Background: Medical and dental students are at risk of Hepatitis B Virus (HBV) infection. The study aimed to assess the vaccination status against Hepatitis B Virus of students in clinical and non-clinical years of a ...Background: Medical and dental students are at risk of Hepatitis B Virus (HBV) infection. The study aimed to assess the vaccination status against Hepatitis B Virus of students in clinical and non-clinical years of a private medical and dental college, and their knowledge, attitude, and awareness about the subject. Methods: A cross-sectional study was conducted using a pretested, self-administered questionnaire among 203 medical and dental students of CMH Lahore Medical College and Institute of Dentistry (CMH LMC & IOD) in Lahore, Pakistan. Participants were evaluated for their knowledge and vaccination status against Hepatitis B Virus. Students were considered to be fully vaccinated (recipients of 3 doses), partially vaccinated (recipients of 1 or 2 doses), and unvaccinated. Comparisons were made between students of clinical and non-clinical years. Data was entered and analysed using Statistical Package for the Social Sciences (SPSS) version 23. Results: Only 66% (n = 134) of the 203 participants had ever received a Hepatitis B Virus vaccine out of which a meagre 17.2% (n = 35) were fully vaccinated. No significant difference was found in vaccine uptake between students of clinical and non-clinical years (p-value = 0.181) despite significant differences seen in the knowledge of vaccination schedule (p-value = 0.001), the prevalence of needle-stick injuries (p-value = 0.001), and knowledge of protocols to be followed after a needle-stick injury (p-value = 0.001). Conclusion: Our study found that a large proportion of the student population is vulnerable to HBV infection. There is a need to create awareness regarding the subject to increase vaccine uptake. HBV vaccination should be offered to all currently enrolled students and be made mandatory at the time of admission in the future.展开更多
Background and Aims:Natural vaginal delivery and breastfeeding favor the development of a strong immune system in infants,and the immune response of infants to vaccines is closely related to their immune system.This l...Background and Aims:Natural vaginal delivery and breastfeeding favor the development of a strong immune system in infants,and the immune response of infants to vaccines is closely related to their immune system.This large prospective cohort study aimed to explore the effects of delivery and feeding mode on infant’s immune response to hepatitis B vaccine(HepB).Methods:A total of 1,254 infants who completed the whole course of HepB immunization and whose parents were both HBsAg negative were enrolled from infants born in Jinchang City during 2018-2019 by cluster sampling method.Results:Twenty(1.59%)of the 1,254 infants were nonresponders to HepB.Among the other 1,234 infants,10.05%(124/1,234),81.69%(1,008/1,234)and 8.27%(102/1,234)of infants had low,medium,and high responses to HepB,respectively.Logistic regression analysis showed that cesarean section(OR:8.58,95%CI:3.11-23.65,p<0.001)and birth weight<3.18 kg(OR:5.58,95%CI:1.89-16.51,p=0.002)were independent risk factors for infant nonresponse to HepB,and cesarean section(OR:7.63,95%CI:4.64-12.56,p<0.001),formula feeding(OR:4.91,95%CI:1.47-16.45,p=0.001),maternal antiHBs negativity(OR:27.2,95%CI:10.67-69.35,p<0.001),paternal non-response history of HepB(OR:7.86,95%CI:2.22-27.82,p=0.014)and birth weight<3.22 kg(OR:4.00,95%CI:2.43-6.59,p<0.001)were independent risk factors for infant low response to HepB.In cases where birth weight and genetic factors are unmodifiable and maternal anti-HBs effects are controversial,it makes sense to enhance infant response by changing delivery and feeding patterns.Conclusions:Natural vaginal delivery and breastfeeding are beneficial to the infant’s immune response to HepB.展开更多
Background: Prevention is one of the safe schemes against the high prevalence of viral Hepatitis. Negative perceptions or perceptions about the risks of hepatitis B among medical students and health care workers may i...Background: Prevention is one of the safe schemes against the high prevalence of viral Hepatitis. Negative perceptions or perceptions about the risks of hepatitis B among medical students and health care workers may influence the behavioral pattern and adoption of preventive measures against the virus and can affect the uptake of the Hepatitis B vaccine. This study assesses the perception of medical students towards Hepatitis B virus infection and Hepatitis B Vaccination in a Private Tertiary Hospital in Jos North Local Government, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in August 2021 among 236 clinical medical students using a multistage sampling technique. Data was collected using an interviewer-administered structured questionnaire and analysed using the IBM SPSS 28 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: Two-thirds of respondents were of the opinion that they are at risk of contracting HBV. Half were of the opinion that the risk is very much while a third believed the risk is moderate. Among those who think they are not at risk of contracting HBV, the majority felt so because they are vaccinated while 10.3% believe that they are safe. 43.2% of respondents think that HBV Vaccine is very effective in preventing HBV infection while 39.8% think it is slightly effective, and 7.6% think it is not effective. Almost all respondents, 99.2% are of the opinion that HBV Vaccination is important for students while 0.8% think it is not important. The majority of the respondents at 95.8% were willing to be screened for HBV. The majority (85.6%) of respondents are willing to pay for HBV Vaccine as against 14.4% of respondents who are not willing to pay. Conclusion: Summarily, 21 (8.9%) of the students had a negative perception of Hepatitis B Vaccination, and 215 (91.1%) had a positive perception of Hepatitis B Vaccination. Perception-sustaining events like seminars, workshops, road shows, and campaigns should be organized among students and health workers.展开更多
Background and Aims:Hepatitis B vaccine is the most effective preventive measure against hepatitis B virus(HBV)infection.However,the risk of HBV breakthrough infection in fully immunized children(neonatal hepatitis B ...Background and Aims:Hepatitis B vaccine is the most effective preventive measure against hepatitis B virus(HBV)infection.However,the risk of HBV breakthrough infection in fully immunized children(neonatal hepatitis B immunization)who receive immunosuppressive therapy and transfusion of blood components is not well characterized.In this real-world study,we aimed to investigate the immune protection conferred by neonatal hepatitis B vaccine in children with acute lymphoblastic leukemia(ALL)who were treated with immunosuppressive therapy and blood component transfusions.Methods:Children with ALL who had received all three doses of neonatal hepatitis B vaccine were included in this study.HBV seromarkers were detected before and after the initiation of immunosuppressive therapy.Results:A total of 1,011 children with ALL who were fully vaccinated against hepatitis B in infancy before the initiation of immunosuppressive therapy were eligible for inclusion.HBV infection was detected in four of 410 children(0.98%)with an HBsAg test after the initiation of immunosuppressive therapy.The median interval from treatment initiation was 19 months.Conclusions:Three doses of neonatal hepatitis B vaccine conferred adequate protection.In endemic regions,there is a low risk of HBV breakthrough infection in fully immunized children with immunosuppressive therapy.展开更多
AIM To determine whether hepatitis B virus(HBV)-testing could serve as a gateway to vaccinate non-immunized individuals in a low-prevalent country.METHODS Non-immunized subjects participating in a multi-center, HBV-te...AIM To determine whether hepatitis B virus(HBV)-testing could serve as a gateway to vaccinate non-immunized individuals in a low-prevalent country.METHODS Non-immunized subjects participating in a multi-center, HBV-testing campaign in Paris, France were identified and contacted via telephone 3-9 mo after testing in order to determine vaccination status. Vaccination coverage was evaluated in per-protocol(for all respondents) and intent-to-treat analysis(assuming all non-responders did not vaccinate).RESULTS In total, 1215/4924(24.7%) enrolled subjects with complete HBV serology were identified as nonimmunized and eligible for analysis. There were 99/902 successfully contacted subjects who had initiated HBV vaccination after screening: per-protocol, 11.0%(95%CI: 9.0-13.2); intent-to-treat, 8.2%(95%CI: 6.7-9.8). In multivariable analysis, vaccination was more likely to be initiated in individuals originating from moderate or high HBV-endemic countries(P < 0.001), patients with limited healthcare coverage(P = 0.01) and men who have sex with men(P = 0.02). When asked about the reasons for not initiating HBV vaccination, the most frequent response was "will be vaccinated later"(33.4%), followed by "did not want to vaccinate"(29.8%), and "vaccination was not proposed by the physician"(21.5%). Sub-group analysis indicated a stark contrast in vaccination coverage across centers, ranging from 0%-56%.CONCLUSION HBV-vaccination after HBV screening was very low in this study, which appeared largely attributed to physician-patient motivation towards vaccination. Increased vaccination coverage might be achieved by emphasizing its need at the organizational level.展开更多
Hepatitis B virus(HBV)is the leading cause of chronic viral hepatitis.Annually,almost two million children younger than 5 years acquire the infection,mostly through vertical or horizontal transmission in early life.Ve...Hepatitis B virus(HBV)is the leading cause of chronic viral hepatitis.Annually,almost two million children younger than 5 years acquire the infection,mostly through vertical or horizontal transmission in early life.Vertical transmission of HBV is a high efficacy phenomenon ranging,in the absence of any preventive interventions,from 70%to 90%for hepatitis e antigen positive mothers and from 10%to 40%for hepatitis e antigen-negative mothers.Maternal viraemia is a preeminent risk factor for vertical transmission of HBV.Maternal screening is the first step to prevent vertical transmission of HBV.Hepatitis B passive and active immunoprophylaxis at birth together with antiviral treatment of highly viraemic mothers are the key strategies for global elimination of HBV infection.Strategies are needed to promote implementation of birth-dose vaccination and hepatitis B immunoglobulins in low-and middle-income countries where the prevalence of the infection is at the highest.展开更多
Chronic Hepatitis B is a highly prevalent disease worldwide and is estimated to cause more than 800000 annual deaths from complications such as cirrhosis and hepatocellular carcinoma(HCC).Although universal hepatitis ...Chronic Hepatitis B is a highly prevalent disease worldwide and is estimated to cause more than 800000 annual deaths from complications such as cirrhosis and hepatocellular carcinoma(HCC).Although universal hepatitis B vaccination programs may have reduced the incidence and prevalence of chronic hepatitis B and related HCC,the disease still imposes a significant healthcare burden in many endemic regions such as Africa and the Asia-Pacific region.This is especially concerning given the global underdiagnosis of hepatitis B and the limited availability of vaccination,screening,and treatment in low-resource regions.Demographics including male gender,older age,ethnicity,and geographic location as well as low socioeconomic status are more heavily impacted by chronic hepatitis B and related HCC.Methods to mitigate this impact include increasing screening in high-risk groups according to national guidelines,increasing awareness and health literacy in vulnerable populations,and developing more robust vaccination programs in under-served regions.展开更多
Objective With the same times of injection to compare low-dose intradermal regimen with routine-dose intramuscular inoculation in revaccination of non-responders to hepatitis B vaccine. Methods 40 healthy non-responde...Objective With the same times of injection to compare low-dose intradermal regimen with routine-dose intramuscular inoculation in revaccination of non-responders to hepatitis B vaccine. Methods 40 healthy non-responder children collected by screening were administrated a three-dose revaccination randomly by intramuscular or intradermal route (10vs 2g per dose), and regularly tested for serologic markers up to five years. By the end of follow-up, a booster dose (5μg) was given to those who had lost anti-HBs of ≥10mIU/mL (seroprotection) and anamnestic response was estimated thereafter. Results All 17 intramuscular and 22 of 23 intradermal children effected seroprotection after revaccination. Intradermal children lost seroprotection over time significantly rapider compared with intramuscular children (Log Rank test, P= 0.029). In year 5, 50% of intramuscular but only 18.2% of intradermal children still maintained seroprotection (P=0.075). 12-14 days after the booster dose, all the eight intramuscular children developed an anamnestic response with anti-HBs titer increasing greater, but two of the 18 intradermal children failed to mount seroprotective level. Conclusion Three-routine-dose intramuscular revaccination was significantly effective than low-dose intradermal one with the same times of injection, especially in long-term immunity. We recommend routine-dose intramuscular protocol in revaccination of non-responders.展开更多
Chronic hepatitis B(CHB)continues to contribute to worldwide morbidity and mortality significantly.Scientists,clinicians,pharmaceutical companies,and health organizations have dedicated substantial Intellectual and mo...Chronic hepatitis B(CHB)continues to contribute to worldwide morbidity and mortality significantly.Scientists,clinicians,pharmaceutical companies,and health organizations have dedicated substantial Intellectual and monetary resources to finding a cure,increasing immunization rates,and reducing the global burden of CHB.National and international health-related organizations including the center for disease control,the national institute of health,the American Association for the study of liver disease(AASLD),The European association for the study of the Liver(EASL),The Asia Pacific association for the study of the Liver(APASL)and the world health organization release periodic recommendations for disease prevention and treatment.Our review of the most recent guidelines by EASL,AASLD,APASL,and Taiwan Association for the Study of the Liver revealed that an overwhelming majority of cited studies were published before 2018.We reviewed Hepatitis B-related literature published 2018 onwards to identify recent developments and current barriers that will likely direct future efforts towards eradicating hepatitis B.The breakthrough in our understanding of the hepatitis B virus life cycle and resulting drug development is encouraging with significant room for further progress.Data from high-risk populations,most vulnerable to the devastating effects of hepatitis B infection and reactivation remain sparse.Utilization of systems approach,optimization of experimental models,identification and validation of next-generation biomarkers,and precise modulation of the human immune response will be critical for future innovation.Within the foreseeable future,new treatments will likely complement conventional therapies rather than replace them.Most Importantly,pragmatic management of CHB related population health challenges must be prioritized to produce real-world results.展开更多
In 2016,the World Health Assembly adopted a Global Health Sector Strategy on viral hepatitis,with targets set for the years 2020 and 2030 to achieve hepatitis elimination.The main target of hepatitis elimination strat...In 2016,the World Health Assembly adopted a Global Health Sector Strategy on viral hepatitis,with targets set for the years 2020 and 2030 to achieve hepatitis elimination.The main target of hepatitis elimination strategy is to reduce the incidence of hepatitis B virus(HBV)and hepatitis C virus(HCV)by 90%and mortality by 65%in 2030.In last 5 years,the number of people receiving HCV treatment has increased from 1 million to 9.4 million;however,this number is far from the 2030 target of 40 million people receiving HCV treatment.HBV and HCV incidence rates are down from 1.4 million to 1.1 million annual deaths but this is far from the 2030 target of<0.5 million deaths.The coronavirus disease 2019 pandemic has severely affected the efforts in the fight against hepatitis.No major donor has committed to investing in the fight against hepatitis.Time is running out.There is a need to speed up efforts in the fight against hepatitis to achieve hepatitis elimination by 2030.展开更多
Objective:To determine the proportion of HBV surface antigen(anti-HBs)antibody positive children under five years of age born to HBs Ag-negative mothers and to analyze the possible related factors following implementa...Objective:To determine the proportion of HBV surface antigen(anti-HBs)antibody positive children under five years of age born to HBs Ag-negative mothers and to analyze the possible related factors following implementation of a hepatitis B vaccination program for infants in Indonesia 22 years ago.Methods:Blood samples were taken from children under five years of age born to HBsAg-negative mothers who have completed primary vaccination series.Anti-HBs antibodies were determined by using rapid test.Data of age,gender,nutritional status,vaccination timing or vaccination compliance,and booster vaccination were collected from vaccination card.Results:Ninety children were enrolled,consisting of 47 females and 43 males with a mean age of 2.3 years.Twenty two(24.4%)children received booster vaccine between 18 and 24 months and 55(61.1%)were anti-HBs positive.Among factors of age,gender,nutritional status,compliance to vaccination and booster vaccine,only administration of booster vaccine was significantly associated with anti-HBs status(OR 5.45,95%CI 1.45,20.52).Children who received booster vaccine at age of 18-24 months were 5.45 times more likely to be anti-HBs positive than that of children who did not receive booster vaccine.Conclusions:Booster vaccine rate is low among children under 5 years of age but is associated with anti-HBs positivity.Booster vaccination may be required to improve anti-HBs seropositivity.展开更多
Background and Aims:A functional cure,or hepatitis B virus(HBV)surface antigen(HBsAg)loss,is difficult to achieve in patients with hepatitis B virus e antigen(HBeAg)-positive chronic hepatitis B.The HBV vaccine and gr...Background and Aims:A functional cure,or hepatitis B virus(HBV)surface antigen(HBsAg)loss,is difficult to achieve in patients with hepatitis B virus e antigen(HBeAg)-positive chronic hepatitis B.The HBV vaccine and granulocyte-macrophage colony-stimulating factor(GM-CSF)have been reported to help reduce HBsAg levels and promote HBsAg loss.In this prospective randomized trial,we evaluated HBsAg loss in patients receiving pegylated interferon α2b(PEGIFN-α2b)and tenofovir disoproxil fumarate(TDF),with and without GM-CSF and HBV vaccination.Methods:A total of 287 patients with HBeAg positive chronic hepati-tis B and seroconversion after nucleot(s)ide analog treat-ment were assigned randomly to three treatment groups for 48 weeks,TDF alone(control),PEGIFN-α2b+TDF,and PEGIFN-α2b+TDF+GM-CSF+HBV vaccine.The prima-ry endpoints were the proportions of patients with HBsAg loss and seroconversion at 48 and 72 weeks.Resu/ts:The cumulative HBsAg loss rates in the control,PEGIFN-α2b+TDF,and PEGIFN-α2b+TDF+GM-CSF+HBV vaccine groups at week 48 were 0.0%,28.3%,and 41.1%,respec-tively.The cumulative HBsAg seroconversion rates in these groups at week 48 were 0.0%,21.7%,and 33.9%,respec-tively.Multivariate regression analysis showed that GM-CSF use plus HBV vaccination was significantly associated with HBsAg loss(p=0.017)and seroconversion(p=0.030).Con-clusions:In patients with HBeAg-positive chronic hepatitis B and seroconversion after nucleot(s)ide analog treatment,immunomodulatory/antiviral treatment regimens effective-ly improved HBsAg loss,and the regimen including GM-CSF and HBV vaccination was most effective.展开更多
Background and Aims:Hepatitis B vaccination is the most cost effective way to prevent hepatitis B virus(HBV)infection.Hepatitis B vaccine(HepB)efficacy is usually assessed by an-ti-hepatitis B surface antigen(HBsAg)le...Background and Aims:Hepatitis B vaccination is the most cost effective way to prevent hepatitis B virus(HBV)infection.Hepatitis B vaccine(HepB)efficacy is usually assessed by an-ti-hepatitis B surface antigen(HBsAg)level,but there are few reports of humoral and cellular immune responses to HepB in children after neonatal vaccination.Methods:A group of 100 children with a history of primary hepatitis B immunization were included in this study to evaluate the efficacy of HepB.Blood samples were obtained from 80 children before,and 41 children after,a single HepB booster dose.Children with low anti-HBsAg(HBs)titers of<100 mIU/mL received a booster dose after giving their informed consent.Anti-HBsAg,T-cell re-sponse and percentage of B-cell subsets were assayed before and after the booster.Results:Of the 80 children,81.36%had positive T cell and anti-HBsAg responses at baseline.After the booster dose,the anti-HBsAg titer(p<0.0001),positive HBsAg-specific T-cell response(p=0.0036),and spot-form-ing cells(p=0.0003)increased significantly.Compared with pre-existing anti-HBsAg titer<10 mIU/mL,the anti-HBsAg(p=0.0005)and HBsAg-specific T-cell responses(p<0.0001)increased significantly in preexisting anti-HBsAg titer between 10 and 100 mIU/mL group.Change of the HBV-specific hu-moral response was the reverse of the T-cell response with age.Peripheral blood lymphocytes,B cells,and subset fre-quency decreased.Conclusions:HBV immunization protec-tion persisted at least 13 years after primary immunization because of the complementary presence of HBV-specific hu-moral antibodies and a T-cell immune response.One dose of a HepB booster induced protective anti-HBsAg and promoted an HBsAg-specific T-cell response.In HBV endemic regions,a HepB booster is recommended to children without anti-HBsAg because of effectiveness in HBV prevention.展开更多
Hepatocellular carcinoma(HCC)is the fourth leading global cause of tumor-related mortality.HCC has a high prevalence in patients with chronic liver diseases,and it mostly results from cirrhosis caused by infection wit...Hepatocellular carcinoma(HCC)is the fourth leading global cause of tumor-related mortality.HCC has a high prevalence in patients with chronic liver diseases,and it mostly results from cirrhosis caused by infection with blood-borne viruses.Despite the implementation of various diagnostic and prevention strategies,the rates of new HCC cases and mortality are increasing globally due to the aging and growth of the world population as well as their increased exposure to dominant risk factors like alcohol,hepatitis B and C,and clinical correlates of metabolic syndrome.Modeling studies indicate that sanitation practices,implementation of vaccination programs against hepatitis B,and expanded recognition and treatment of patients with chronic hepatitis B and C could greatly contribute to the eradication of viral hepatitis B and C.While the availability of generic antiviral drugs could partially overcome the bottleneck represented by the lack of resources in low and middle-income countries,where viral hepatitis is the leading cause of liver cancer,the enthusiasm for the prevention of liver cancer through antiviral therapy is mitigated by the risk of cancer in many patients who are treated late in the hepatitis course.The present work aimed to review in detail the various types,epidemiology,and carcinogenesis mechanisms of viral infections that are associated with a significantly increased risk for the development of HCC.展开更多
文摘Background: Medical and dental students are at risk of Hepatitis B Virus (HBV) infection. The study aimed to assess the vaccination status against Hepatitis B Virus of students in clinical and non-clinical years of a private medical and dental college, and their knowledge, attitude, and awareness about the subject. Methods: A cross-sectional study was conducted using a pretested, self-administered questionnaire among 203 medical and dental students of CMH Lahore Medical College and Institute of Dentistry (CMH LMC & IOD) in Lahore, Pakistan. Participants were evaluated for their knowledge and vaccination status against Hepatitis B Virus. Students were considered to be fully vaccinated (recipients of 3 doses), partially vaccinated (recipients of 1 or 2 doses), and unvaccinated. Comparisons were made between students of clinical and non-clinical years. Data was entered and analysed using Statistical Package for the Social Sciences (SPSS) version 23. Results: Only 66% (n = 134) of the 203 participants had ever received a Hepatitis B Virus vaccine out of which a meagre 17.2% (n = 35) were fully vaccinated. No significant difference was found in vaccine uptake between students of clinical and non-clinical years (p-value = 0.181) despite significant differences seen in the knowledge of vaccination schedule (p-value = 0.001), the prevalence of needle-stick injuries (p-value = 0.001), and knowledge of protocols to be followed after a needle-stick injury (p-value = 0.001). Conclusion: Our study found that a large proportion of the student population is vulnerable to HBV infection. There is a need to create awareness regarding the subject to increase vaccine uptake. HBV vaccination should be offered to all currently enrolled students and be made mandatory at the time of admission in the future.
基金This study was supported by grants from the Chinese Foundation for Hepatitis Prevention and Control(YGFK20180006).
文摘Background and Aims:Natural vaginal delivery and breastfeeding favor the development of a strong immune system in infants,and the immune response of infants to vaccines is closely related to their immune system.This large prospective cohort study aimed to explore the effects of delivery and feeding mode on infant’s immune response to hepatitis B vaccine(HepB).Methods:A total of 1,254 infants who completed the whole course of HepB immunization and whose parents were both HBsAg negative were enrolled from infants born in Jinchang City during 2018-2019 by cluster sampling method.Results:Twenty(1.59%)of the 1,254 infants were nonresponders to HepB.Among the other 1,234 infants,10.05%(124/1,234),81.69%(1,008/1,234)and 8.27%(102/1,234)of infants had low,medium,and high responses to HepB,respectively.Logistic regression analysis showed that cesarean section(OR:8.58,95%CI:3.11-23.65,p<0.001)and birth weight<3.18 kg(OR:5.58,95%CI:1.89-16.51,p=0.002)were independent risk factors for infant nonresponse to HepB,and cesarean section(OR:7.63,95%CI:4.64-12.56,p<0.001),formula feeding(OR:4.91,95%CI:1.47-16.45,p=0.001),maternal antiHBs negativity(OR:27.2,95%CI:10.67-69.35,p<0.001),paternal non-response history of HepB(OR:7.86,95%CI:2.22-27.82,p=0.014)and birth weight<3.22 kg(OR:4.00,95%CI:2.43-6.59,p<0.001)were independent risk factors for infant low response to HepB.In cases where birth weight and genetic factors are unmodifiable and maternal anti-HBs effects are controversial,it makes sense to enhance infant response by changing delivery and feeding patterns.Conclusions:Natural vaginal delivery and breastfeeding are beneficial to the infant’s immune response to HepB.
文摘Background: Prevention is one of the safe schemes against the high prevalence of viral Hepatitis. Negative perceptions or perceptions about the risks of hepatitis B among medical students and health care workers may influence the behavioral pattern and adoption of preventive measures against the virus and can affect the uptake of the Hepatitis B vaccine. This study assesses the perception of medical students towards Hepatitis B virus infection and Hepatitis B Vaccination in a Private Tertiary Hospital in Jos North Local Government, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in August 2021 among 236 clinical medical students using a multistage sampling technique. Data was collected using an interviewer-administered structured questionnaire and analysed using the IBM SPSS 28 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: Two-thirds of respondents were of the opinion that they are at risk of contracting HBV. Half were of the opinion that the risk is very much while a third believed the risk is moderate. Among those who think they are not at risk of contracting HBV, the majority felt so because they are vaccinated while 10.3% believe that they are safe. 43.2% of respondents think that HBV Vaccine is very effective in preventing HBV infection while 39.8% think it is slightly effective, and 7.6% think it is not effective. Almost all respondents, 99.2% are of the opinion that HBV Vaccination is important for students while 0.8% think it is not important. The majority of the respondents at 95.8% were willing to be screened for HBV. The majority (85.6%) of respondents are willing to pay for HBV Vaccine as against 14.4% of respondents who are not willing to pay. Conclusion: Summarily, 21 (8.9%) of the students had a negative perception of Hepatitis B Vaccination, and 215 (91.1%) had a positive perception of Hepatitis B Vaccination. Perception-sustaining events like seminars, workshops, road shows, and campaigns should be organized among students and health workers.
基金supported by the National Natural Science Foundation of China(No.81371876)National Clinical Re-search Center for Child Health and Disorders General Pro-ject(No.NCRCCHD-2019-GP-04)+2 种基金National Clinical Research Center for Child Health and Disorders Youth Project(No.NCRCCHD-2021-YP-03)Outstanding Youth Foundation of Children’s Hospital of Chongqing Medical UniversityCentral Government Guides Local Science,Technology Develop-ment Projects-demonstration of Science and Technology In-novation projects.
文摘Background and Aims:Hepatitis B vaccine is the most effective preventive measure against hepatitis B virus(HBV)infection.However,the risk of HBV breakthrough infection in fully immunized children(neonatal hepatitis B immunization)who receive immunosuppressive therapy and transfusion of blood components is not well characterized.In this real-world study,we aimed to investigate the immune protection conferred by neonatal hepatitis B vaccine in children with acute lymphoblastic leukemia(ALL)who were treated with immunosuppressive therapy and blood component transfusions.Methods:Children with ALL who had received all three doses of neonatal hepatitis B vaccine were included in this study.HBV seromarkers were detected before and after the initiation of immunosuppressive therapy.Results:A total of 1,011 children with ALL who were fully vaccinated against hepatitis B in infancy before the initiation of immunosuppressive therapy were eligible for inclusion.HBV infection was detected in four of 410 children(0.98%)with an HBsAg test after the initiation of immunosuppressive therapy.The median interval from treatment initiation was 19 months.Conclusions:Three doses of neonatal hepatitis B vaccine conferred adequate protection.In endemic regions,there is a low risk of HBV breakthrough infection in fully immunized children with immunosuppressive therapy.
基金Supported by the ANRS(Agence Nationale de Recherche contre le Sida et les Hépatites)and Mairie de Paris,No.2010-334
文摘AIM To determine whether hepatitis B virus(HBV)-testing could serve as a gateway to vaccinate non-immunized individuals in a low-prevalent country.METHODS Non-immunized subjects participating in a multi-center, HBV-testing campaign in Paris, France were identified and contacted via telephone 3-9 mo after testing in order to determine vaccination status. Vaccination coverage was evaluated in per-protocol(for all respondents) and intent-to-treat analysis(assuming all non-responders did not vaccinate).RESULTS In total, 1215/4924(24.7%) enrolled subjects with complete HBV serology were identified as nonimmunized and eligible for analysis. There were 99/902 successfully contacted subjects who had initiated HBV vaccination after screening: per-protocol, 11.0%(95%CI: 9.0-13.2); intent-to-treat, 8.2%(95%CI: 6.7-9.8). In multivariable analysis, vaccination was more likely to be initiated in individuals originating from moderate or high HBV-endemic countries(P < 0.001), patients with limited healthcare coverage(P = 0.01) and men who have sex with men(P = 0.02). When asked about the reasons for not initiating HBV vaccination, the most frequent response was "will be vaccinated later"(33.4%), followed by "did not want to vaccinate"(29.8%), and "vaccination was not proposed by the physician"(21.5%). Sub-group analysis indicated a stark contrast in vaccination coverage across centers, ranging from 0%-56%.CONCLUSION HBV-vaccination after HBV screening was very low in this study, which appeared largely attributed to physician-patient motivation towards vaccination. Increased vaccination coverage might be achieved by emphasizing its need at the organizational level.
文摘Hepatitis B virus(HBV)is the leading cause of chronic viral hepatitis.Annually,almost two million children younger than 5 years acquire the infection,mostly through vertical or horizontal transmission in early life.Vertical transmission of HBV is a high efficacy phenomenon ranging,in the absence of any preventive interventions,from 70%to 90%for hepatitis e antigen positive mothers and from 10%to 40%for hepatitis e antigen-negative mothers.Maternal viraemia is a preeminent risk factor for vertical transmission of HBV.Maternal screening is the first step to prevent vertical transmission of HBV.Hepatitis B passive and active immunoprophylaxis at birth together with antiviral treatment of highly viraemic mothers are the key strategies for global elimination of HBV infection.Strategies are needed to promote implementation of birth-dose vaccination and hepatitis B immunoglobulins in low-and middle-income countries where the prevalence of the infection is at the highest.
文摘Chronic Hepatitis B is a highly prevalent disease worldwide and is estimated to cause more than 800000 annual deaths from complications such as cirrhosis and hepatocellular carcinoma(HCC).Although universal hepatitis B vaccination programs may have reduced the incidence and prevalence of chronic hepatitis B and related HCC,the disease still imposes a significant healthcare burden in many endemic regions such as Africa and the Asia-Pacific region.This is especially concerning given the global underdiagnosis of hepatitis B and the limited availability of vaccination,screening,and treatment in low-resource regions.Demographics including male gender,older age,ethnicity,and geographic location as well as low socioeconomic status are more heavily impacted by chronic hepatitis B and related HCC.Methods to mitigate this impact include increasing screening in high-risk groups according to national guidelines,increasing awareness and health literacy in vulnerable populations,and developing more robust vaccination programs in under-served regions.
文摘Objective With the same times of injection to compare low-dose intradermal regimen with routine-dose intramuscular inoculation in revaccination of non-responders to hepatitis B vaccine. Methods 40 healthy non-responder children collected by screening were administrated a three-dose revaccination randomly by intramuscular or intradermal route (10vs 2g per dose), and regularly tested for serologic markers up to five years. By the end of follow-up, a booster dose (5μg) was given to those who had lost anti-HBs of ≥10mIU/mL (seroprotection) and anamnestic response was estimated thereafter. Results All 17 intramuscular and 22 of 23 intradermal children effected seroprotection after revaccination. Intradermal children lost seroprotection over time significantly rapider compared with intramuscular children (Log Rank test, P= 0.029). In year 5, 50% of intramuscular but only 18.2% of intradermal children still maintained seroprotection (P=0.075). 12-14 days after the booster dose, all the eight intramuscular children developed an anamnestic response with anti-HBs titer increasing greater, but two of the 18 intradermal children failed to mount seroprotective level. Conclusion Three-routine-dose intramuscular revaccination was significantly effective than low-dose intradermal one with the same times of injection, especially in long-term immunity. We recommend routine-dose intramuscular protocol in revaccination of non-responders.
文摘Chronic hepatitis B(CHB)continues to contribute to worldwide morbidity and mortality significantly.Scientists,clinicians,pharmaceutical companies,and health organizations have dedicated substantial Intellectual and monetary resources to finding a cure,increasing immunization rates,and reducing the global burden of CHB.National and international health-related organizations including the center for disease control,the national institute of health,the American Association for the study of liver disease(AASLD),The European association for the study of the Liver(EASL),The Asia Pacific association for the study of the Liver(APASL)and the world health organization release periodic recommendations for disease prevention and treatment.Our review of the most recent guidelines by EASL,AASLD,APASL,and Taiwan Association for the Study of the Liver revealed that an overwhelming majority of cited studies were published before 2018.We reviewed Hepatitis B-related literature published 2018 onwards to identify recent developments and current barriers that will likely direct future efforts towards eradicating hepatitis B.The breakthrough in our understanding of the hepatitis B virus life cycle and resulting drug development is encouraging with significant room for further progress.Data from high-risk populations,most vulnerable to the devastating effects of hepatitis B infection and reactivation remain sparse.Utilization of systems approach,optimization of experimental models,identification and validation of next-generation biomarkers,and precise modulation of the human immune response will be critical for future innovation.Within the foreseeable future,new treatments will likely complement conventional therapies rather than replace them.Most Importantly,pragmatic management of CHB related population health challenges must be prioritized to produce real-world results.
文摘In 2016,the World Health Assembly adopted a Global Health Sector Strategy on viral hepatitis,with targets set for the years 2020 and 2030 to achieve hepatitis elimination.The main target of hepatitis elimination strategy is to reduce the incidence of hepatitis B virus(HBV)and hepatitis C virus(HCV)by 90%and mortality by 65%in 2030.In last 5 years,the number of people receiving HCV treatment has increased from 1 million to 9.4 million;however,this number is far from the 2030 target of 40 million people receiving HCV treatment.HBV and HCV incidence rates are down from 1.4 million to 1.1 million annual deaths but this is far from the 2030 target of<0.5 million deaths.The coronavirus disease 2019 pandemic has severely affected the efforts in the fight against hepatitis.No major donor has committed to investing in the fight against hepatitis.Time is running out.There is a need to speed up efforts in the fight against hepatitis to achieve hepatitis elimination by 2030.
文摘Objective:To determine the proportion of HBV surface antigen(anti-HBs)antibody positive children under five years of age born to HBs Ag-negative mothers and to analyze the possible related factors following implementation of a hepatitis B vaccination program for infants in Indonesia 22 years ago.Methods:Blood samples were taken from children under five years of age born to HBsAg-negative mothers who have completed primary vaccination series.Anti-HBs antibodies were determined by using rapid test.Data of age,gender,nutritional status,vaccination timing or vaccination compliance,and booster vaccination were collected from vaccination card.Results:Ninety children were enrolled,consisting of 47 females and 43 males with a mean age of 2.3 years.Twenty two(24.4%)children received booster vaccine between 18 and 24 months and 55(61.1%)were anti-HBs positive.Among factors of age,gender,nutritional status,compliance to vaccination and booster vaccine,only administration of booster vaccine was significantly associated with anti-HBs status(OR 5.45,95%CI 1.45,20.52).Children who received booster vaccine at age of 18-24 months were 5.45 times more likely to be anti-HBs positive than that of children who did not receive booster vaccine.Conclusions:Booster vaccine rate is low among children under 5 years of age but is associated with anti-HBs positivity.Booster vaccination may be required to improve anti-HBs seropositivity.
基金Ministry of science and technology of China(2017ZX10202202)CAMS Innovation Fund for Medical Sciences(2019-I2M-5-045)National Key R&D Program of China(2022YFC2304500).
文摘Background and Aims:A functional cure,or hepatitis B virus(HBV)surface antigen(HBsAg)loss,is difficult to achieve in patients with hepatitis B virus e antigen(HBeAg)-positive chronic hepatitis B.The HBV vaccine and granulocyte-macrophage colony-stimulating factor(GM-CSF)have been reported to help reduce HBsAg levels and promote HBsAg loss.In this prospective randomized trial,we evaluated HBsAg loss in patients receiving pegylated interferon α2b(PEGIFN-α2b)and tenofovir disoproxil fumarate(TDF),with and without GM-CSF and HBV vaccination.Methods:A total of 287 patients with HBeAg positive chronic hepati-tis B and seroconversion after nucleot(s)ide analog treat-ment were assigned randomly to three treatment groups for 48 weeks,TDF alone(control),PEGIFN-α2b+TDF,and PEGIFN-α2b+TDF+GM-CSF+HBV vaccine.The prima-ry endpoints were the proportions of patients with HBsAg loss and seroconversion at 48 and 72 weeks.Resu/ts:The cumulative HBsAg loss rates in the control,PEGIFN-α2b+TDF,and PEGIFN-α2b+TDF+GM-CSF+HBV vaccine groups at week 48 were 0.0%,28.3%,and 41.1%,respec-tively.The cumulative HBsAg seroconversion rates in these groups at week 48 were 0.0%,21.7%,and 33.9%,respec-tively.Multivariate regression analysis showed that GM-CSF use plus HBV vaccination was significantly associated with HBsAg loss(p=0.017)and seroconversion(p=0.030).Con-clusions:In patients with HBeAg-positive chronic hepatitis B and seroconversion after nucleot(s)ide analog treatment,immunomodulatory/antiviral treatment regimens effective-ly improved HBsAg loss,and the regimen including GM-CSF and HBV vaccination was most effective.
基金This study was supported by the National Clinical Research Center for Child Health and Disorders General project(No.NCRCCHD-2019-GP-04)Central Government Guides Local Science and Technology Development projects-demonstration of Science and Technology Innovation projects,National Natural Science Foundation of China(No.81371876)Outstanding Youth Foundation of Children’s Hospital of Chongqing Medical University.
文摘Background and Aims:Hepatitis B vaccination is the most cost effective way to prevent hepatitis B virus(HBV)infection.Hepatitis B vaccine(HepB)efficacy is usually assessed by an-ti-hepatitis B surface antigen(HBsAg)level,but there are few reports of humoral and cellular immune responses to HepB in children after neonatal vaccination.Methods:A group of 100 children with a history of primary hepatitis B immunization were included in this study to evaluate the efficacy of HepB.Blood samples were obtained from 80 children before,and 41 children after,a single HepB booster dose.Children with low anti-HBsAg(HBs)titers of<100 mIU/mL received a booster dose after giving their informed consent.Anti-HBsAg,T-cell re-sponse and percentage of B-cell subsets were assayed before and after the booster.Results:Of the 80 children,81.36%had positive T cell and anti-HBsAg responses at baseline.After the booster dose,the anti-HBsAg titer(p<0.0001),positive HBsAg-specific T-cell response(p=0.0036),and spot-form-ing cells(p=0.0003)increased significantly.Compared with pre-existing anti-HBsAg titer<10 mIU/mL,the anti-HBsAg(p=0.0005)and HBsAg-specific T-cell responses(p<0.0001)increased significantly in preexisting anti-HBsAg titer between 10 and 100 mIU/mL group.Change of the HBV-specific hu-moral response was the reverse of the T-cell response with age.Peripheral blood lymphocytes,B cells,and subset fre-quency decreased.Conclusions:HBV immunization protec-tion persisted at least 13 years after primary immunization because of the complementary presence of HBV-specific hu-moral antibodies and a T-cell immune response.One dose of a HepB booster induced protective anti-HBsAg and promoted an HBsAg-specific T-cell response.In HBV endemic regions,a HepB booster is recommended to children without anti-HBsAg because of effectiveness in HBV prevention.
文摘Hepatocellular carcinoma(HCC)is the fourth leading global cause of tumor-related mortality.HCC has a high prevalence in patients with chronic liver diseases,and it mostly results from cirrhosis caused by infection with blood-borne viruses.Despite the implementation of various diagnostic and prevention strategies,the rates of new HCC cases and mortality are increasing globally due to the aging and growth of the world population as well as their increased exposure to dominant risk factors like alcohol,hepatitis B and C,and clinical correlates of metabolic syndrome.Modeling studies indicate that sanitation practices,implementation of vaccination programs against hepatitis B,and expanded recognition and treatment of patients with chronic hepatitis B and C could greatly contribute to the eradication of viral hepatitis B and C.While the availability of generic antiviral drugs could partially overcome the bottleneck represented by the lack of resources in low and middle-income countries,where viral hepatitis is the leading cause of liver cancer,the enthusiasm for the prevention of liver cancer through antiviral therapy is mitigated by the risk of cancer in many patients who are treated late in the hepatitis course.The present work aimed to review in detail the various types,epidemiology,and carcinogenesis mechanisms of viral infections that are associated with a significantly increased risk for the development of HCC.
