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Introduction: since the introduction of the anti-HBV vaccine into the Expanded Program on Immunization (EPI) in 2005 in Cameroon, vaccination coverage has reached 99.0%. This coverage would indicate an increase in the number of children immune to Hepatitis B Virus (HBV) and a decrease in susceptibility to HBV-infection. This study was conducted to evaluate the effect of the HBV vaccine on pediatric HBV-infection in Yaounde, Cameroon. Methods: this school-based cross-sectional study was conducted from February to May 2016 among 180 children from Nkomo public school. The study population was stratified into two groups: vaccinated (n=95) versus (vs) unvaccinated (n=85). Screening for HBV biomarkers was done using a rapid panel test for detection (HBsAg, HBeAg and anti-HBc) and anti-HBs titer using enzyme linked immunosorbent assay (ELISA). Statistical analyses were done using SPSS v. 22 with p < 0.05 considered significant. Results: the mean age was 9.65 years. HBsAg (p=0.019) and anti-HBc (p=0.001) rates were detected in children aged =10 years and children aged < 10 years (95.95% [71/74]) were vaccinated vs 22.64% (24/106) for those aged =10 years (OR: 80.86; 95% CI: 23.36%-279.87%, p < 0.0001). According to anti-HBV vaccination status, HBsAg rate varied from [9.41% (8/85) to 1.05% (1/95), p=0.025], HBeAg rate varied from [2.35% (2/85) to 0% (0/95), p= 0.42] and anti-HBc rate ranged from [12.94% (11/85) to 2.10% (2/95), p= 0.011]. Conclusion: despite the variability of the anti-HBs titer, vaccination against HBV has a positive effect on the reduction of HBV-infection in children in tropical settings such as Cameroon. [ABSTRACT FROM AUTHOR]

Hepatitis B, despite of being a controlled infection today, is one of the most common form of hepatitis in the world. According to the experts' evaluation there are about 3 million patients with chronic hepatitis B in our country. The global strategy of the World Health Organization includes the elimination of viral hepatitis by 2030.The program used in the North-West Federal District to eliminate acute hepatitis B has reduced the incidence rate due to the widespread vaccination coverage of children and the annual increase in adult immunization coverage.However, the relevance of HBV-infection in children still remains high which is associated with a high infection by hepatitis B virus in women of childbearing age and the possibility of the transmission of the infection from mother to her child. In case of perinatal infection the formation of chronic hepatitis B in children reaches up to 90%. The natural course of chronic hepatitis B is characterized by a change in pathogenetically determined phases, and HBsAg-negative infection, which is a latent (occult) form of hepatitis, was added to them in 2009. Occult hepatitis B is an epidemiological danger, for the child as well, if the mother suffers from this form of chronic hepatitis B. Monitoring of pregnant women is often limited to identifying only HBsAg, which is not enough to detect occult hepatitis B. Lately diagnosed occult HBV-infection can become a source of the infection for the baby, especially in cases when due to some reasons there are disorders in hepatitis B vaccination schedule after birth. The article presents an interesting clinical case of family hepatitis B.

Objective: to study the status of markers of the transport system of iron metabolism and the marker profile of HBV infection, depending on the degree of iron overload syndrome in children with chronic hepatitis B.The object of the study were 1 85 children with HBV with iron overload syndrome, aged 4—18 years. Specific research methods included determination by ELISA: sTfR (soluble transferrin receptors), FR (ferritin), FPN (ferroportin), HEPH (hefestin), TfR-2 (transferrin-2 receptors) and serum active Hepcidin-25 (HPS) blood. Viro-logical verification was performed by ELISA and PCR: HBsAg, HBsAb, HBeAg, HBeAb, total HBcorAb, HCVAb, HDVAb, HBV-DNA.A directly proportional dependence of the FPN level and an inversely proportional dependence of the level of HEPH/TfR-2 on the degree of iron overload syndrome were revealed — the higher the presentability of hemosiderosis, the higher the expression of FPN and the suppression of HEPH/TfR-2 with the consequence of decreased transcription of hepcidin-25 in hepatocytes. Confirmation of this fact served as the severity of HBV activity, which correlated with the degree of iron overload syndrome, the lower the transferrin saturation ratio, the higher the viral aggression, which we interpreted as an unfavorable factor in terms of the prognosis of the disease.

Analysis and examination of 220 families allowed to reveal the presence of interfamily concentration of chronic HBV-infection in 30.9% cases. The role of interdependence of the different haptoglobin (HP) phenotypes with the genotypic properties of the virus in the formation of «family cases» of chronic hepatitis В (CHB) were defined and the peculiarities of the profile of HBV markers depending on the carrier and HP viral genotype in children from family cases with CHB were discovered.

In analytical review describes the pathogenic mechanisms of hepatocarcinogenesis and some risk factors of grow more serious progress of HCC. There modern classifications of HCC, aetiology, some of diagnostic methods in suspicion on HCC and different variants of treatment by means of medical drugs and nonmedical tactics are presented. The main risk factors for the development HCC — liver cirrhosis, man, the age of 50 year, HBV DNA > 104 copies/ml, positive HBeAg in blood serum, genotype С HBV, mutations in the area core promoter, increased activity ALT. The clinical example of patient with HCC and the outcome of liver cirrhosis are illustrated.

A total of 717 serum samples from haematological patients, who were hospitalized in Botkin City Clinical Hospital (Moscow) in the 2011–2014, were tested. High frequency of hepatitis B virus (HBV) serologic markers was established: HBsAg — 4.5%; anti-HBc + anti-HBs — 14.6%; anti-HBs alone — 7.0%; anti-HBe + anti-HBc — 14.5%. HBV DNA was detected in 29 of 32 (90.6%) HBsAg-positive and 13 of 717 (1.8%) HBsAg-negative patients. S-gene DNA sequencing of 24 HBV isolates revealed the subtype ay in 100% of cases: ayw3 — 50%, ayw2 — 33.4%, ayw1 — 8.3% and in 8.3% subtype was not detected. Sequence analysis of PCR products amplified from the S region of 18 HBV isolates with genotype D revealed the replacements in 75.0% of cases. Expressed variability of HBV in patients with hematological malignancies receiving chemotherapy/immunotherapy and glucocorticoid hormones represents considerable danger of HBV-infection reactivation and requires the use of antiviral drugs protected from the resistance development. It also testifies the implementation of the wide spectrum of serological and molecular-biological diagnostic methods in this category of patients. The use of vaccines that contain only the «ad» antigenic determinant does not allow to maximize the effectiveness of immunization and may cause the growth of hepatitis B cases among vaccinated patients.

The analysis of serological efficiency and duration of maintaining specific immunity at the children imparted by various vaccines against hepatitis B within the national calendar of inoculations in the territory of St. Petersburg is submitted. It is revealed that high credits of antibodies (more 100 mME/ml) were more often observed at children in the first 3 years after vaccination (68.2%). Eventually levels of antibodies decreased, and in 5 years protective credits have remained at 84.5% examined, the number of patients with a caption of antibodies less than 10 Mmeml has grown from 8.5 to 15.5%.

The objective of the work – is to study the course of HBV-infection in pregnant women, infected and uninfected with HIV, based on the analysis of clinical-laboratory parameters. Materials and methods. HBV-infection was diagnosed in 5.6% of women with negative HIV-status and in 9.4% positive with HIV. To verify the diagnosis of HBV-infection, the data of anamnesis, clinical examination, laboratory tests: general clinical, biochemical, EIA, PCR, and VL in each trimester of pregnancy were used. Research. In HIV-negative pregnant women, 71.6% of the patients were diagnosed with HBsAg carrier status and 28.4% – the replication stages. Replication stages were only in HIV-positive patients. The frequency of clinical manifestations of CHB is higher in HIV-positive women – it is 33.33% vs 10.00% in HIV-negative (p

Objective — to study the peculiarities of chronic viral hepatitis B (CHB) in children, depending on the duration of the disease, strain of the virus and viral load. We have examined 61 children aged 3–18 years with CHB. All patients underwent clinical, laboratory and instrumental examination. The clinical course of CHB was evaluated by the presence of clinical and laboratory syndromes throughout the entire period of the disease. Using polymerase chain reaction and enzyme-linked immunosorbent assay, we have identified strain of hepatitis B virus (HBV) and viral load. Liver fibrosis was assessed using the APRI index. CHB in one third of children was characterized by inactive course (immune tolerant phase), half of the patients had low and minimal activity of the inflammatory process in the liver with minimal clinical symptoms. In 55.9 % of children, horizontal transmission of the virus took place. It was found that in patients with high viral load and a wild-type HBV, CHB had significantly more active course. With increasing CHB duration, the viral load decreases. Moderate direct correlation between strain of the virus and viral load and strong correlation with the activity of the process in the liver has been established. In children with CHB, the activity of hepatitis is a predictor of hepatic fibrosis progression.

This review article deals with the possibility of using the quantitative determination of HBsAg (qHBsAg) to monitor the natural history of the disease. The necessity of unification of qHBsAg use to monitor the natural history of the disease and antiviral therapy, with insuring recommendations in the continental guidelines for HBV-infection, is indicated.

The article presents the result of observation of children born to mothers with HBV infection and peculiarities of primary chronic hepatitis B in the dynamics.

To date, the problem of HBV-infection in pregnant women remains relevant and one of the most important for medical science and health care, as it can be considered as a maternal-fetal infection. The aim of the research is to investigate the course of HBV-infection in pregnant women, depending on the duration of the disease, the degree of viremia and the activity of hepatitis, taking into account gestational periods. Materials and methods. The course of pregnancy in 142 women aged 18-35 years with HBV-infection was monitored. Serum markers and viral load (VL) of hepatitis B (HB) were determined, as well as the levels of ALT, AST, thymol test, serum bilirubin levels during each trimester of pregnancy. Results. In pregnant women with HBV-infection, HBsAg-carriage was most often diagnosed, and the replication stages were less frequent (96 and 46, respectively). Clinical picture of the immune-active phase of chronic HBV-infection was oligosymptomatic without violation of pigment metabolism and manifestations of mesenchymal-inflammatory reaction. The minimal degree of cytolysis prevailed, which did not depend on the degree of the viremia. In women with immune-tolerant phase of cytolysis during pregnancy was not observed. In pregnant women with replication stage of HBV-infection and low degree of viremia, the VL increased at 1-2 log compared to the second and third trimesters, and in women with high viremia – at 2-3 log. In most women-carriers of HBsAg moderate degree of viremia predominated, and in the rest – it was not determined. During the entire pregnancy, the immune-tolerant phase of chronic HBV-infection was latent and did not transform into the immune-active phase. Conclusion. Thus, the diagnosis of chronic HBV-infection was verified before pregnancy in 2.8 %, and during pregnancy – in 97.2 % of women. Carriage of HBsAg prevailed in them (67.6 %), and replicative forms were registered in 32.4 % of patients. The peculiarity of replicative forms is subclinical (65.3 %) and asymptomatic (34.7 %) clinical course with low VL (˂ 105 copies/mL), which in most cases (91.3 %) increases before delivery at 1-2 log and is accompanied by low activity of hepatitis, without violation of pigment metabolism.

We studied 11 cases of HBV-infection de novo in patients after orthotopic liver transplantation performed because of non-viral cirrhosis. Serum НBeAg, was revedled in all patients. In most cases clinical course of HBV-infection was benign. Treatment with entecavir was more effective than lamivudin, and brought to НBsAg elimination in 4 patients. Treatment with lamivudin led to descrease viral load in all patients and HBsAg elimination in one case.

The aim of review. To estimate safety and efficacy of prescription of nucleoside analogues the patient with liver cirrhosis in an outcome of chronic hepatitis B.Original positions of the report. Rates of progression of persistent HBV infection to liver cirrhosis stage depend on several factors – spectrum of viral markers, immune status of the patient, his/her age, gender, genetic predisposition, etc. Lamivudine has capacity for prolonged and persistent block of HBV replication. Its antiviral effect limited basically by development of drug resistance of a virus as a result of mutant strains development. Terms of lamivudine treatment for patients with liver cirrhosis should be no less than 22 months, and clearance HBV DNA is achieved in 93,9 % of patients. Sustained virologic response (it was assessed in 4 years after termination of treatment course) is estimated as 39%. Entecavir has higher (in comparison to lamivudine) efficacy in relation of supression of HBV virus replication and achievement of non-detectable level of viral load. The biochemical response in the group of cirrhotic patients at entecavir application is obtained at 63% НВеAg-positive and at 78% of НВеAg-negative patients. The virological response (supression of HBV replication) at entecavir treatment was: at НВеAg positive – 91%, at НВеAg-negative – 96%. The rate of histological response in the group treated by entecavir was significantly higher, than in group treated by lamivudine: in НВеAg-positive – 80 and 64%, in НВеAg-negative – 75 and 60% respectively.Conclusion. At application of entecavir on a background of supression of viral replication the main strategic goal of antiviral therapy - regression of necroinflammatory changes in the liver at patients with HBV-viral cirrhosis is achieved.

Hepatitis B virus (HBV) infection represents a major public health problem infecting approximately 400 million people worldwide. Despite the availability of a preventive vaccine and anti-viral therapies, chronic HBV infection remains a major health issue because it increases the risk of developing liver cirrhosis and hepatocellular carcinoma (HCC). The lack of a relevant in vitro model for the study of the molecular mechanisms that drive HBV replication and latency, as well as HBV-related carcinogenesis, has been one of the major obstacles to the development of curative strategies. Here, we propose the use of human liver organoids as a platform for modeling HBV infection and related tumorigenesis. Human liver organoids can be seeded from both healthy and cirrhotic liver biopsies. They can be expanded in vitro when culturing in a medium containing a specific set of growth factors. When the culture medium is changed into a new medium containing growth factors that promote differentiation, organoids differentiate into functional hepatocytes, which makes them susceptible to infection with recombinant HBV. The novel in vitro primary model system described in this protocol can be utilized as a platform to study HBV pathogenesis and drug screening. Organoids generated from cirrhotic liver biopsies can be a potential tool for personalized medicine, and for modeling HCC and other liver diseases. Graphic abstract., Competing Interests: Competing interestsThe authors declare no conflict of interest., (Copyright © The Authors; exclusive licensee Bio-protocol LLC.)

Background: Anti-HBc only positive liver grafts may be suitable for HBV-naive recipients insofar as an appropriate infection prophylaxis is performed. Therefore, we investigated the effect of prophylactic regimens on HBV infection prevention and long-term outcome of anti-HBc-positive graft recipients., Patients and Methods: This retrospective monocenter study consisted of a cohort of 1912 patients who underwent deceased donor liver transplantation at our transplant center between June 1987 and July 2019. 81 HBV-naïve patients after reception of an anti-HBc-positive liver-graft and consecutive HBV prophylaxis were selected for further examination. HBV infection rate and host- and graft-survival rates were compared to a matched control group consisting of 162 HBV-naïve patients after reception of anti-HBc-negative grafts. Pharmaceutical HBV prophylaxis included: only HBIG, only NUCs, or combined HBIG and NUCs., Results: Compared to control cases of HBV-naïve anti-HBc-negative graft recipients, no differences in host- and graft-survival rate were determined.13 of 81 anti-HBc-positive graft recipients (16%) developed HBV-infection after liver transplantation. No patient suffered from HBV infection after receiving modern NUCs. Survival analysis showed no statistical differences between patients with and without infection concerning host- and graft-survival., Conclusion: Especially in times of organ shortage, anti-HBc-positive liver grafts may be useful for liver transplantation in HBV-naïve recipients. Efficient prophylactic regimens can prevent HBV-infection., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)