems to be problematic partly due to the presence of escape mutants of its etiological agent, hepatitis B virus (HBV) (iHepadnaviridae: Orthohepadnavirus: Hepatitis B virus/i), that are spreading mainly in the risk groups. Specific routine diagnostic assays aimed at identification of HBV escape mutants do not exist. The study aimed the evaluation of the serological fingerprinting method adapted for routine detection of escape mutations in 143 and 145 aa positions of HBV surface antigen (HBsAg). Material and methods. HBV DNA from 56 samples of HBsAg-positive blood sera obtained from donors, chronic HBsAg carriers and oncohematology patients has been sequenced. After the identification of mutations in HBsAg, the samples were tested in the enzyme-linked immunosorbent assay (ELISA) kit «Hepastrip-mutant-3K». Results and discussion. Escape mutations were detected mainly in patients with hematologic malignancies. Substitutions in 143 and 145 aa were found in 10.81% and in 8.11% of such patients, respectively. The G145R mutation was recognized using ELISA kit in almost all cases. The kit specifically recognized the S143L substitution in contrast to the S143T variant. The presence of neighbor mutation D144E can be assumed due to it special serological fingerprint. Conclusion. ELISA-based detection of escape mutations S143L, D144E and G145R can be used for routine diagnostics, especially in the risk groups. The diagnostic parameters of the kit can be refined in additional studies. This immunoassay and methodology are applicable for the development and quality control of vaccines against escape mutants.

Objective – before and after the treatment to determine the functional state of the liver, serum levels of enzymes and biochemical indices in syphilis patients with viral hepatites B and C. The results of the study are based on the data from a comprehensive examination of 35 patients with syphilis alone and 127 patients with syphilis co-infected with viral hepatites B and C before and after treatment. Test methods: hepatology, rheogeopathography, enzyme content and biochemical parameters determined in the serum. According to the results of radionuclide hepatology it has been established that disorders of the functional capacity of the liver already occur in the early stages of the disease. The most significant disorders have been in the patients with the prescription of infection for more than 12 months and in the patients co-infected with viral hepatites B and C. A disorder of pigment metabolism and increased activity of trans­aminases have been revealed in early latent syphilis. In co-infection with viral hepatites B and C an increase in total bilirubin, Lactate dehydrogenase, Alanine transaminase, Aspartate aminotransferase and albumin has been revealed. Dysproteinemia has been revealed in patients with early latent syphilis co-infected with hepatitis C. Patients with early latent syphilis treated with immunomodulators tend to normalize these indices. In patients with syphilis a disorder of the functional state of the liver have been revealed already at an early stage of the disease. The most pronounced disorder of biochemical parameters and activity of liver enzymes are observed in syphilis patients with viral hepatites B and C, as well as in patients with early latent syphilis only with the prescription of the infection for more than 12 months; in such a case it is advisable to use drugs affecting the immune system.

The aim is to explore the clinical effects of combined treatment of Traditional Chinese Medicine (TCM) and western medicine in viral hepatitis B cirrhosis and the effects on microRNA (miR)-122 and miR-200a. 116 patients with chronic hepatitis B cirrhosis were admitted to our hospital. Real-time fluorescent quantitative PCR (qPCR) was employed to reveal the level of serum miR-122 and miR-200a in the three groups. The clinical effects of the two groups were compared, including alanine aminotransferase (ALT), aspartate amino transferase (AST), total bilirubin (TBIL) and alpha fetoprotein (AFP) indexes, coagulation function indexes, liver elasticity value and the main therapeutic effects. After treatment, the ALT, AST, TBIL and AFP indexes significantly decreased in both groups, which were much lower in the western medicine (WM) + TCM Group. The levels of albumin (ALB) all increased, and the increase was more significant in the WM + TCM Group. The prothrombin time (PT) was down-regulated while the prothrombin activity (PTA) was up-regulated in both groups. Both groups showed a decrease in liver elasticity after treatment, which was more obvious in the WM + TCM Group. The incidence of primary peritonitis, hepatic encephalopathy, hepatorenal syndrome, gastrointestinal bleeding and electrolyte disturbance in the WM + TCM Group was significantly lower than those in the WM Group. The combination of Chinese and western medicine in the treatment of cirrhosis can reduce the occurrence of complications, improve the clinical symptoms and improve the clinical effects effectively, which is worthy of further study and clinical popularization. Viral hepatitis B, Liver cirrhosis, Combination of TCM and Western medicine, miR-122, miR-200a.

Patient living with chronic viral hepatitis in India faces the high cost of treatment and impoverishment. The present study is aimed to assess the cost of treatment and economic consequences among chronically infected viral hepatitis patients at a tertiary care hospital in Delhi. The descriptive cross-sectional study was undertaken during October 2016–January 2017. Three hundred and eighty-nine participants were interviewed through a schedule for variables and assessing both direct and indirect costs. Costs of hospital expenditure were extracted from records available with patients or databases of the hospital. The average outpatient expenditure and the inpatient costs were calculated. Direct nonmedical costs were also included. The analysis revealed the total cost of treatment ranged from Rs. 16,600/-to Rs. 1,709,000/-with a median of Rs. 193,500 per year. The cost of treatment increased with the severity of the disease. The cost of treatment led to impoverishment in 52.8% of families and imposed a substantial economic burden and consequences on the patients.

Copyright of Pediatrics & Infectious Diseases / Detski i Infekciozni Bolesti is the property of Medical University - Sofia, Central Medical Library and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Current study was aimed at investigating prevalence of overt and occult hepatitis B infection in HIV-positive individuals as well as molecular-epidemiological characteristics of the circulating hepatitis B virus (HBV) strains in the Far Eastern Federal District (FEFD). A total number of 297 blood serum/plasma samples obtained from HIV-positive patients residing in the FEFD were enrolled in the study. The first control group included 351 blood serum/plasma samples of general population without indication on HIV and HBV-infection that underwent laboratory check up at the Centers for AIDS Prevention and Control. After evaluating the group of HIV-positive patients 20 HIV-HBV positive samples were selected for further detailed analysis. The second control group included 43 patients with chronic hepatitis B. All groups were age and gender-matched. The research included serological and molecular-genetic (real-time PCR, positive for HBV DNA samples underwent clonal sequencing of PCR-amplified HBV P/S gene) assessment of the biological material followed by a phylogenetic analysis of the HBV sequences. Our research revealed that HIV-positive patients are exposed to a higher risk of HBV infection compared to general population enrolled in the study, which is evident from the prevalence of anti-HBcAg antibodies in the groups examined. HIV-positive vs. first control group was positive for anti-HBcAg antibodies at higher rate (35.02%, CI 95: 29.59–40.45% versus 22.22%, CI 95: 17.87–26.57%, p = 0.0003). Abundance of ongoing HBV-infection markers was also higher in HIV-positive individuals compared to general population (6.73%, CI 95: 3.88–9.58% versus 0.85%, CI 95: 0–1.81%, p = 0.0001, respectively). Should be noted, that HBsAg-negative HBV infection in HIV-positive patient cohort comprised 1.01% (CI 95: 0–2.15%) whereas in general population this index was as low as 0.28% (CI 95: 0–0.84%). Virus hepatitis С and D were revealed at higher rate in HIV-positive individuals compared to patients with HIV-negative chronic HBV infection (p = 5.84 × 10–7 and p = 0.000001 respectively). HCV and HDV prevalence rates comprised 50.0% (CI 95: 27.46–77.46%) and 40.0% (CI 95: 17.97–62.03%) in HIV-positive patients. Similar indices in control group were 4.65% (CI 95: 0–10.94%) and 4.65% (CI 95: 0–10.94%), respectively. The phylogenetic analysis of the six isolated HBV sequences showed that the five samples belonged to genotype D, with dominant subtype D2 (verified in 4 cases). Further, HBV genotype С was detected only in one case. The obtained data indicate a necessity for further in-depth diagnostic examination of viral hepatitis in HIV-positive patients to lower a risk of developing life-threatening complications as well as preventing hepatitis spread in human population.

The article presents the results of a retrospective analysis of viral hepatitis B incidence in the Russian Federation from 2013 to 2017, taking into account the use of vaccines included into the National Immunisation Schedule and the Immunisation Programme in Case of Epidemic Outbreaks. The analysis of the data revealed a trend towards a reduction in the incidence of acute and chronic forms of hepatitis B in the territory of the Russian Federation during the past five years. The reduction of viral hepatitis B incidence was achieved thanks to a higher vaccination coverage of both children and adults. The article presents an overview of monovalent and combination recombinant hepatitis B vaccines licensed in the Russian Federation. It describes the WHO position on preventive vaccination against viral hepatitis B, and pays special attention to vaccination of people at risk. The article considers promising areas for improving immunobiological products for hepatitis B prevention, including new technologies used in vaccine production, development and introduction of new adjuvants or adjuvants systems, and development of therapeutic vaccines.

Viral hepatitis is a major health problem. Despite preventive efficacy with hepatitis B vaccine and therapeutic efficacy with nucleosi(ti)de analogs against B hepatitis or new direct acting anti-virals against C hepatitis, number of cases remain undiagnosed. In case of B hepatitis (positive HBsAg) or C hepatitis (positive HCV RNA) in a member of the couple, the use of assisted reproductive therapy (ART) is always dictated by the cause of infertility and there is currently not enough evidence to recommend one technique (IUI/IVF/ICSI) over another in patients infected with hepatitis. Overall, the data from the literature regarding the impact of B or C hepatitis on fertility and ART outcomes are controversial. The results are mainly reassuring and live birth rates are not different from couples without hepatitis and the risk of transmission remains very low. It has been reported that the positivity of HCV RNA in gametes cannot be excluded, which encourages to reinforce the washing procedure in a laboratory agreed for the viral risk. Providing a successful vaccination course, the risk of HBV horizontal transmission seems to be eliminated. Finally, it is important to inform the couple that ART procedure does not prevent mother to child transmission in case of maternal infection with hepatitis B or C. [ABSTRACT FROM AUTHOR]

The association between hepatitis virus infection and Parkinson's disease remains controversial. To determine whether hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are associated with an increased risk of Parkinson's disease in Korean aged ≥40 years, we completed a population‐based prospective study including patients without infections and those with HBV, HCV and HBV/HCV infections from 2005 to 2015. We used the International Classification of Diseases 10th Revision to identify Parkinson's disease (G20) and chronic hepatitis C virus (B18.2) and chronic hepatitis B virus infections (B18.0 or B18.1). To identify Parkinson's disease risk, competing risk analysis adjusted for age, sex, comorbidities and death was performed. Overall, 1 010 317 patients (358 052, noninfection; 488 990, hepatitis B; 144 459 hepatitis C; and 18 680 hepatitis B/C) were included. The incidence density of Parkinson's disease per 10 000 person‐years was highest in the hepatitis C group (8.0), followed by the hepatitis B/C (6.8) and hepatitis B (5.0) groups. Hypertension, ischaemic heart disease, epilepsy, stroke and depressive disorder increased the hazard of Parkinson's disease in all groups. The adjusted hazard ratios were 1.25 (95% confidence interval: 1.17‐1.35), 1.39 (95% confidence interval: 1.27‐1.52) and 1.46 (95% confidence interval: 1.14‐1.85) in the HBV, HCV, and HBV/HCV groups, respectively. Our findings suggest that adult patient of 40 years and older with HBV and HCV infections should be monitored for signs of Parkinson's disease so that early intervention and accurate treatment can be provided for minimizing the development and consequences of Parkinson's disease. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Viral hepatitis B remains a major public health problem around the world, especially in underdeveloped and developing countries. Cameroon shows a grate variability in prevalence of this infection in the country and even within different populations groups. The aim of this study was to determine the prevalence and factors associated with viral hepatitis B infection in the rural area of Dschang. METHODS: We conducted a cross-sectional community-based study, involving 551 participants of both genders recruited by a voluntary sampling technique. The biological diagnosis of HBsAg was done by the Immunochromatographic method (PKL® kit of PARAMEDICAL srl laboratories). Positive cases were confirmed by ELISA method (reagent Kit from DIALAB Laboratories). RESULTS: Results show a Viral Hepatitis B prevalence of 5.08% (95% CI: 3.2-6.9). University students were the most infected (11/88) with a positivity rate of 12.50% (95%CI: 5.6-19.4). Only 29/551 participants (5.26%) had received at least one dose of vaccine against the disease and were less infected (3.44%) than the others (5.17%). Age (p =0.000), level of education (p =0.013), occupation (p = 0.002), belief in the traditional healing of hepatitis B (p =0.000) and knowledge about the disease and its contamination roads (p=0.049) were associated with viral hepatitis B. CONCLUSION: There is a need of intensifying awareness, education, routine screening and vaccination of the population, especially in schools and university milieu to better counteract the infection with hepatitis B virus in our local Communities.

From all group of infectious pathology viral hepatitises, from which the most priority are the parenteral hepatitises B and С, are essential for health of mankind, also the Irkutsk region isn’t an exception. The aim of the study: to assess an epidemiological situation in sharp and chronic forms of the viral hepatitises B and С in the territory of the Irkutsk region for the long-term period. Materials and methods. The retrospective analysis of an epidemiological situation on viral hepatitises B and C in Russia, Siberian Federal District and in the Irkutsk region for 2008–2016 is carried out. Results. The expressed decrease in incidence of acute viral hepatitis B is noted, at a chronic form of this disease rates of decrease had less expressed character that can be connected with carrying out by mass vaccinal prevention. The carried-out ranged distribution of territories for all forms of viral hepatitis B and viral hepatitis C in the Irkutsk region has allowed to reveal territories of risk. Conclusion. Parenteral viral hepatitises (sharp and chronic forms) are widespread in the territory of the Irkutsk region. From 43 administrative territories of the area, 24 belong to unsuccessful on incidences from which five are to territories of high epidemiological risk: cities of Irkutsk, Angarsk and Ust-Ilimsk and also Katangsky and Shelekhovsky districts.

Hepatitis B infection is a worldwide healthcare problem, especially in developing areas. The current study was to evaluate the alterations in different biochemical parameters including paraoxonase (PON), 5′-Nucleotidase (5NT), total bilirubin, direct bilirubin, indirect bilirubin, Prothrombin time (PT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), Total serum protein (TSP), albumin (Alb), Superoxide dismutase (SOD) and ɣ-glutamyl transpeptidase (GGT) in the serum samples of the viral hepatitis patients (n=100) compared with healthy controls(n=100). This study shown that there were significant increase (p

Background: Prevention of mother‐to‐child transmission (PMTCT) is a challenge for controlling the hepatitis B epidemic. In Sub‐Saharan countries, pilot interventions including the screening of pregnant women for HBsAg, implementation of anti‐HBV therapy and infant immunization within 24 hours of life are initiated and need to be evaluated. This pilot study aimed to describe the cascade of care for hepatitis B PMTCT in a real life situation, and to identify sociodemographic factors associated with adequate management of pregnant women and infants. Method: The study was conducted from October 1st, 2014 to February 28th, 2016 in the antenatal clinics (ANCV) of Baskuy district which comprises nine first‐level public health centres. Univariate and multivariate logistic regression analysis were used to identify sociodemographic factors associated with the likelihood of retention in the cohort, HBV DNA testing, birth dose delivery and HBsAg testing of the children at 6 months of age; P ˂.05 was selected as cut off for significance. Results: In this prospective cohort study, of 5200 pregnant women consulting for the antenatal visit, 2261 (43.5%) were proposed pre‐test counselling and HBsAg screening and 2220 (98.2%) have agreed to screening. Among 1580 (71.2%) women that came back for the post‐counselling interview, 75 were positive for HBsAg (4.8%), 73 (97.3% of the women provided HBsAg result) consented to medical consultation with hepatogastroenterologists and 53 (72.6%); performed the HBV DNA testing. Forty‐seven out of 60 (78.3%; 65.8‐87.9) children born alive were immunized for HBV within 24 hours of life. Retention in care was associated with the level of education of the infant's father, secondary school or higher was associated with a better retention in care of the women (OR: 6.6; P =.03). Conclusion: Our study shows large gaps in HBV PMTCT. Resources for hepatitis B screening, care and prevention including universal access to the vaccine birth dose should be allocated to reduce infection in HBV exposed infants born in Burkina Faso. [ABSTRACT FROM AUTHOR]

To study the molecular genetic structure of hepatitis B virus (HBV) D4 isolates first identified in the Russian Federation. Blood plasma samples of patients from the Republic of Dagestan with previously identified HBV subgenotype D4 were used in the work. For amplification and sequencing reaction, overlapping pairs of specific primers, jointly flanking the entire HBV genome, were used. HBV subgenotype D4 isolates were first detected in the Russian Federation. All 3 isolates were of the ayw2 serotype. Pharmacoresistance mutations L80V and M204I were found in the HIV-infected patient with HBsAg-negative occult HBV. A high frequency of natural polymorphic variants of the Pol gene was shown in all three isolates. In the Precore/Core region, Precore mutations A1846T, C1858T and Core mutations E40D, N74T, N87S, I97F were detected in all 3 isolates. In the X region, all 3 isolates had V5L and P38S mutations. Phylogenetic analysis of the full-length HBV genome showed that the isolates were grouped together with the subgenotype D4 isolate from South Africa. The origin of all three patients with the above isolates from the same geographic region, the phylogenetic proximity of the nucleotide sequences of the complete virus genomes, and a number of identical mutations and polymorphic variants in different genes in all three isolates indicate an independent single import of the virus with the subsequent spread. The routes of distribution, as well as the frequency of HBV D4 occurrence in the Republic of Dagestan, remain unknown and require further research. [ABSTRACT FROM AUTHOR]

Introduction: viral hepatitis B remains a major public health problem around the world, especially in underdeveloped and developing countries. Cameroon shows a grate variability in prevalence of this infection in the country and even within different populations groups. The aim of this study was to determine the prevalence and factors associated with viral hepatitis B infection in the rural area of Dschang. Methods: we conducted a cross-sectional community-based study, involving 551 participants of both genders recruited by a voluntary sampling technique. The biological diagnosis of HBsAg was done by the Immunochromatographic method (PKL® kit of PARAMEDICAL srl laboratories). Positive cases were confirmed by ELISA method (reagent Kit from DIALAB Laboratories). Results: results show a Viral Hepatitis B prevalence of 5.08% (95% CI: 3.2-6.9). University students were the most infected (11/88) with a positivity rate of 12.50% (95%CI: 5.6-19.4). Only 29/551 participants (5.26%) had received at least one dose of vaccine against the disease and were less infected (3.44%) than the others (5.17%). Age (p=0.000), level of education (p=0.013), occupation (p = 0.002), belief in the traditional healing of hepatitis B (p=0.000) and knowledge about the disease and its contamination roads (p=0.049) were associated with viral hepatitis B. Conclusion: there is a need of intensifying awareness, education, routine screening and vaccination of the population, especially in schools and university milieu to better counteract the infection with hepatitis B virus in our local Communities. [ABSTRACT FROM AUTHOR]

The immunologic activity (specific activity) is one of the main indicators of quality of vaccines for prophylaxis of hepatitis B, along with their safety. Retrospective analysis of the use of laboratory methods for assessment of specific (immunogenic) activity of modern vaccines against hepatitis B using indicators was carried out: in vitro method based on evaluation of HBsAg content and in vivo method based on evaluation of immunogenic activity in mice. Both methods are standardized and described in normative documents on the vaccines against hepatitis B of domestic production registered in the Russian Federation. Indicators of specific (immunogenic) activity of vaccines against hepatitis B were used to investigate more than 170 vaccine series using the ELISA method in the period from 2013 to 2015. The obtained control results confirmed the expediency and efficiency of enzyme immunoassay for determination of HBsAg content, as well as permissibility of use of ready sets of the Murex HBsAg Version 3 test systems for testing vaccines against hepatitis B by the ELISA method. Analysis of the results of laboratory control of series of vaccines against hepatitis B using a biological method for immunogenicity evaluation based on ED50 analysis confirms persistently high immunogenic activity of the Russian commercial vaccines intended for prophylaxis of hepatitis B. The confirmed comparability of methods allows the number of in vivo tests to be further reduced in favor of the enzyme immunoassay authentically characterizing the produced drug.

The article presents data on the state of immunization against major vaccine-controlled infections in international and regional subnational aspects. Some factors of worsening the epidemiological situation in Ukraine and the role of vaccination in the surveillance for infections that are controlled by means of specific immunoprophylaxis are identified. The features and causes of the anti-vaccine movement and possible ways of counteracting it are highlighted.

Objective: Study of the prevalence of the viral hepatitis C and viral hepatitis B in the territory of Saratov City and Saratov Region, analysis of the revealed cases and discussion of laboratory diagnostics issues. Methods: Statistical and reporting forms were used in the CJSC «Doctor Paramonov’s Clinic» in Saratov City, immunoenzyme method of testing blood serum which identify antibodies and antigens, and statistical analysis. Results: Analysis of the received data shows the increasing number of persons, who tested for viral hepatitis C and B. A tendency of annual increase of infected among tested persons are observed. Prolonged absence of rich clinical presentation complicates the process of actual diagnose arrangements. Conclusion: Results of the research dictate the need of a wide examination of patients, which will provide a high detectability, timely treated patients with hepatitis C and B, will assist the reduction of prevalence of these kind of viruses.

Bone metastases from liver cancer are rare. We report two cases of bone metastases revealing HBV-induced HCC. A 26-year-old african man presented with 4 months of low back pain in the context of general deterioration. Examination revealed a lumbar spinal syndrome and hepatomegaly. Abdominal ultrasound revealed a multinodular liver, and a CT scan of the spine revealed osteolytic lesions. Biological tests revealed a hepatic cytolysis syndrome, hepatic cholestasis and hepatocellular insufficiency. Alpha foetoprotein levels were elevated and hepatitis B serology was positive. We adopted the diagnosis of HCC of viral B origin with bone metastasis. The second case involved a 44-year-old African man admitted for 10 days with back pain. Examination revealed a spinal syndrome, paraplegia and hepatomegaly. A thoracic-abdominal-pelvic CT scan revealed typical HCC lesions and osteolytic lesions on the ribs, pelvis and vertebrae. The biology revealed a biological inflammatory syndrome, hepatic cytolysis, a hepatocellular insufficiency syndrome and a cholestasis syndrome. Alfa-feto proteins were elevated and HBV serology was positive. The diagnosis of bone metastasis of HCC secondary to HBV infection was accepted.

Clinical manifestations of hepatitis B virus (HBV) infection are ranged from fulminant hepatitis to decompensated cirrhosis or hepatocellular carcinoma. Liver transplantation (LT) is one therapeutic option of these HBV infection complications. Intrahepatic viral persistence and low levels of circulating viral particles despite treatment optimization may lead to HBV recurrence after LT, which jeopardizes graft and patients survival after LT. HBV recurrence prophylactic strategies are based on nucleos(t)ides analogues (NUCs) treatment to block viral replication and anti-HBs immunoglobulin administration to neutralize circulating viral particles. The risk of HBV recurrence is also important in case of transplantation with a graft from a donor with a history of HBV infection (HBc+) to a "HBV naive" recipient or in case of immunosuppressive therapy after solid organ or hematopoietic stem cell transplantation for a HBc+ recipient. Prophylactic strategies are mainly focused on biological monitoring and NUCs therapy for high-risk situations. [ABSTRACT FROM AUTHOR]

Abstract Background Cameroon is one of the countries in Africa with the highest burden of Hepatitis B infection. Health care workers are known to be at risk of occupational exposure to blood and other infectious bodily fluids. The aim of this study was to assess the profile of serological markers of hepatitis B virus (HBV) infection, knowledge and perceptions regarding HBV infection among health care workers in a health area in Yaoundé. Methods A cross-sectional study was conducted in the Mvog-Ada Health Area of the Djoungolo Health District from March 1 to November 31, 2014. All consenting health care workers were included in the study. Serological markers of HBV (HBs Ag, Hbe Ag, anti-HBs Ab, anti-HBe Ab, anti-HBc Ab) were qualitatively tested using Biotech®(OneHBV-5 parameter rapid test website) in each participant and the anti-HBs antibodies were quantified by ELISA (Biorex) among those who were positive with the qualitative test. Chi square test or its equivalents were used to compare qualitative variables and a p-value less than or equal to 0.05 was considered significant. Result A total of 100 participants were retained for the study out of 163 in the health area giving a response rate of 61.34 %; the mean age was 30.5 (SD 6.8) years and 71 % of participants were women. Forty seven percent (47 %) of workers had good level of knowledge of HBV infection. The men were 3.20 times (95 % CI: 1.02–9.19, p = 0.04) more likely to have a good level of knowledge than women. Participants with a university study level were more (95 % CI: 3.17–25, p

The article is devoted to the problem of viral hepatitis B and C in children with malignant hematologic disorders. Given the peculiarities of antiviral therapy of a patient with a combination of these diseases.

Background/aim: The aim of the current study was to obtain comprehensive genomic information on viral hepatitis B (HBV)-related hepatocellular carcinoma (HCC) and identify potential biomarkers of early recurrence in patients receiving curative surgery., Patients and Methods: A total of 104 patients with HBV-related HCC receiving curative surgery at Kaohsiung Chang Gung Memorial Hospital between January 2017 and December 2020 were identified, including 52 patients each with and without recurrence. Next-generation sequencing was performed to investigate genomic alterations caused by surgical resection of specimens. The Kaplan-Meier method was used to estimate disease-free survival and overall survival., Results: The landscape of gene mutations in HCC patients of our cohort showed a median number of single nucleotide variants of 250, a median number of insertions and deletions of 22, and a median number of protein-coding mutations of 185. The 10 most frequently mutated genes were TP53 (43%), TTN (39%), MUC16 (28%), PCLO (25%), OBSCN (22%), ADGRV1 (19%), ALB (18%), SYNE1 (18%), DNAH17 (17%), and RYR1 (17%). The tumour mutation burden was 4.8 mutations per megabase, and high microsatellite instability was reported in only three patients. In addition, the mutational signatures showed that aristolochic acid exposure was highly implicated in our HCC cohort. Five mutant genes, TBC1D4, ITGA4, RPS6KA3, VWA8, and FMN2, were more frequent in the recurrence group than that in the non-recurrence group., Conclusion: Our results present an in-depth genomic analysis of HBV-related HCC. The study findings provide an improved understanding of the related molecular mechanisms and identify potential biomarkers associated with early tumour recurrence after curative resection., (Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)