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Zang Q, Ju Y, Liu S, Wu S, Zhu C, Liu L, Xu W, He Y. The significance of m6A RNA methylation regulators in diagnosis and subtype classification of HBV-related hepatocellular carcinoma. Hum Cell 2024; 37:752-767. [PMID: 38536633 DOI: 10.1007/s13577-024-01044-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 02/14/2024] [Indexed: 04/15/2024]
Abstract
In recent years, abnormal m6A alteration in hepatocellular carcinoma (HCC) has been a focus on investigating the biological implications. In this study, our objective is to determine whether m6A modification contributes to the progression of HBV-related HCC. To achieve this, we employed a random forest model to screen top 8 characteristic m6A regulators from 19 candidate genes. Subsequently, we developed a nomogram model that utilizes these 8 characteristic m6A regulators to predict the prevalence of HBV-related HCC. According to decision curve analysis, patients may benefit from the nomogram model. The clinical impact curves exhibited a robust predictive capability of the nomogram models. Additionally, consensus molecular subtyping was employed to identify m6A modification patterns and m6A-related gene signature. The quantification of immune cell subsets was accomplished through the implementation of ssGSEA algorithms. PCA algorithms were developed to compute the m6A score for individual tumors. Two distinct m6A modification patterns, namely cluster A and cluster B, exhibited significant correlations with distinct immune infiltration patterns and biological pathways. Notably, patients belonging to cluster B demonstrated higher m6A scores compared to those in cluster A, as determined by the m6A score metric. Furthermore, the expression of IGFBP3 proteins was validated through immunofluorescence, revealing their pronounced lower expression in tumor tissues. In summary, our study underscores the importance of m6A modification in the advancement of HBV-related HCC. This research has the potential to yield novel prognostic biomarkers and therapeutic targets for the identification of HBV-related HCC.
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Affiliation(s)
- Qijuan Zang
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta Road(W), Xi'an, 710061, Shaanxi, China
| | - Yalin Ju
- Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Siyi Liu
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta Road(W), Xi'an, 710061, Shaanxi, China
| | - Shaobo Wu
- Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chengbin Zhu
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta Road(W), Xi'an, 710061, Shaanxi, China
| | - Liangru Liu
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta Road(W), Xi'an, 710061, Shaanxi, China
| | - Weicheng Xu
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta Road(W), Xi'an, 710061, Shaanxi, China
| | - Yingli He
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta Road(W), Xi'an, 710061, Shaanxi, China.
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Wang L, Wang J, Zhao K, Jiang L, Zhang X, Zhao J, Li J, Lu F. The Relationship between Viral Replication and the Severity of Hepatic Necroinflammatory Damage Changed before HBeAg Loss in Patients with Chronic Hepatitis B Virus Infection. J Clin Transl Hepatol 2024; 12:381-388. [PMID: 38638381 PMCID: PMC11022060 DOI: 10.14218/jcth.2023.00378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/31/2023] [Accepted: 01/01/2024] [Indexed: 04/20/2024] Open
Abstract
Background and Aims Disease progression of chronic hepatitis B virus (HBV) infection is driven by the interactions between viral replication and the host immune response against the infection. This study aimed to clarify the relationship between HBV replication and hepatic inflammation during disease progression. Methods Two cross-sectional, one validation cohort, and meta-analyses were used to explore the relationship between HBV replication and liver inflammation. Spearman analysis, multiple linear regression, and logistic regression were used to explore the relationship between variables. Results In the cross-sectional cohorts A and B including 1,350 chronic hepatitis B patients, Spearman analysis revealed a negative relationship between HBV replication (such as HBV DNA) and liver inflammation (such as ALT) in HBeAg-positive patients with higher HBV DNA >2×106 IU/mL (rho=-0.160 and -0.042) which turned to be positive in HBeAg-positive patients with HBV DNA ≤2×106 IU/mL (rho=0.278 and 0.260) and HBeAg-negative patients (rho=0.450 and 0.363). After adjustment for sex, age, and anti-HBe, results from logistic regression and multiple linear regression showed the opposite relationship still existed in HBeAg-positive patients with different DNA levels; the opposite relationship in HBeAg-positive patients with different DNA levels was validated in a third cohort; the opposite relationship in patients with different HBeAg status was partially confirmed by meta-analysis (overall R: -0.004 vs 0.481). Conclusions These results suggested a negative relationship between viral replication and liver inflammation in HBeAg-positive patients with high HBV DNA, which changed to a positive relationship for those HBeAg-positive patients with DNA less than 2×106 IU/mL and HBeAg-negative patients.
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Affiliation(s)
- Leijie Wang
- Department of Microbiology and Immunology, College of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Jian Wang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Kunyu Zhao
- Department of Microbiology and Immunology, College of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Lina Jiang
- Department of Pathology and Hepatology, The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Xinxin Zhang
- Department of Infectious Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingming Zhao
- Department of Pathology and Hepatology, The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Jie Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Fengmin Lu
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University, Beijing, China
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Yuan P, Liu H, Dong X. Scenario-based assessment of emergency management of urban infectious disease outbreaks. Front Public Health 2024; 12:1368154. [PMID: 38721540 PMCID: PMC11076719 DOI: 10.3389/fpubh.2024.1368154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/08/2024] [Indexed: 05/15/2024] Open
Abstract
Infectious diseases pose a severe threat to human health and are accompanied by significant economic losses. Studies of urban outbreaks of infectious diseases are diverse. However, previous studies have neglected the identification of critical events and the evaluation of scenario-based modeling of urban infectious disease outbreak emergency management mechanisms. In this paper, we aim to conduct an empirical analysis and scenario extrapolation using a questionnaire survey of 18 experts, based on the CIA-ISM method and scenario theory, to identify the key factors influencing urban infectious disease outbreaks. Subsequently, we evaluate the effectiveness of urban infectious disease outbreak emergency management mechanisms. Finally, we compare and verify the actual situation of COVID-19 in China, drawing the following conclusions and recommendations. (1) The scenario-based urban infectious disease emergency management model can effectively replicate the development of urban infectious diseases. (2) The establishment of an emergency command center and the isolation and observation of individuals exposed to infectious diseases are crucial factors in the emergency management of urban outbreaks of infectious disease.
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Affiliation(s)
- Pengwei Yuan
- Business School, University of Jinan, Jinan, Shandong, China
| | - Huifang Liu
- College of Management and Economics, Tianjin University, Tianjin, China
| | - Xiaoqing Dong
- Business School, University of Jinan, Jinan, Shandong, China
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Debsikréo N, Mankréo BL, Moukénet A, Ouangkake M, Mara N, Moussa AM, Toure-Kane NC, Lunel-Fabiani F. Prevalence of hepatitis B virus infection and its associated factors among students in N'Djamena, Chad. PLoS One 2024; 19:e0273589. [PMID: 38635501 PMCID: PMC11025733 DOI: 10.1371/journal.pone.0273589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 03/05/2024] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION Infection by hepatitis B virus (HBV) is a major issue in public health. The prevalence of HBV in Chad is 12.4%, all age groups considered. Here, we aimed to determine the prevalence of HBV and its associated factors among university students in N'Djamena, the country's capital. METHODS A cross-sectional survey of students at either the University of N'djamena or Emi Koussi University was conducted from 3 to 23 July 2021. All participating students provided signed, informed consent and were included in the study consecutively. Blood samples were collected, and serum tested for hepatitis B surface antigen (HBsAg) using the Determine HBsAg rapid test kit, with confirmation of positive tests on an Abbott Architect i1000SR analyzer. Descriptive analysis and logistic regression were used to determine associations between the outcome variable and independent/covariate variables. RESULTS A total of 457 students with a median age of 24 years were included across different faculties. The prevalence of HBV infection was 14.87% (68/457). Most students (75%) were aged 25 years or less. Unprotected sex was reported by 64.9% of the students and multiple sexual partners by 53.6%. Furthermore, 45.7% of them reported having no knowledge of hepatitis B. Having an HBsAg-positive mother (AOR: 2.11), having a history of transcutaneous medical procedures (AOR: 2.97) and living with a family (AOR: 4.63) were significantly associated with HBV status. Age ≥26 years appeared as a protective factor (AOR = 0.41). CONCLUSION Our study detected a high, 14.87% prevalence of HBV infection among students in N'djamena, Chad, and shed light on its associated factors. HBV prevention strategies should include raising awareness among students, making full hepatitis vaccination mandatory before children begin school, promoting mass screening to identify and treat chronic HBV carriers and reduce transmission, and reducing the cost of vaccination.
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Affiliation(s)
- Nalda Debsikréo
- Cheikh Anta Diop University, Dakar, Senegal
- Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation, Dakar, Sénégal
| | | | - Azoukalné Moukénet
- Cheikh Anta Diop University, Dakar, Senegal
- University of N’Djamena, N’Djamena, Chad
| | | | | | - Ali Mahamat Moussa
- University of N’Djamena, N’Djamena, Chad
- Centre Hospitalier Universitaire la Référence, N’Djamena, Chad
| | - Ndèye Coumba Toure-Kane
- Cheikh Anta Diop University, Dakar, Senegal
- Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation, Dakar, Sénégal
| | - Françoise Lunel-Fabiani
- Centre Hospitalier Universitaire Angers, BAT IBS-4 rue Larrey, Angers, France
- Laboratoire HIFIH, UFR Santé département Médecine, SFR 4208-UPRES EA3859, Université d’Angers, Angers Cedex 01, France
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Zahoor MA, Feld JB, Lin HHS, Mosa AI, Salimzadeh L, Perrillo RP, Chung RT, Schwarz KB, Janssen HLA, Gehring AJ, Feld JJ. Neutralizing antibodies to interferon alfa arising during peginterferon therapy of chronic hepatitis B in children and adults: Results from the HBRN Trials. Hepatology 2024:01515467-990000000-00849. [PMID: 38630448 DOI: 10.1097/hep.0000000000000878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/12/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND AIMS Pegylated interferon-α (PegIFNα) is of limited utility during immunotolerant or immune active phases of chronic hepatitis B infection but is being explored as part of new cure regimens. Low/absent levels of IFNα found in some patients receiving treatment are associated with limited/no virological responses. The study aimed to determine if sera from participants inhibit IFNα activity and/or contain therapy-induced anti-IFNα antibodies. APPROACH RESULTS Pre-treatment, on-treatment, and post-treatment sera from 61 immunotolerant trial participants on PegIFNα/entecavir therapy and 88 immune active trial participants on PegIFNα/tenofovir therapy were screened for anti-IFNα antibodies by indirect ELISA. The neutralization capacity of antibodies was measured by preincubation of sera±recombinant human IFNα added to Huh7 cells with the measurement of interferon-stimulated gene (ISG)-induction by qPCR. Correlations between serum-induced ISG inhibition, presence, and titer of anti-IFNα antibodies and virological responses were evaluated. Preincubation of on-treatment serum from 26 immunotolerant (43%) and 13 immune active (15%) participants with recombinant-human IFNα markedly blunted ISG-induction in Huh7 cells. The degree of ISG inhibition correlated with IFNα antibody titer ( p < 0.0001; r = 0.87). On-treatment development of anti-IFNα neutralizing antibodies (nAbs) was associated with reduced quantitative HBsAg and qHBeAg declines ( p < 0.05) and inhibited IFNα bioactivity to 240 weeks after PegIFNα cessation. Children developed anti-IFNα nAbs more frequently than adults ( p = 0.004) but nAbs in children had less impact on virological responses. CONCLUSIONS The development of anti-IFNα nAbs during PegIFNα treatment diminishes responses to antiviral therapy. Understanding how and why anti-IFNα antibodies develop may allow for the optimization of IFN-based therapy, which is critical given its renewed use in HBV-cure strategies.
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Affiliation(s)
- Muhammad Atif Zahoor
- Department of Medicine, Division of Gastroenterology & Hepatology, Toronto Center for Liver Disease, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Joshua B Feld
- Department of Medicine, Division of Gastroenterology & Hepatology, Toronto Center for Liver Disease, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Hsing-Hua Sylvia Lin
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alexander I Mosa
- Department of Medicine, Division of Gastroenterology & Hepatology, Toronto Center for Liver Disease, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Loghman Salimzadeh
- Department of Medicine, Division of Gastroenterology & Hepatology, Toronto Center for Liver Disease, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Robert P Perrillo
- Department of Medicine, Baylor Scott & White Medical Center, Dallas, Texas, USA
| | - Raymond T Chung
- Masschusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kathleen B Schwarz
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Harry L A Janssen
- Department of Medicine, Division of Gastroenterology & Hepatology, Toronto Center for Liver Disease, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of Gastroenterology & Hepatology, Erasmus MC University Hospital Rotterdam, Rotterdam, The Netherlands
| | - Adam J Gehring
- Department of Medicine, Division of Gastroenterology & Hepatology, Toronto Center for Liver Disease, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Jordan J Feld
- Department of Medicine, Division of Gastroenterology & Hepatology, Toronto Center for Liver Disease, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
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Amin I, Rafique S, Ali A, Ahmed N, Shahid M, Afzal S, Tahir S, Waqas M, Bibi S, Elgorban AM, Idrees M, Shah M, Syed A. Improving Access to Anti-HDV Testing: Development and Validation of an Affordable In-House ELISA Assay. ACS OMEGA 2024; 9:17137-17142. [PMID: 38645367 PMCID: PMC11024977 DOI: 10.1021/acsomega.3c09843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 03/01/2024] [Accepted: 03/06/2024] [Indexed: 04/23/2024]
Abstract
In certain low-income nations, the hepatitis Delta virus and hepatitis B virus (HBV) pose a serious medical burden, where the prevalence of hepatitis B surface antigen (HBsAg) is greater than 8%. Especially in rural places, irregular diagnostic exams are the main restriction and reason for underestimation. Utilizing serum samples from a Pakistani isolate, an internal ELISA for the quick identification of anti-HDV was created, and the effectiveness of the test was compared to a commercial diagnostic kit. HDV-positive serum samples were collected, and a highly antigenic domain of HDAg antigen was derived from them. This antigenic HDAg was expressed in a bacterial expression system, purified by Ni-chromatography, and confirmed by SDS-PAGE and Western blot analysis. The purified antigen was utilized to develop an in-house ELISA assay for anti-HDV antibody detection of the patient's serum samples at very low cost. Purified antigens and positive and negative controls can detect anti-HDV (antibodies) in ELISA plates. The in-house developed kit's efficiency was compared with that of a commercial kit (Witech Inc., USA) by the mean optical density values of both kits. No significant difference was observed (a P value of 0.576) by applying statistical analysis. The newly developed in-house ELISA is equally efficient compared to commercial kits, and these may be useful in regular diagnostic laboratories, especially for analyzing local isolates.
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Affiliation(s)
- Iram Amin
- Centre
of Excellence in Molecular Biology (CEMB), University of the Punjab, Lahore 54590, Pakistan
- Centre
of Applied Molecular Biology (CAMB), University
of the Punjab, Lahore 54590, Pakistan
| | - Shazia Rafique
- Centre
of Excellence in Molecular Biology (CEMB), University of the Punjab, Lahore 54590, Pakistan
| | - Amjad Ali
- Department
of Biotechnology and Genetic Engineering, Hazara University Mansehra, Mansehra 2100, Pakistan
| | - Nadeem Ahmed
- Centre
of Excellence in Molecular Biology (CEMB), University of the Punjab, Lahore 54590, Pakistan
| | - Muhammad Shahid
- Centre
of Excellence in Molecular Biology (CEMB), University of the Punjab, Lahore 54590, Pakistan
| | - Samia Afzal
- Centre
of Excellence in Molecular Biology (CEMB), University of the Punjab, Lahore 54590, Pakistan
| | - Saad Tahir
- Centre
of Excellence in Molecular Biology (CEMB), University of the Punjab, Lahore 54590, Pakistan
| | - Muhammad Waqas
- Department
of Biotechnology and Genetic Engineering, Hazara University Mansehra, Mansehra 2100, Pakistan
| | - Sadia Bibi
- Department
of Botany, University of Malakand, Dir (Lower), Chakdara 18800, Khyber Pakhtunkhwa, Pakistan
| | - Abdallah M. Elgorban
- Department
of Botany and Microbiology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
| | - Muhammad Idrees
- Centre
of Excellence in Molecular Biology (CEMB), University of the Punjab, Lahore 54590, Pakistan
| | - Masaud Shah
- Department
of Physiology, Ajou University School of
Medicine, Suwon 16499, Republic
of Korea
| | - Asad Syed
- Department
of Botany and Microbiology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
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Monir ZM, El-Din EMS, Kandeel WA, Sallam SF, Elsheikh E, Abushady MM, Allah FH, Tawfik S, Zeid DA. Evaluation of apparently healthy Egyptian infants and toddlers on the bayley-III scales according to age and sex. Ital J Pediatr 2024; 50:68. [PMID: 38616286 PMCID: PMC11017649 DOI: 10.1186/s13052-024-01635-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 03/23/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Child development is shaped throughout the first years of life through the interaction of genetics and the environment. Bayley-III is valuably used to determine early developmental delay (DD). The aim of this study was to detect the differences in performance of a sample of apparently healthy Egyptian infants and toddlers on the Bayley-III scales in relation to their age and gender. METHODS This was a cross-sectional study. Bayley scales were applied to 270 of the 300 recruited children following the inclusion criteria; to avoid potential risk factors affecting development. Assessment included cognitive, language and motor skills. Engaged children aged 18-42 months were divided into 4 age groups with six-month intervals. RESULTS Approximately 78.4%, 76.2%, and 72% of the participants had average and above average scores in the cognitive, motor, and language domains, respectively. The language domain was characteristically impacted. The oldest age group (36-42 months) scored the highest means composite scores, while the 2nd group aged 24 - <30 months, scored the lowest means in the three evaluated domains. In general, girls had non-significantly higher composite scores than boys, with a small effect size (d = 0.2-0.4). In the language domain, girls aged 30 to < 36 months scored significantly higher composite scores than boys (p < 0.05), with a medium effect size (d = 0.73). CONCLUSION The study indicates that the performance of apparently healthy Egyptian children on the Bayley III evaluation differs in relation to age and sex. The most vulnerable age group at potential risk of DD was children aged 24-30 months. Efforts must be directed to investigate the nutritional, physical, psychological and safety needs of this group. Attention must be paid to early childhood intervention programs that stimulate development, especially language development, and they must be tailored on the basis of age and gender. Gender-specific norms may be needed in the evaluation of language development.
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Affiliation(s)
- Zeinab M Monir
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Ebtissam M Salah El-Din
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Wafaa A Kandeel
- Biological Anthropology Department/Medical Research and Clinical Studies Institute, National Research Centre, 60014618, Cairo, Dokki, Egypt
| | - Sara F Sallam
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Eman Elsheikh
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Mones M Abushady
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Fawzia Hasseb Allah
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Sawsan Tawfik
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Dina Abu Zeid
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt.
- Child Health Department Medical Research and Clinical Studies Institute, National Research Centre, P.O.12622, Cairo, Egypt.
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Pocurull A, Collazos C, Miralpeix A, Tapias L, Wang T, Moreta MJ, Mariño Z, Lens S, Forns X. Influence of language barrier and cultural background in hepatitis B disease knowledge in a Chinese community of Spain. Front Public Health 2024; 12:1324336. [PMID: 38660346 PMCID: PMC11040686 DOI: 10.3389/fpubh.2024.1324336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Hepatitis B infection (HBV) is prevalent in China. Due to language barriers and cultural differences, it is not always straightforward to evaluate disease knowledge in liver clinics. We aimed to assess the awareness on HBV and its mechanisms of transmission in HBV-infected Chinese patients and their household contacts. Methods HBV-infected Chinese patients and their contacts were interviewed by a native Chinese nurse regarding their knowledge on HBV transmission mechanisms, use of preventive measures and vaccination status. Non-Chinese HBV-infected patients and their household contacts served as a control group. Results In total 182 patients and 398 contacts participated with 85 (47%) patients and 240 (60%) contacts being from China. Language barrier was reported in 80% of Chinese patients and 44% of their contacts. Knowledge on parenteral and sexual HBV transmission was high in all patients (~90%) but Chinese were more aware of vertical transmission than controls (94% vs. 68%; p < 0.01). Regarding the use of preventive measures, Chinese patients were more forewarned in their use to avoid parenteral transmission (93% vs. 74%, p < 0.01). When assessing household contacts, Chinese used preventive measures more frequently than controls for parenteral and sexual transmission (79% vs. 65 and 81% vs. 48%, p < 0.05). Vaccination coverage was slightly lower in Chinese contacts compared to controls (78% vs. 86%, p = 0.05). Conclusion Despite relevant language barriers, Chinese patients are well informed on the mechanisms of HBV transmission. Cultural differences may explain a higher use of preventive measures among the Chinese population. HBV vaccination of household contacts should be reinforced in both groups.
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Affiliation(s)
- Anna Pocurull
- Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Cristina Collazos
- Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Anna Miralpeix
- Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Laura Tapias
- Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Tao Wang
- Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - María Jose Moreta
- Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Zoe Mariño
- Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Sabela Lens
- Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Xavier Forns
- Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
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Cai H, Huang T, Zheng B, Zhu X, Zhou L, Wu J, Xu Y, Huang S, Huang Y, Liu T. Exploring the evolutionary mechanism of hepatitis B and gastric cancer based on Mendelian randomization combined with bioinformatics analysis. Medicine (Baltimore) 2024; 103:e37645. [PMID: 38579038 PMCID: PMC10994552 DOI: 10.1097/md.0000000000037645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/27/2024] [Indexed: 04/07/2024] Open
Abstract
Chronic hepatitis B virus infection (HBV) infection appears to be associated with extrahepatic cancers. This study aims to evaluate the causality and evolutionary mechanism of chronic HBV infection and gastric cancer through Mendelian randomization (MR) analysis and bioinformatics analysis. We conducted 2-sample MR to investigate the causal relationship between chronic HBV infection and gastric cancer. We identified 5 independent genetic variants closely associated with exposure (chronic HBV infection) as instrumental variables in a sample of 1371 cases and 2938 controls of East Asian descent in Korea. The genome wide association study (GWAS) data for the outcome variable came from the Japanese Biobank. Bioinformatics analysis was used to explore the evolutionary mechanism of chronic HBV infection and gastric cancer. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were performed to identify key targets that are commonly associated with both diseases, and their biological functions were investigated. Multiple machine-learning models were employed to select hub genes. The MR analysis showed a positive causal relationship between chronic HBV infection and gastric cancer (IVW: OR = 1.165, 95% CI = 1.085-1.250, P < .001), and the result was robust in sensitivity analysis. According to the bioinformatics analysis, the 5 key targets were mainly enriched in Toll-like receptor signaling and PI3K-Akt signaling. Two hub genes, CXCL9 and COL6A2, were identified, and a high-performing predictive model was constructed. Chronic HBV infection is positively associated with gastric cancer, and the evolutionary mechanism may be related to Toll-like receptor signaling. Prospective studies are still needed to confirm these findings.
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Affiliation(s)
- Huilian Cai
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Tianjian Huang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Bohui Zheng
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xianqiong Zhu
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lisi Zhou
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiayu Wu
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ying Xu
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shulan Huang
- General Hospital of Guangzhou Military Command of PLA, Guangzhou, China
| | - Yuxuan Huang
- Guangdong Pharmaceutical University, Guangzhou, China
| | - Tian Liu
- Foshan Hospital of Traditional Chinese Medicine, Foshan, China
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60
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Yu X, Gong Q, Yu D, Chen Y, Jing Y, Zoulim F, Zhang X. Spatial transcriptomics reveals a low extent of transcriptionally active hepatitis B virus integration in patients with HBsAg loss. Gut 2024; 73:797-809. [PMID: 37968095 PMCID: PMC11041573 DOI: 10.1136/gutjnl-2023-330577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/17/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVE Hepatitis B virus (HBV) can integrate into the chromosomes of infected hepatocytes, contributing to the production of hepatitis B surface antigen (HBsAg) and to hepatocarcinogenesis. In this study, we aimed to explore whether transcriptionally active HBV integration events spread throughout the liver tissue in different phases of chronic HBV infection, especially in patients with HBsAg loss. DESIGN We constructed high-resolution spatial transcriptomes of liver biopsies containing 13 059 tissue spots from 18 patients with chronic HBV infection to analyse the occurrence and relative distribution of transcriptionally active viral integration events. Immunohistochemistry was performed to evaluate the expression of HBsAg and HBV core antigen. Intrahepatic covalently closed circular DNA (cccDNA) levels were quantified by real-time qPCR. RESULTS Spatial transcriptome sequencing identified the presence of 13 154 virus-host chimeric reads in 7.86% (1026 of 13 059) of liver tissue spots in all patients, including three patients with HBsAg loss. These HBV integration sites were randomly distributed on chromosomes and can localise in host genes involved in hepatocarcinogenesis, such as ALB, CLU and APOB. Patients who were receiving or had received antiviral treatment had a significantly lower percentage of viral integration-containing spots and significantly fewer chimeric reads than treatment-naïve patients. Intrahepatic cccDNA levels correlated well with viral integration events. CONCLUSION Transcriptionally active HBV integration occurred in chronically HBV-infected patients at different phases, including in patients with HBsAg loss. Antiviral treatment was associated with a decreased number and extent of transcriptionally active viral integrations, implying that early treatment intervention may further reduce the number of viral integration events.
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Affiliation(s)
- Xiaoqi Yu
- Department of Infectious Diseases, Research Laboratory of Clinical Virology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Qiming Gong
- Department of Infectious Diseases, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Demin Yu
- Department of Infectious Diseases, Research Laboratory of Clinical Virology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Yongyan Chen
- Department of Infectious Diseases, Research Laboratory of Clinical Virology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Ying Jing
- Center for Intelligent Medicine Research, Greater Bay Area Institute of Precision Medicine (Guangzhou), School of Life Sciences, Fudan University, Guangzhou, China
| | - Fabien Zoulim
- INSERM U1052- Cancer Research Center of Lyon (CRCL), Lyon, France
- University of Lyon, UMR_S1052, CRCL, Lyon, France
- Department of Hepatology, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Xinxin Zhang
- Department of Infectious Diseases, Research Laboratory of Clinical Virology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
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61
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Freeland C, Adjei C, Wallace J, Wang S, Hicks J, Adda D, James C, Cohen C. Survey of lived experiences and challenges in hepatitis B management and treatment. BMC Public Health 2024; 24:944. [PMID: 38566070 PMCID: PMC10986103 DOI: 10.1186/s12889-024-18425-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
Almost 300 million people are living with chronic hepatitis B infection worldwide and most remain undiagnosed and at risk for liver cancer. In 2015 the World Health Organization (WHO) developed guidelines for the prevention, care, and treatment of persons with chronic hepatitis B and in early 2023 began to work on updating these guidelines. In March 2023, a self-administered, anonymous online survey was launched, aiming to identify patient preferences related to the clinical management of hepatitis B including current management, treatment, and care experiences, preferences regarding engagement with providers, and preferences related to simplifying hepatitis B care access. A sample of 560 individuals living with hepatitis B (self-identified as HBsAg positive) from 76 countries completed the survey. Key findings demonstrated that less than half (49%, N = 268) of participants regularly visited a doctor to check the health of their liver (every 6-12 months), with 37% of participants prescribed antiviral medication by a specialist (82%, N = 167) or general practitioner (13%, N = 26). Participants reported not being actively involved in care decision making with their providers (42%, N = 217), with an overwhelming majority wanting to participate in hepatitis B management and treatment choices (85%, N = 435). Participants provided qualitative and quantitative details using open-ended responses within the survey about challenges with medication affordability and receiving care from a knowledgeable provider. Overall findings demonstrated key gaps in care, management, and treatment access related to hepatitis B: identifying these gaps can be used to identify areas for improvement along the care continuum for viral hepatitis. The survey found a need for the comprehensive simplification of clinical management and health care services related to hepatitis B. A thematic analysis of the open-ended survey responses highlighted major overarching themes including the cost and access burdens associated with hepatitis B management and treatment, and challenges in finding knowledgeable providers. Results from this mixed methods survey were used to inform the WHO hepatitis B guidelines update. Efforts should continue to explore public health approaches to address barriers and facilitators to testing, care, and treatment for people with hepatitis B to improve awareness of hepatitis B and access, care, and treatment among patients and providers.
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Affiliation(s)
| | | | - Jack Wallace
- Burnet Institute, Melbourne, Australia
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia
| | - Su Wang
- Saint Barnabas Medical Center, Livingston, NJ, USA
| | | | - Danjuma Adda
- World Hepatitis Alliance, London, UK
- CFID Taraba, Taraba, Nigeria
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62
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Gerlich WH. Do HBsAg subdeterminants matter for vaccination against hepatitis B? Virus Genes 2024; 60:240-242. [PMID: 38353809 PMCID: PMC10978618 DOI: 10.1007/s11262-024-02061-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 04/01/2024]
Affiliation(s)
- Wolfram H Gerlich
- Institute of Medical Virology, Justus Liebig University Giessen, National Reference Center for Hepatitis B and D, Schubert Str. 81, Giessen, D35392, Germany.
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63
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Khader Y, Warrad N, Maiteh S. Prevalence Rates of Tuberculosis, Human Immunodeficiency Virus, and Hepatitis B and C among Migrant Workers in Jordan. J Glob Infect Dis 2024; 16:54-59. [PMID: 39081509 PMCID: PMC11286085 DOI: 10.4103/jgid.jgid_104_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 11/19/2023] [Accepted: 01/28/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Migration across national borders is an influential factor of consideration in the control of infectious diseases. Therefore, including migrants in surveillance and screening programs as well as linkage to care is mandatory to meet the public health targets of countries and regions. This study aimed to determine the prevalence of tuberculosis (TB), human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among migrant workers applying for work permits in Jordan during the period 2018-2020. The findings of this study are expected to guide health policy to prevent the spread of infectious diseases in Jordan. Methods During the period 2018-2020, 439,622 migrant workers underwent routine testing for TB, HIV, and hepatitis B and C. Demographic, laboratory, and clinical data for those migrants were retrieved from the Directorate of Chest Diseases and Immigrants Health records. The overall prevalence of the mentioned diseases as well as by subgroups was calculated. Results The prevalence rates of TB and HIV among migrants were 54 per 100,000 migrants (11 per 100,000 male migrants and 138 per 100,000 female migrants, P < 0.001) and 21 per 100,000 (11 per 100,000 male migrants and 41 per 100,000 female migrants, P < 0.001), respectively. The prevalence of hepatitis B was 10 per 1000 migrants (12 per 1000 male migrants and 7 per 1000 female migrants, P < 0.001) and the prevalence of hepatitis C was 37 per 1000 (51 per 1000 male migrants and 10 per 1000 female migrants, P < 0.001). The prevalence of all studied conditions varied significantly according to gender, age, occupation, and country of origin. Conclusions The prevalence rates of TB, HIV, HBV, and HCV were generally higher among migrants than Jordanians. Evidence-based health policies need to be drafted that aim to address migrant workers health care to ensure the lowest possible risk from infectious diseases to the people of Jordan is maintained. The study findings can inform the formulation of immigration and public health policies, including screening requirements for migrant workers, health insurance provisions, labor regulations, and support services for those with these conditions.
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Affiliation(s)
- Yousef Khader
- Department of Public Health, Community Medicine, and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Center of Excellence for Applied Epidemiology, Global Health Development Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Nathirah Warrad
- Department of Public Health, Community Medicine, and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Sudi Maiteh
- Center of Excellence for Applied Epidemiology, Global Health Development Eastern Mediterranean Public Health Network, Amman, Jordan
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64
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Morgan CE, Ngimbi P, Boisson-Walsh AJN, Ntambua S, Matondo J, Tabala M, Kashamuka MM, Emch M, Edwards JK, Powers KA, James L, Mbonze N, Mampunza S, Yotebieng M, Thompson P, Parr JB. Hepatitis B Virus Prevalence and Transmission in the Households of Pregnant Women in Kinshasa, Democratic Republic of Congo. Open Forum Infect Dis 2024; 11:ofae150. [PMID: 38623568 PMCID: PMC11017325 DOI: 10.1093/ofid/ofae150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Indexed: 04/17/2024] Open
Abstract
Background The World Health Organization Africa region has high regional hepatitis B virus (HBV) prevalence, and evidence suggests more frequent horizontal HBV transmission than other regions. Context-specific epidemiological studies are needed to inform additional HBV prevention measures. Methods In the cross-sectional Horizontal and Vertical Transmission of Hepatitis B (HOVER-HBV) study, we introduced HBV surface antigen (HBsAg) screening alongside existing HIV screening as part of routine antenatal care in high-volume maternity clinics in Kinshasa, Democratic Republic of Congo. We recruited households of pregnant women ("index mothers") who were HBsAg-positive and HBsAg-negative, defining households as index-positive and index-negative, respectively. Household members underwent HBsAg testing and an epidemiological survey. We evaluated HBsAg prevalence and potential transmission correlates. Results We enrolled 1006 participants from 200 households (100 index-positive, 100 index-negative) across Kinshasa. HBsAg-positivity prevalence was more than twice as high in index-positive households (5.0% [95% confidence interval {CI}, 2.8%-7.1%]) as in index-negative households (1.9% [95% CI, .6%-3.2%]). HBsAg-positivity prevalence was 3.3 (95% CI, .9-11.8) times as high among direct offspring in index-positive versus index-negative households. Factors associated with HBsAg positivity included older age, marriage, and having multiple recent partners or any new sexual partners among index mothers; and older age, lower household wealth, sharing nail clippers, and using street salons among offspring in index-positive households. Conclusions Vertical and horizontal HBV transmission within households is ongoing in Kinshasa. Factors associated with infection reveal opportunities for HBV prevention efforts, including perinatal prevention, protection during sexual contact, and sanitation of shared personal items.
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Affiliation(s)
- Camille E Morgan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Patrick Ngimbi
- Faculté de Médecine, Université Protestante du Congo, Kinshasa, Democratic Republic of the Congo
| | - Alix J N Boisson-Walsh
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah Ntambua
- Faculté de Médecine, Université Protestante du Congo, Kinshasa, Democratic Republic of the Congo
| | - Jolie Matondo
- Faculté de Médecine, Université Protestante du Congo, Kinshasa, Democratic Republic of the Congo
| | - Martine Tabala
- L‘École de Santé Publique, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | - Michael Emch
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jessie K Edwards
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kimberly A Powers
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Linda James
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Nana Mbonze
- L‘École de Santé Publique, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Samuel Mampunza
- Faculté de Médecine, Université Protestante du Congo, Kinshasa, Democratic Republic of the Congo
| | - Marcel Yotebieng
- Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Peyton Thompson
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jonathan B Parr
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Hige S, Aoki K, Nakamoto D, Flaherty JF, Botros I, Mizutani H, Ishizaki A, Konishi H, Yuan J, Jinushi M, Ng LJ. Real-world safety and effectiveness of tenofovir alafenamide for 144 weeks in Japanese patients with chronic hepatitis B. J Viral Hepat 2024; 31:165-175. [PMID: 38163911 DOI: 10.1111/jvh.13912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/17/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
Tenofovir alafenamide (TAF), a prodrug of tenofovir, delivers high levels of active drug to hepatocytes and is given in a lower dose than tenofovir disoproxil fumarate (TDF). TAF reduces viral replication in patients with chronic hepatitis B (CHB) similar to TDF and has shown a lower risk of the renal and bone toxicities associated with TDF use. This post-marketing surveillance study examined the safety and effectiveness of TAF in treatment-naïve and -experienced CHB patients who received TAF for 144 weeks at real-world clinical sites in Japan. Safety assessments included the incidence of adverse drug reactions (ADRs), renal and bone events, and changes in selected laboratory parameters. Effectiveness was based on the proportion of patients with HBV DNA levels below the lower limit of quantitation or <29 IU/mL. This analysis included 580 patients; 18.4% of whom were treatment-naïve. The cumulative incidence of ADRs was 0.21 per 100 person-months, and the incidence of serious ADRs was 0.01 (95% CI, 0.00-0.04) per 100 person-months. There were no ADRs of declines in estimated glomerular filtration rates, renal failure or proximal tubulopathy. The most common ADR was hypophosphataemia in seven (1.2%) patients. Two (0.4%) patients each had decreased blood phosphorus, bone mineral density decreased, dizziness and alopecia. Overall, the proportion of virologically suppressed patients increased from 68.8% at baseline to 97.5% at Week 144. These results confirm the real-world safety and effectiveness of TAF in Japanese patients with CHB and are consistent with the findings of other evaluations of the safety and efficacy of TAF in CHB.
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Affiliation(s)
- Shuhei Hige
- Department of Gastroenterology, Sapporo-Kosei General Hospital, Sapporo, Japan
| | - Kouji Aoki
- Gilead Sciences K.K., Chiyoda-Ku, Tokyo, Japan
| | | | | | - Irina Botros
- Gilead Sciences, Inc., Foster City, California, USA
| | | | | | | | - Jason Yuan
- Gilead Sciences, Inc., Foster City, California, USA
| | | | - Leslie J Ng
- Gilead Sciences, Inc., Foster City, California, USA
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Zhang Y, Yuan X, Wang J, Han M, Lu H, Wang Y, Liu S, Yang S, Xing HC, Cheng J. TRPV4 promotes HBV replication and capsid assembly via methylation modification of H3K4 and HBc ubiquitin. J Med Virol 2024; 96:e29510. [PMID: 38573018 DOI: 10.1002/jmv.29510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/21/2024] [Accepted: 02/25/2024] [Indexed: 04/05/2024]
Abstract
Hepatitis B virus (HBV) infection poses a significant burden on global public health. Unfortunately, current treatments cannot fully alleviate this burden as they have limited effect on the transcriptional activity of the tenacious covalently closed circular DNA (cccDNA) responsible for viral persistence. Consequently, the HBV life cycle should be further investigated to develop new anti-HBV pharmaceutical targets. Our previous study discovered that the host gene TMEM203 hinders HBV replication by participating in calcium ion regulation. The involvement of intracellular calcium in HBV replication has also been confirmed. In this study, we found that transient receptor potential vanilloid 4 (TRPV4) notably enhances HBV reproduction by investigating the effects of several calcium ion-related molecules on HBV replication. The in-depth study showed that TRPV4 promotes hepatitis B core/capsid protein (HBc) protein stability through the ubiquitination pathway and then promotes the nucleocapsid assembly. HBc binds to cccDNA and reduces the nucleosome spacing of the cccDNA-histones complex, which may regulate HBV transcription by altering the nucleosome arrangement of the HBV genome. Moreover, our results showed that TRPV4 promotes cccDNA-dependent transcription by accelerating the methylation modification of H3K4. In conclusion, TRPV4 could interact with HBV core protein and regulate HBV during transcription and replication. These data suggest that TRPV4 exerts multifaceted HBV-related synergistic factors and may serve as a therapeutic target for CHB.
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Affiliation(s)
- Yu Zhang
- Peking University Ditan Teaching Hospital, Beijing, China
- Department of Hepatology, Beijing Ditan Hospital of Capital Medical University, Beijing, China
| | - Xiaoxue Yuan
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Jun Wang
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Emerging Infectious Diseases, Peking University Ditan Teaching Hospital, Beijing, China
| | - Ming Han
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Hongping Lu
- Beijing Pan-Asia Tongze Institute of Biomedicine Co, Ltd, Beijing, China
| | - Yun Wang
- Department of Hepatology, Beijing Ditan Hospital of Capital Medical University, Beijing, China
- Beijing Key Laboratory of Emerging Infectious Diseases, The First Section of Liver Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Shunai Liu
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Song Yang
- Department of Hepatology, Beijing Ditan Hospital of Capital Medical University, Beijing, China
| | - Hui-Chun Xing
- Department of Hepatology, Beijing Ditan Hospital of Capital Medical University, Beijing, China
| | - Jun Cheng
- Peking University Ditan Teaching Hospital, Beijing, China
- Department of Hepatology, Beijing Ditan Hospital of Capital Medical University, Beijing, China
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Cooke GS, Flower B, Cunningham E, Marshall AD, Lazarus JV, Palayew A, Jia J, Aggarwal R, Al-Mahtab M, Tanaka Y, Jeong SH, Poovorawan K, Waked I, Hiebert L, Khue PM, Grebely J, Alcantara-Payawal D, Sanchez-Avila JF, Mbendi C, Muljono DH, Lesi O, Desalegn H, Hamid S, de Araujo A, Cheinquer H, Onyekwere CA, Malyuta R, Ivanchuk I, Thomas DL, Pimenov N, Chulanov V, Dirac MA, Han H, Ward JW. Progress towards elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission update. Lancet Gastroenterol Hepatol 2024; 9:346-365. [PMID: 38367629 DOI: 10.1016/s2468-1253(23)00321-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 02/19/2024]
Abstract
The top 20 highest burdened countries (in disability-adjusted life years) account for more than 75% of the global burden of viral hepatitis. An effective response in these 20 countries is crucial if global elimination targets are to be achieved. In this update of the Lancet Gastroenterology & Hepatology Commission on accelerating the elimination of viral hepatitis, we convene national experts from each of the top 20 highest burdened countries to provide an update on progress. Although the global burden of diseases is falling, progress towards elimination varies greatly by country. By use of a hepatitis elimination policy index conceived as part of the 2019 Commission, we measure countries' progress towards elimination. Progress in elimination policy has been made in 14 of 20 countries with the highest burden since 2018, with the most substantial gains observed in Bangladesh, India, Indonesia, Japan, and Russia. Most improvements are attributable to the publication of formalised national action plans for the elimination of viral hepatitis, provision of publicly funded screening programmes, and government subsidisation of antiviral treatments. Key themes that emerged from discussion between national commissioners from the highest burdened countries build on the original recommendations to accelerate the global elimination of viral hepatitis. These themes include the need for simplified models of care, improved access to appropriate diagnostics, financing initiatives, and rapid implementation of lessons from the COVID-19 pandemic.
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Affiliation(s)
- Graham S Cooke
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA.
| | - Barnaby Flower
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | | | | | - Jeffrey V Lazarus
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA; Barcelona Institute for Global Health, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Adam Palayew
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Jidong Jia
- Liver Research Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Rakesh Aggarwal
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Mamum Al-Mahtab
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Yashuito Tanaka
- Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seongnam, South Korea
| | - Kittiyod Poovorawan
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Mahidol Oxford Research Unit, Faculty of Tropical Medicine, Mahidol University, Thailand
| | - Imam Waked
- Hepatology Department, National Liver Institute, Shibin El Kom, Egypt
| | - Lindsey Hiebert
- Coalition for Global Hepatitis Elimination, Task Force for Global Health, Decatur, GA, USA
| | - Pham M Khue
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Haiphong, Viet Nam
| | - Jason Grebely
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Diana Alcantara-Payawal
- Department of Internal Medicine, Fatima University Medical Center, Valenzuela, Philippines; Committee on Hepatology, Section of Gastroenterology, Cardinal Santos Medical Center, San Juan, Philippines
| | - Juan F Sanchez-Avila
- Global Health and Emerging Diseases Investigation Group, Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey Monterrey, Mexico
| | - Charles Mbendi
- Service of Gastroenterology, Internal Medicine, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasha, DR Congo
| | - David H Muljono
- Ministry of Health, Jakarta, Indonesia; Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia; Indonesian Academy of Sciences, Jakarta, Indonesia
| | - Olufunmilayo Lesi
- Gastroenterology and Hepatology Unit, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Lagos, Nigeria
| | - Hailemichael Desalegn
- Department of Internal Medicine, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Saeed Hamid
- Clinical Trials Unit, Aga Khan University, Karachi, Pakistan
| | - Alexandre de Araujo
- Universidade Federal do Rio Grande do Sul, Gastroenterology and Hepatology Unit of Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Hugo Cheinquer
- Universidade Federal do Rio Grande do Sul, Gastroenterology and Hepatology Unit of Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Charles A Onyekwere
- Deparment Of Medicine, Lagos State University College of Medicine, Lagos, Nigeria
| | | | - Iryna Ivanchuk
- Department of Viral Hepatitis Control at National Institute of Public Health, Kyiv, Ukraine
| | - David L Thomas
- Divison of Infectious Diseases, John Hopkins School of Medicine, Baltimore, MD, USA
| | - Nikolay Pimenov
- National Medical Research Center of Tuberculosis and Infectious Diseases, Moscow, Russia
| | | | - Mae Ashworth Dirac
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA; Department of Family Medicine, University of Washington, Seattle, WA, USA
| | - Hannah Han
- Department of Epidemiology, University of Washington, Seattle, WA, USA; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - John W Ward
- Coalition for Global Hepatitis Elimination, Task Force for Global Health, Decatur, GA, USA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Olakunde BO, Ifeorah IM, Adeyinka DA, Olakunde OA, Ogundipe T, Olawepo JO, Ezeanolue EE. Immune response to hepatitis B vaccine among children under 5 years in Africa: a meta-analysis. Trop Med Health 2024; 52:28. [PMID: 38561838 PMCID: PMC10983738 DOI: 10.1186/s41182-024-00594-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/17/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection in Africa is mostly acquired before the age of 5 years through vertical or horizontal routes. While all the countries in the World Health Organization African region have introduced HBV vaccination into their national immunization programs, the rate of protective immune response to HBV vaccine among children in Africa has not been systematically synthesized. In this study, we estimated the HBV vaccine seroprotection rate (defined as anti-HBs titer ≥ 10 IU/L) and the associated factors among under-five children who completed a primary series of HBV vaccination in Africa. METHODS We systematically searched PubMed, Web Science, and Scopus databases from inception to May 2022 for potentially eligible studies. The pooled seroprotection rate was estimated using a random-effects model with Freeman-Tukey double arcsine transformation and the associated factors were examined using odds ratio estimated by the DerSimonian and Laird method. RESULTS From the 1063 records identified, 29 studies with a total sample size of 9167 under-five children were included in the meta-analysis. The pooled seroprotection rate was 89.23% (95% CI 85.68-92.33%, I2 = 95.96%, p < 0.001). In the subgroup analyses, there was a significant difference in the rate by the assay method, vaccine dose, and vaccine combination. HIV-positive children had lower odds of achieving seroprotection when compared with HIV-negative children (OR = 0.22, 95%CI 0.12-0.40). CONCLUSIONS The majority of under-five children in Africa achieved seroprotection after completing three or four doses of HBV vaccine. However, the rate was lower among children living with HIV. This calls for interventions to timely identify and address nonresponse to HBV vaccine, particularly among immunosuppressed children.
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Affiliation(s)
- Babayemi O Olakunde
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria.
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria.
- Department of Population and Community Health, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX, 76107, USA.
| | - Ijeoma M Ifeorah
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Medical Laboratory Sciences, University of Nigeria Nsukka, Enugu, Nigeria
| | - Daniel A Adeyinka
- Department of Research, Saskatchewan Health Authority, Saskatoon, SK, Canada
- Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | - Olubunmi A Olakunde
- Department of Disease Control and Immunization, Ondo State Primary Health Care Development Agency, Ondo, Nigeria
| | | | - John O Olawepo
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Health Sciences, Northeastern University, Boston, MA, USA
| | - Echezona E Ezeanolue
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Healthy Sunrise Foundation, Nevada, USA
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69
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Lv R, Lu Y, Xiang W, Meng M, Li S. Chronic viral hepatitis C micro-elimination program using telemedicine in Guigang city. J Viral Hepat 2024; 31:208-215. [PMID: 38326936 DOI: 10.1111/jvh.13922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/08/2024] [Accepted: 01/13/2024] [Indexed: 02/09/2024]
Abstract
Hepatitis C virus (HCV) represents a formidable menace to human health, necessitating urgent attention. The objective of this study was to assess the efficacy and safety of HCV health management in the city of Guigang which consists of five districts, employing a comprehensive multi-modal approach. The study systematically carried out HCV screening in Guigang city which consists of five districts, such as Gangbei District, Gangnan District, Guiping District, Qintang District, and Pingnan District from 1 January 2016 to 30 December 2022. The target population consisted of individuals residing in these aforementioned districts, falling within the age range of 30-75 years. A multidisciplinary HCV management team was established to deliver anti-HCV screening, diagnosis, and direct-acting antiviral (DAA) therapy. The primary outcome of interest was the achievement of sustained virologic response (SVR). A total of 2489 individuals were included as the target population, with 1694 individuals residing in Gangbei District, 202 in Gangnan District, 111 in Qintang District, 167 in Pingnan District, and 315 in Guiping District. Out of these individuals, 2478 were subjected to anti-HCV screening. The screening rates varied across the districts, ranging from a peak of 99.55% in Guigang City to a nadir of 98.41% in Guiping District. Remarkably, within Guigang City, a noteworthy enhancement was observed in the HCV-RNA diagnosis rate from 23.4% prior to program implementation to a remarkable 100% following 7 years of intervention and management. Furthermore, the diagnosis and treatment coordination rate experienced a substantial improvement, rising from 26.8% before program inception to 80%. Importantly, a total of 1180 individuals affected by hepatitis C were successfully cured, equating to a 100% cure rate. Logistic regression analysis revealed a significant association between serological status and factors such as Aging, bilirubin, and glutamic oxalacetic transaminase. The findings from our investigation unveil a pioneering HCV management model, exemplified by the Guigang model, which has contributed crucially to HCV microclearance efforts and serves as an invaluable reference for future initiatives.
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Affiliation(s)
- Riying Lv
- Department of Infectious Diseases, Guigang City People's Hospital, Guigang, Guangxi, China
| | - Yanmeng Lu
- Department of Infectious Diseases, Guigang City People's Hospital, Guigang, Guangxi, China
| | - Wenyao Xiang
- Department of Infectious Diseases, Guigang City People's Hospital, Guigang, Guangxi, China
| | - Menglan Meng
- Department of Infectious Diseases, Guigang City People's Hospital, Guigang, Guangxi, China
| | - Shixiong Li
- Department of Infectious Diseases, Guigang City People's Hospital, Guigang, Guangxi, China
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Blanchet M, Angelo L, Tétreault Y, Khabir M, Sureau C, Vaillant A, Labonté P. HepG2BD: A Novel and Versatile Cell Line with Inducible HDV Replication and Constitutive HBV Expression. Viruses 2024; 16:532. [PMID: 38675875 PMCID: PMC11053718 DOI: 10.3390/v16040532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/23/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
Individuals chronically infected with hepatitis B virus (HBV) and hepatitis Delta virus (HDV) present an increased risk of developing cirrhosis and hepatocellular carcinoma in comparison to HBV mono-infected individuals. Although HDV only replicates in individuals coinfected or superinfected with HBV, there is currently no in vitro model that can stably express both viruses simultaneously, mimicking the chronic infections seen in HBV/HDV patients. Here, we present the HepG2BD cell line as a novel in vitro culture system for long-term replication of HBV and HDV. HepG2BD cells derive from HepG2.2.15 cells in which a 2 kb HDV cDNA sequence was inserted into the adeno-associated virus safe harbor integration site 1 (AAVS1) using CRISPR-Cas9. A Tet-Off promoter was placed 5' of the genomic HDV sequence for reliable initiation/repression of viral replication and secretion. HBV and HDV replication were then thoroughly characterized. Of note, non-dividing cells adopt a hepatocyte-like morphology associated with an increased production of both HDV and HBV virions. Finally, HDV seems to negatively interfere with HBV in this model system. Altogether, HepG2BD cells will be instrumental to evaluate, in vitro, the fundamental HBV-HDV interplay during simultaneous chronic replication as well as for antivirals screening targeting both viruses.
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Affiliation(s)
- Matthieu Blanchet
- INRS-Centre Armand-Frappier Santé Biotechnologie, Laval, QC H7V 1B7, Canada; (L.A.); (Y.T.); (M.K.)
- Replicor Inc., Montréal, QC H4P 2R2, Canada;
| | - Léna Angelo
- INRS-Centre Armand-Frappier Santé Biotechnologie, Laval, QC H7V 1B7, Canada; (L.A.); (Y.T.); (M.K.)
| | - Yasmine Tétreault
- INRS-Centre Armand-Frappier Santé Biotechnologie, Laval, QC H7V 1B7, Canada; (L.A.); (Y.T.); (M.K.)
| | - Marwa Khabir
- INRS-Centre Armand-Frappier Santé Biotechnologie, Laval, QC H7V 1B7, Canada; (L.A.); (Y.T.); (M.K.)
| | | | | | - Patrick Labonté
- INRS-Centre Armand-Frappier Santé Biotechnologie, Laval, QC H7V 1B7, Canada; (L.A.); (Y.T.); (M.K.)
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Wei S, Xie Q, Liao G, Chen H, Hu M, Lin X, Li H, Peng J. Patients with chronic hepatitis B who have persistently normal alanine aminotransferase or aged < 30 years may exhibit significant histologic damage. BMC Gastroenterol 2024; 24:120. [PMID: 38532310 DOI: 10.1186/s12876-024-03208-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND The timing of antiviral therapy for chronic hepatitis B (CHB) patients with normal alanine transaminase (ALT) or aged < 30 years is still undetermined. We aimed to elucidate the correlation between liver histology, age, and ALT level in CHB patients and analyze the histological characteristics of the liver among patients with persistently normal ALT or aged < 30 years. METHODS A retrospective analysis was conducted on 697 treatment-naive CHB patients. Liver biopsies were performed, and significant histological damage was defined as the grade of liver inflammation ≥ G2 and/or fibrosis ≥ S2 based on the Scheuer scoring system. RESULTS The liver inflammation grades and fibrosis stages correlated positively with age, ALT, AST, GGT levels and negatively with the counts of PLT (all p < 0.050) in HBeAg-positive patients. Higher ALT levels and lower PLT counts were independently associated with significant liver inflammation and fibrosis in both HBeAg-positive and HBeAg-negative patients. Furthermore, among those with persistently normal ALT levels, the incidence of significant liver inflammation and fibrosis were 66.1% and 53.7% in HBeAg-positive groups, and 63.0% and 55.5% in HBeAg-negative groups. Moreover, there was no significant difference in the prevalence of significant liver damage between patients aged < 30 years and those aged ≥ 30 years, in both HBeAg-positive (≥ G2 or ≥ S2: 63.8% vs. 75.8%, p = 0.276) and HBeAg-negative (≥ G2 or ≥ S2: 65.9% vs. 72.5%, p = 0.504) groups, among patients with persistently normal ALT levels. CONCLUSIONS A considerable proportion of CHB patients with persistently normal ALT, including those below the age of 30 years, exhibited significant histological damage. This highlights the importance of initiating early antiviral therapy for HBV-infected individuals, even in the absence of elevated ALT levels.
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Affiliation(s)
- Sufang Wei
- Department of Infectious Diseases, Shunde Hospital, Southern Medical University, Foshan, 528308, China
- Department of Infectious Diseases, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Nanfang Hospital, Southern Medical University, Guangzhou, 510080, China
| | - Qiuli Xie
- Department of Infectious Diseases, Shunde Hospital, Southern Medical University, Foshan, 528308, China
| | - Guichan Liao
- Department of Infectious Diseases, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Nanfang Hospital, Southern Medical University, Guangzhou, 510080, China
| | - Hongjie Chen
- Department of Infectious Diseases, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Nanfang Hospital, Southern Medical University, Guangzhou, 510080, China
| | - Meixin Hu
- Department of Infectious Diseases, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Nanfang Hospital, Southern Medical University, Guangzhou, 510080, China
| | - Xiaoli Lin
- Department of Infectious Diseases, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Nanfang Hospital, Southern Medical University, Guangzhou, 510080, China
| | - Hong Li
- Department of Infectious Diseases, Shunde Hospital, Southern Medical University, Foshan, 528308, China
| | - Jie Peng
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510080, China.
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Lam R, Lim JK. Advances in discovery of novel investigational agents for functional cure of chronic hepatitis B: A comprehensive review of phases II and III therapeutic agents. World J Hepatol 2024; 16:331-343. [PMID: 38577537 PMCID: PMC10989302 DOI: 10.4254/wjh.v16.i3.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/23/2024] [Accepted: 02/29/2024] [Indexed: 03/27/2024] Open
Abstract
Chronic hepatitis B virus (HBV) infection affects over 295 million people globally and an estimated 1.6 million people in the United States. It is associated with significant morbidity and mortality due to cirrhosis, liver failure, and liver cancer. Antiviral therapy with oral nucleos(t)ide analogues is associated with high rates of virologic suppression, which in turn has been associated with a decreased risk of liver complications. However, current antiviral regimens are limited by concerns with adverse effects, adherence, resistance, long-term treatment, and ongoing risk for liver events. Novel investigational agents are currently in development and are targeted at achieving functional cure with sustained hepatitis B surface antigen (HBsAg) loss and suppression of HBV DNA. Herein we review key evidence from phases II and III trials defining the efficacy and safety profiles for key investigational agents for functional cure of chronic hepatitis B, including core/capsid inhibitors, entry inhibitors, RNA interference (siRNA/ASO), HBsAg inhibitors, Toll-like receptor agonists, checkpoint inhibitors, and therapeutic vaccines.
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Affiliation(s)
- Robert Lam
- Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT 06520, United States
| | - Joseph K Lim
- Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT 06520, United States.
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73
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Liu S, Li R, Sun YW, Lin H, Li HF. Protein succinylation, hepatic metabolism, and liver diseases. World J Hepatol 2024; 16:344-352. [PMID: 38577527 PMCID: PMC10989315 DOI: 10.4254/wjh.v16.i3.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/08/2024] [Accepted: 03/01/2024] [Indexed: 03/27/2024] Open
Abstract
Succinylation is a highly conserved post-translational modification that is processed via enzymatic and non-enzymatic mechanisms. Succinylation exhibits strong effects on protein stability, enzyme activity, and transcriptional regulation. Protein succinylation is extensively present in the liver, and increasing evidence has demonstrated that succinylation is closely related to hepatic metabolism. For instance, histone acetyltransferase 1 promotes liver glycolysis, and the sirtuin 5-induced desuccinylation is involved in the regulation of the hepatic urea cycle and lipid metabolism. Therefore, the effects of succinylation on hepatic glucose, amino acid, and lipid metabolism under the action of various enzymes will be discussed in this work. In addition, how succinylases regulate the progression of different liver diseases will be reviewed, including the desuccinylation activity of sirtuin 7, which is closely associated with fatty liver disease and hepatitis, and the actions of lysine acetyltransferase 2A and histone acetyltransferase 1 that act as succinyltransferases to regulate the succinylation of target genes that influence the development of hepatocellular carcinoma. In view of the diversity and significance of protein succinylation, targeting the succinylation pathway may serve as an attractive direction for the treatment of liver diseases.
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Affiliation(s)
- Shuang Liu
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, Tai'an 271018, Shandong Province, China
| | - Rui Li
- College of Life Sciences, Shandong Agricultural University, Tai'an 271018, Shandong Province, China
| | - Ya-Wen Sun
- College of Life Sciences, Shandong Agricultural University, Tai'an 271018, Shandong Province, China
| | - Hai Lin
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, Tai'an 271018, Shandong Province, China
| | - Hai-Fang Li
- College of Life Sciences, Shandong Agricultural University, Tai'an 271018, Shandong Province, China.
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74
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Huang XX, Lin Q, Li Y, Li L. Effects of Maternal Health During Pregnancy and Child Immunization on Mother-to-Child Transmission of Hepatitis B Virus: A Multicentre, Large-Sample Study in Southeast China. Infect Drug Resist 2024; 17:989-1001. [PMID: 38505249 PMCID: PMC10949338 DOI: 10.2147/idr.s443172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/19/2024] [Indexed: 03/21/2024] Open
Abstract
Purpose High hepatitis B infection rates in China are a major public health issue, and mother-to-child transmission (MTCT) is a significant risk factor. Patients and Methods This study was conducted with a prospective multicentre design from January 2021 to December 2022 in 245 hospitals providing midwifery services in southeastern China. The participants were pregnant women who were positive for hepatitis B surface antigen (HBs Ag) and their children. The HBs Ag concentration was tested in children aged 8-12 months. The odds ratio for each risk factor was calculated by logistic regression analysis, and the decision tree model was used. Results A total of 5369 children born to hepatitis B-infected mothers between 8 and 12 months of age were enrolled, among whom 81 (1.51%) were positive for HBsAg. The risk factors for hepatitis B infection in 5369 children under one-year-old were a high intrauterine hepatitis B exposure level, a history of hepatitis B immunoglobulin (HBIG) delay beyond 12 hours after birth, and lack of full hepatitis B vaccine (HepB), with risks of 3.356 (1.223~9.209), 5.691 (1.931~16.773), and 5.137 (2.265~11.650), respectively. The discrimination accuracy of the decision tree was 98.5%. The risk factors for hepatitis B infection in 4542 children under one year old with high exposure risk were nonstandard treatment by the mother during pregnancy, HBIG delay beyond 12 hours after birth, and no complete HepB administration, with risks of 2.925 (1.063-8.047), 5.354 (1.806-15.871) and 5.147 (2.258-11.733), respectively. The discrimination accuracy of the decision tree was 98.3%. Conclusion To prevent mother-to-child transmission of hepatitis B, it is necessary to standardize the treatment of pregnant women with a high exposure risk of hepatitis B, implement combined vaccination within 12 hours of birth, and standardise the full course of HepB.
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Affiliation(s)
- Xin-Xin Huang
- The Ministry of Health, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, People’s Republic of China
| | - Quan Lin
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, People’s Republic of China
| | - Yun Li
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, People’s Republic of China
| | - Li Li
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, People’s Republic of China
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Mestareehi A, Abu-Farsakh N. Impact of Protein Phosphatase Expressions on the Prognosis of Hepatocellular Carcinoma Patients. ACS OMEGA 2024; 9:10299-10331. [PMID: 38463290 PMCID: PMC10918787 DOI: 10.1021/acsomega.3c07787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 03/12/2024]
Abstract
The study was conducted to unveil the significance of protein phosphatases in the prognosis of hepatocellular carcinoma (HCC) patients and its related molecular biological attributes as well as to discover novel potential biomarkers for therapeutic significance and diagnostic purposes that may benefit clinical practice. Analyzing a data set from 159 HCC patients using high-throughput phosphoproteomics, we examined the dysregulated expression of protein phosphatases. Employing bioinformatic and pathway analyses, we explored differentially expressed genes linked to protein phosphatases. A protein-protein interaction network was constructed using the search tool for the retrieval of interacting genes/proteins database. We quantified a total of 11,547 phosphorylation sites associated with 4043 phosphoproteins from HCC patients. Within this data set, we identified 105 identified phosphorylation sites associated with protein phosphatases; 28 genes were upregulated and 3 were downregulated in HCC. Enriched pathways using Gene Set Enrichment Analysis encompassed oocyte meiosis, proteoglycans in cancer, the oxytocin signaling pathway, the cGMP-PKG signaling pathway, the vascular smooth muscle, and the cAMP signaling pathway. The Kyoto encyclopedia of genes and genomes (KEGG) analysis highlighted pathways like mitogen-activated protein kinase, AMPK, and PI3K-Akt, indicating potential involvement in HCC progression. Notably, the PPI network identified hub genes, emphasizing their interconnections and potential roles in HCC. In our study, we found significantly upregulated levels of CDC25C, PPP1R13L, and PPP1CA, which emerge as promising avenues. This significant expression could serve as potent diagnostic and prognostic markers to enhance the effectiveness of HCC cancer treatment, offering efficiency and accuracy in patient assessment. The findings regarding protein phosphatases reveal their elevated expression in HCC, correlating with unfavorable prognosis. Moreover, the outcomes of gene ontology and KEGG pathway analyses suggest that protein phosphatases may influence liver cancer by engaging diverse targets and pathways, ultimately fostering the progression of HCC. These results underscore the substantial potential of protein phosphatases as key contributors to HCC's development and advancement. This insight holds promise for identifying therapeutic targets and charting research avenues to enhance the comprehension of the intricate molecular mechanisms underpinning HCC.
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Affiliation(s)
- Aktham Mestareehi
- Department
of Pharmaceutical Sciences, Faculty of Pharmacy, Isra University, P.O. Box 22, Amman 11622, Jordan
- Department
of Pharmaceutical Sciences, School of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan 48201, United States
- School
of Medicine, The Ohio State University, Columbus, Ohio 43202, United States
| | - Noor Abu-Farsakh
- Department
of Gastroenterology and Hepatology, Internal Medicine Department, Jordan University Hospital, Amman 11942, Jordan
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Chan HL, Buti M, Lim YS, Agarwal K, Marcellin P, Brunetto M, Chuang WL, Janssen HL, Fung S, Izumi N, Abdurakhmanov D, Jabłkowski M, Celen MK, Ma X, Caruntu F, Flaherty JF, Abramov F, Wang H, Camus G, Osinusi A, Pan CQ, Shalimar, Seto WK, Gane E. Long-Term Treatment With Tenofovir Alafenamide for Chronic Hepatitis B Results in High Rates of Viral Suppression and Favorable Renal and Bone Safety. Am J Gastroenterol 2024; 119:486-496. [PMID: 37561058 PMCID: PMC10903997 DOI: 10.14309/ajg.0000000000002468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/08/2023] [Indexed: 08/11/2023]
Abstract
INTRODUCTION The results from 2 phase 3 studies, through 2 years, in chronic hepatitis B infection showed tenofovir alafenamide (TAF) had similar efficacy to tenofovir disoproxil fumarate (TDF) with superior renal and bone safety. We report updated results through 5 years. METHODS Patients with HBeAg-negative or HBeAg-positive chronic hepatitis B infection with or without compensated cirrhosis were randomized (2:1) to TAF 25 mg or TDF 300 mg once daily in double-blind (DB) fashion for up to 3 years, followed by open-label (OL) TAF up to 8 years. Efficacy (antiviral, biochemical, and serologic), resistance (deep sequencing of polymerase/reverse transcriptase and phenotyping), and safety, including renal and bone parameters, were evaluated by pooled analyses. RESULTS Of 1,298 randomized and treated patients, 866 receiving TAF (DB and OL) and 432 receiving TDF with rollover to OL TAF at year 2 (n = 180; TDF→TAF3y) or year 3 (n = 202; TDF→TAF2y) were included. Fifty (4%) TDF patients who discontinued during DB were excluded. At year 5, 85%, 83%, and 90% achieved HBV DNA <29 IU/mL (missing = failure) in the TAF, TDF→TAF3y, and TDF→TAF2y groups, respectively; no patient developed TAF or TDF resistance. Median estimated glomerular filtration rate (by using Cockcroft-Gault) declined <2.5 mL/min, and mean declines of <1% in hip and spine bone mineral density were seen at year 5 in the TAF group; patients in the TDF→TAF groups had improvements in these parameters at year 5 after switching to OL TAF. DISCUSSION Long-term TAF treatment resulted in high rates of viral suppression, no resistance, and favorable renal and bone safety.
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Affiliation(s)
- Henry L.Y. Chan
- Faculty of Medicine, the Chinese University of Hong Kong, People's Republic of China
| | - Maria Buti
- Hospital Universitario Vall d'Hebron and CIBEREHD del Instituto Carlos III, Barcelona, Spain
| | - Young-Suk Lim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kosh Agarwal
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Patrick Marcellin
- Hepatology Department, Hôpital Beaujon, APHP, INSERM, University of Paris, France
| | | | - Wan-Long Chuang
- Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Harry L.A. Janssen
- Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
- Erasmus Medical Center, Rotterdam, Netherlands
| | - Scott Fung
- University of Toronto, Toronto, Ontario, Canada
| | - Namiki Izumi
- Department of Gastroenterology and Hepatology, Japanese Red Cross Musashino Hospital, Tokyo, Japan
| | | | | | | | - Xiaoli Ma
- Hahnemann University Hospital, Philadelphia, Pennsylvania, USA
| | - Florin Caruntu
- National Institute for Infectious Diseases “Matei Bals,” Bucharest, Romania
| | | | | | | | | | - Anu Osinusi
- Gilead Sciences, Inc, Foster City, California, USA
| | - Calvin Q. Pan
- NYU Langone Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Shalimar
- All India Institute of Medical Sciences, New Delhi, India
| | - Wai-Kay Seto
- Department of Medicine and School of Clinical Medicine, The University of Hong Kong, Hong Kong
| | - Edward Gane
- Auckland Clinical Studies, Auckland, New Zealand.
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Kang NL, Wu LY, Zheng Q, Yu XP, Hu AR, Guo Y, Li H, Ye XY, Ruan QF, Lu ZH, Wu L, Jin W, Liu YR, Pan C, Liu SS, Zhang JM, Jiang JJ, Zeng DW. Determining optimal ALT cut-off values for predicting significant hepatic histological changes in patients with normal ALT in the grey zone of chronic hepatitis B virus infection. Aliment Pharmacol Ther 2024; 59:692-704. [PMID: 38178641 DOI: 10.1111/apt.17862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/04/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND AND AIMS We aimed to define gender-specific, optimal alanine aminotransferase (ALT) cut-off values for the prediction of significant liver histological changes (SLHC) in Chinese patients with grey zone (GZ) chronic hepatitis B (CHB) and normal ALT. METHODS In a retrospective study, we included 1101 consecutive patients with GZ CHB and normal ALT assigned to training or internal validation cohorts. We included an independent cohort of 842 patients for external validation. We performed receiver operating characteristic (ROC) curve, smoothed curve fitting, and threshold effect analyses to determine optimal ALT cut-off values. Area under the curve (AUC) values were calculated to assess their predictive performance. RESULTS A proportion of 79.3% of patients with GZ CHB and normal ALT (≤40 U/L) had SLHC. ROC curve analysis initially identified optimal ALT cut-off values of 29 U/L (male) and 22 U/L (female). After smoothed curve fitting and threshold effect analyses, new optimal cut-off values were 27 U/L for males and 24 U/L for females. AUCs for these values were 0.836 (male) and 0.833 (female) in the internal validation cohort, and 0.849 (male) and 0.844 (female) in the external validation cohort. The accuracy and discriminative ability of the newly defined ALT cut-off values were greater than those of the current recommendations. CONCLUSION This study established novel optimal ALT cut-off values for more precise prediction of SLHC among Chinese patients with GZ CHB and normal ALT levels. This may help identify individuals who will benefit from timely antiviral therapy.
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Affiliation(s)
- Na-Ling Kang
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Clinical Research Center for Hepatopathy and Intestinal Diseases of Fujian Province, Fujian Medical University, Fuzhou, China
- Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Lu-Ying Wu
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Clinical Research Center for Hepatopathy and Intestinal Diseases of Fujian Province, Fujian Medical University, Fuzhou, China
| | - Qi Zheng
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Clinical Research Center for Hepatopathy and Intestinal Diseases of Fujian Province, Fujian Medical University, Fuzhou, China
- Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xue-Ping Yu
- Department of Infectious Diseases, The First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, Fujian, China
| | - Ai-Rong Hu
- Ningbo Institute of Liver Diseases, Ningbo No. 2 Hospital, Ningbo, China
| | - Yue Guo
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Huan Li
- Department of Infectious Diseases, Fujian Geriatric Hospital, Fujian Provincial Hospital North Branch, Fuzhou, Fujian, China
| | - Xiang-Yang Ye
- Department of Infectious Disease, The Affiliated Hospital of Putian College, Putian, Fujian, China
| | - Qing-Fa Ruan
- Hepatology Center, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, Fujian, China
| | - Zhong-Hua Lu
- Department of Liver Disease, Wuxi No.5 People's Hospital Affiliated to Jiangnan University, Wuxi, China
| | - Ling Wu
- Department of Infectious Diseases, Anqing Municipal Hospital, Anqing, Anhui, China
| | - Wen Jin
- Department of Hepatology, Fujian Medical University Xiamen Humanity Hospital; Xiamen Quality Control Center of Infectious Diseases, Fujian, China
| | - Yu-Rui Liu
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Clinical Research Center for Hepatopathy and Intestinal Diseases of Fujian Province, Fujian Medical University, Fuzhou, China
- Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Chen Pan
- Hepatology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Shan-Shan Liu
- Department of Liver Disease, Wuxi No.5 People's Hospital Affiliated to Jiangnan University, Wuxi, China
| | - Ji-Ming Zhang
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jia-Ji Jiang
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Clinical Research Center for Hepatopathy and Intestinal Diseases of Fujian Province, Fujian Medical University, Fuzhou, China
- Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Da-Wu Zeng
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Clinical Research Center for Hepatopathy and Intestinal Diseases of Fujian Province, Fujian Medical University, Fuzhou, China
- Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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Chau A, Yeh ML, Tsai PC, Huang DQ, Kim SE, Trinh H, Yoon EL, Oh H, Jeong JY, Ahn SB, An J, Tseng CH, Hsu YC, Jeong SW, Cho YK, Shim JJ, Kim HS, Ito T, Marciano S, Kawashima K, Suzuki T, Watanabe T, Nozaki A, Ishikawa T, Inoue K, Eguchi Y, Uojima H, Abe H, Takahashi H, Chuma M, Ishigami M, Hoang JK, Maeda M, Huang CF, Gadano A, Dai CY, Huang JF, Tanaka Y, Chuang WL, Lim SG, Cheung R, Yu ML, Jun DW, Nguyen MH. Sex Differences in Treatment Response to Nucleos(t)ide Therapy in Chronic Hepatitis B: A Multicenter Longitudinal Study. Clin Gastroenterol Hepatol 2024; 22:572-580.e5. [PMID: 37734582 DOI: 10.1016/j.cgh.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND & AIMS It is unclear if there may be sex differences in response to nucleos(t)ide analogs including virologic response (VR), biochemical response (BR), complete response (CR), and hepatocellular carcinoma (HCC) incidence among hepatitis B patients. We compared nucleos(t)ide analog treatment outcomes by sex. METHODS We performed a retrospective cohort study of 3388 treatment-naïve adult hepatitis B patients (1250 female, 2138 male) from the Real-World Evidence from the Global Alliance for the Study of Hepatitis B Virus consortium who initiated therapy with either entecavir or tenofovir from 22 sites (Argentina, Korea, Japan, Taiwan, and the United States). We used propensity-score matching to balance background characteristics of the male and female groups and competing-risks analysis to estimate the incidence and subdistribution hazard ratios (SHRs) of VR, BR, CR, and HCC. RESULTS Females (vs males) were older (52.0 vs 48.6 y); less likely to be overweight/obese (49.3% vs 65.7%), diabetic (9.9% vs 13.1%), or cirrhotic (27.9% vs 33.0%); and had a lower HBV DNA level (5.9 vs 6.0 log10 IU/mL) and alanine aminotransferase level (91 vs 102 IU/L) (all P < .01). However, after propensity-score matching, relevant background characteristics were balanced between the 2 groups. Females (vs males) had similar 5-year cumulative VR (91.3% vs 90.3%; P = .40) and HCC incidence rates (5.1% vs 4.4%; P = .64), but lower BR (84.0% vs 90.9%; P < .001) and CR (78.8% vs 83.4%; P = .016). Males were more likely to achieve BR (SHR, 1.31; 95% CI, 1.17-1.46; P < .001) and CR (SHR, 1.16; 95% CI, 1.03-1.31; P = .016), but VR and HCC risks were similar. CONCLUSIONS Sex differences exist for treatment outcomes among hepatitis B patients. Male sex was associated with a 16% higher likelihood of clinical remission and a 31% higher likelihood of biochemical response than females, while virologic response and HCC incidence were similar between the 2 groups.
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Affiliation(s)
- Angela Chau
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California
| | - Ming-Lun Yeh
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Chien Tsai
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Daniel Q Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sung Eun Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, China
| | - Huy Trinh
- San Jose Gastroenterology, San Jose, California
| | - Eileen L Yoon
- Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea; Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Hyunwoo Oh
- Division of Gastroenterology, Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
| | - Jae Yoon Jeong
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Sang Bong Ahn
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
| | - Jihyun An
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Cheng-Hao Tseng
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Cancer Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Yao-Chun Hsu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Cancer Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Soung Won Jeong
- Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yong Kyun Cho
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Jun Shim
- Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - Hyoung Su Kim
- Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Takanori Ito
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sebastián Marciano
- Hepatología and Departamento de Investigación, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Keigo Kawashima
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takanori Suzuki
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tsunamasa Watanabe
- Division of Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Akito Nozaki
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Toru Ishikawa
- Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan
| | - Kaori Inoue
- Liver Center, Saga University Hospital, Saga, Japan
| | - Yuichiro Eguchi
- Liver Center, Saga University Hospital, Saga, Japan; Locomedical General Institute, Locomedical Eguchi Hospital, Saga, Japan
| | - Haruki Uojima
- Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hiroshi Abe
- Division of Gastroenterology and Hepatology, Shinmatsudo Central General Hospital, Chiba, Japan
| | - Hirokazu Takahashi
- Liver Center, Saga University Hospital, Saga, Japan; Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan
| | - Makoto Chuma
- Division of Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masatoshi Ishigami
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Joseph K Hoang
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California
| | - Mayumi Maeda
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California
| | - Chung-Feng Huang
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Adrian Gadano
- Hepatología and Departamento de Investigación, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Chia-Yen Dai
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jee-Fu Huang
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yasuhito Tanaka
- Department of Gastroenterology and Hepatology, Kumamoto University, Kumamoto, Japan
| | - Wan-Long Chuang
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Seng Gee Lim
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ramsey Cheung
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California
| | - Ming-Lung Yu
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Dae-Won Jun
- Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea.
| | - Mindie H Nguyen
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California.
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79
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Zhang C, An S, Lv R, Li K, Liu H, Li J, Tang Y, Cai Z, Huang T, Long L, Deng W. The dynamic variation position and predominant quasispecies of hepatitis B virus: Novel predictors of early hepatocarcinoma. Virus Res 2024; 341:199317. [PMID: 38242020 PMCID: PMC10831745 DOI: 10.1016/j.virusres.2024.199317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 01/21/2024]
Abstract
To find the predictors of early HCC based on the dynamic changes of HBV quasispecies, this study utilizing the second-generation sequencing (NGS) and high-order multiplex droplet digital PCR (ddPCR) technology to examine the HBV quasispecies in serum of total 247 subjects recruited from high-incidence area of HCC. In the discovery stage, 15 non-synonymous Single Nucleotide Polymorphisms (SNPs) with higher variant proportion in HCC case group were founded (all P<0.05). Furthermore, the variant proportions in some of these SNPs were observed changing regularly within 5 years before the onset of HCC, and 5 of them located in HBX, 2 in HBS and 2 in HBC. The HBV predominant quasispecies and their consensus sequences were identified by genetic evolution analysis, in which the high HBS and HBC quasispecies heterogeneity were found associated with the forming of multifarious quasispecies clones, and the HBX gene had the highest proportion of predominant quasispecies (46.7 % in HBX vs 12.7 % and 13.8 % in HBS and HBC respectively) with the key variations (G1512A, A1630G, T1753C/G/A, A1762T and G1764A) determined. In the validation stage, we confirmed that the combined double mutations of G1512A+A1630G, A1762T+G1764A, and the combined triple mutations of T1753C/G/A + A1762T+G1764A, all expressed higher in early HCC cases when comparing with control group (all P<0.05). We also demonstrated the advantages of ddPCR using in multi-variations detection in large-sample for early HCC surveillance and screening. So we think that the dynamic of key HBV variation positions and their different combinations determined by quasispecies anlysis in this study can act as the novel predictors of early hepatocarcinoma and suitable to popularize and apply in HCC screening.
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Affiliation(s)
- Chaojun Zhang
- Department of experimental research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - Sanchun An
- Department of experimental research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - Ruibo Lv
- Department of experimental research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - Kezhi Li
- Department of experimental research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China; Guangxi Cancer Molecular Medicine Engineering Research Center, China
| | - Haizhou Liu
- Department of experimental research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China; Guangxi Cancer Molecular Medicine Engineering Research Center, China
| | - Jilin Li
- Department of experimental research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China; Guangxi Cancer Molecular Medicine Engineering Research Center, China
| | - Yanping Tang
- Department of experimental research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China; Guangxi Cancer Molecular Medicine Engineering Research Center, China
| | - Zhengmin Cai
- Department of experimental research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China; Guangxi Cancer Molecular Medicine Engineering Research Center, China
| | - Tianren Huang
- Department of experimental research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China; Guangxi Cancer Molecular Medicine Engineering Research Center, China.
| | - Long Long
- Big data College of Nanning normal University, Nanning, Guangxi 530100, China.
| | - Wei Deng
- Department of experimental research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China; Guangxi Cancer Molecular Medicine Engineering Research Center, China.
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80
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Osiowy C, Giles E, Lowe CF, Matic N, Murphy DG, Uzicanin S, Drews SJ, O'Brien SF. Hepatitis B virus genotype surveillance in Canadian blood donors and a referred patient population, 2016-2021. Vox Sang 2024; 119:232-241. [PMID: 38141175 DOI: 10.1111/vox.13568] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/06/2023] [Accepted: 11/05/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND AND OBJECTIVES Hepatitis B virus (HBV) genotypes (A-H) have a distinct geographic distribution and are highly associated with the country of birth. Canada has experienced increased immigration over the past decade, primarily from regions where HBV is endemic. This study investigated the proportions and trends of HBV genotypes within blood donor and clinical populations of Canada over the period 2016-2021. MATERIALS AND METHODS Study samples involved two cohorts: (1) Canadian blood donors (n = 246) deferred from donation due to HBV test positivity and (2) chronic HBV patients from across Canada (clinically referred population, n = 3539). Plasma or serum was extracted, and the surface antigen and/or polymerase-coding region was amplified and sequenced to determine genotype by phylogenetic analysis. RESULTS Six (A-E, G) and eight (A-H) HBV genotypes were detected among deferred blood donors and the clinically referred population, respectively. Differences in HBV genotype proportions between the two cohorts were observed across Canada. Males comprised most of the referred population among genotypes A-E (p < 0.0001), except for genotypes B and C. The median age was younger among blood donors (36 years [range 17-72]) compared with the referred population (41 years [range 0-99]). Distinct trends of increasing (E, referred; B, blood donor) and decreasing genotype prevalence were observed over the study period. CONCLUSION HBV genotypes in Canada are highly diverse, suggesting a large immigrant population. Observed trends in genotype prevalence and proportional differences among cohorts imply shifts among the HBV-infected population of Canada, which warrants continued surveillance.
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Affiliation(s)
- Carla Osiowy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Elizabeth Giles
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Christopher F Lowe
- St. Paul's Hospital, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nancy Matic
- St. Paul's Hospital, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Donald G Murphy
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada
| | | | - Steven J Drews
- Canadian Blood Services, Edmonton, Alberta, Canada
- Division of Diagnostic and Applied Microbiology, Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Sheila F O'Brien
- Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada
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81
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Holt B, Fernandez M, Nguyen D, Delima D, Duy LD, Gaspar M, Hamoy G, Le BN, Llevado J, Manlutac JMD, Mendoza J, Mercado T, Nguyen H, Nguyen HT, Ong J, Rombaoa MC, Florendo J, Dela Cruz JM, Pham T, Thai PN, Truong PX, Pollack T, Duong D. Embedding viral hepatitis into primary healthcare: results of a strategic landscape analysis in Vietnam and the Philippines. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 44:100990. [PMID: 38204496 PMCID: PMC10777101 DOI: 10.1016/j.lanwpc.2023.100990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/23/2023] [Accepted: 12/04/2023] [Indexed: 01/12/2024]
Abstract
Chronic viral hepatitis is a significant public health concern in the Western Pacific, including in Vietnam and the Philippines. To accelerate progress toward meeting the 2030 elimination goals, the World Health Organization (WHO) encourages countries to adopt an integrated, people-centered health sector response to hepatitis, grounded in Primary Health Care (PHC). A review of the academic and grey literature, along with policy documents, was conducted to describe the national health system and PHC response to hepatitis B and C in Vietnam and the Philippines. Information was analyzed against the four strategic levers of the WHO Operational Framework for PHC to identify challenges and opportunities. The findings suggest that both countries have relatively robust policy frameworks, with some room for improvement. Vietnam may have stronger political commitment and funding than the Philippines, while the Philippines appears to be stronger in community engagement. Both countries share challenges and opportunities for learning to actualize viral hepatitis elimination utilizing a PHC approach.
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Affiliation(s)
- Bethany Holt
- Program in Global Primary Care and Social Change, Harvard Medical School, Boston, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, USA
| | - Martin Fernandez
- College of Medicine, University of the Philippines, Manila, Philippines
| | - Dang Nguyen
- Massachusetts General Hospital, Corrigan Minehan Heart Center, Harvard Medical School, Boston, USA
| | - Danica Delima
- School of Health Sciences Tarlac, University of the Philippines, Tarlac, Philippines
| | - Lam Dam Duy
- The Partnership for Health Advancement in Vietnam (HAIVN), Hanoi, Vietnam
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, USA
| | - Manu Gaspar
- College of Medicine, University of the Philippines, Manila, Philippines
| | - Geohari Hamoy
- College of Medicine, University of the Philippines, Manila, Philippines
| | - Bao Ngoc Le
- The Partnership for Health Advancement in Vietnam (HAIVN), Hanoi, Vietnam
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, USA
| | - Jan Llevado
- Department of Health, Disease Prevention & Control Bureau Specialty Care Division, Philippines
| | | | - Jhaki Mendoza
- College of Medicine, University of the Philippines, Manila, Philippines
| | - Timothy Mercado
- College of Medicine, University of the Philippines, Manila, Philippines
| | - Hoang Nguyen
- The Partnership for Health Advancement in Vietnam (HAIVN), Hanoi, Vietnam
| | - Huyen Thu Nguyen
- The Partnership for Health Advancement in Vietnam (HAIVN), Hanoi, Vietnam
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, USA
| | - Janus Ong
- College of Medicine, University of the Philippines, Manila, Philippines
| | - Mary Cris Rombaoa
- School of Health Sciences Tarlac, University of the Philippines, Tarlac, Philippines
| | - Jan Florendo
- School of Health Sciences Tarlac, University of the Philippines, Tarlac, Philippines
| | - Jose Mateo Dela Cruz
- School of Health Sciences Tarlac, University of the Philippines, Tarlac, Philippines
| | - Thuy Pham
- The Partnership for Health Advancement in Vietnam (HAIVN), Hanoi, Vietnam
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, USA
| | | | | | - Todd Pollack
- The Partnership for Health Advancement in Vietnam (HAIVN), Hanoi, Vietnam
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, USA
| | - David Duong
- Program in Global Primary Care and Social Change, Harvard Medical School, Boston, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, USA
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Mohareb AM, Kouamé MG, Nouaman M, Kim AY, Larmarange J, Neilan AM, Lacombe K, Freedberg KA, Boyd A, Coffie P, Hyle EP. What does the scale-up of long-acting HIV pre-exposure prophylaxis mean for the global hepatitis B epidemic? J Int AIDS Soc 2024; 27:e26218. [PMID: 38444112 PMCID: PMC10935702 DOI: 10.1002/jia2.26218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/29/2024] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION The HIV and hepatitis B virus (HBV) epidemics are interconnected with shared routes of transmission and specific antiviral drugs that are effective against both viruses. Nearly, 300 million people around the world live with chronic HBV, many of whom are from priority populations who could benefit from HIV prevention services. Oral pre-exposure prophylaxis (PrEP) for HIV has implications in the prevention and treatment of HBV infection, but many people at increased risk of HIV acquisition may instead prefer long-acting formulations of PrEP, which are currently not active against HBV. DISCUSSION People at increased risk for HIV acquisition may also be at risk for or already be living with HBV infection. Oral PrEP with tenofovir is effective in preventing both HIV and HBV, and tenofovir is also the recommended treatment for chronic HBV infection. Although implementation of oral PrEP has been challenging in sub-Saharan Africa, investments in its scale-up could secondarily reduce the clinical impact of HBV. Long-acting PrEP, including injectable medicines and implantable rings, may overcome some of the implementation challenges associated with oral PrEP, such as daily pill burden, adherence challenges and stigma; however, current formulations of long-acting PrEP do not have activity against HBV replication. Ideally, PrEP programmes would offer both oral and long-acting formulations with HBV screening to optimize HIV prevention services and HBV prevention and care, when appropriate. People who are not immune to HBV would benefit from being vaccinated against HBV before initiating long-acting PrEP. People who remain non-immune to HBV despite vaccination may benefit from being offered oral, tenofovir-based PrEP given its potential for HBV PrEP. People using PrEP and living with HBV who are not linked to dedicated HBV care would also benefit from laboratory monitoring at PrEP sites to ensure safety when using and after stopping tenofovir. PrEP programmes are ideal venues to offer HBV screening, HBV vaccination for people who are non-immune and treatment with tenofovir-based PrEP for people with indications for HBV therapy. CONCLUSIONS Long-acting PrEP holds promise for reducing HIV incidence, but its implications for the HBV epidemic, particularly in sub-Saharan Africa, should not be overlooked.
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Affiliation(s)
- Amir M. Mohareb
- Medical Practice Evaluation CenterMassachusetts General HospitalBostonMassachusettsUSA
- Division of Infectious DiseasesMassachusetts General HospitalBostonMassachusettsUSA
- Harvard University Center for AIDS ResearchBostonMassachusettsUSA
| | - Menan Gérard Kouamé
- Département de Santé PubliqueUFR d'Odonto‐stomatologieUniversité Félix Houphouët BoignyAbidjanCôte d'Ivoire
| | - Marcellin Nouaman
- Département de Santé PubliqueUFR d'Odonto‐stomatologieUniversité Félix Houphouët BoignyAbidjanCôte d'Ivoire
| | - Arthur Y. Kim
- Division of Infectious DiseasesMassachusetts General HospitalBostonMassachusettsUSA
- Harvard University Center for AIDS ResearchBostonMassachusettsUSA
| | - Joseph Larmarange
- Centre Population et DéveloppementUniversité Paris Cité, IRD, InsermParisFrance
| | - Anne M. Neilan
- Medical Practice Evaluation CenterMassachusetts General HospitalBostonMassachusettsUSA
- Division of Infectious DiseasesMassachusetts General HospitalBostonMassachusettsUSA
- Harvard University Center for AIDS ResearchBostonMassachusettsUSA
- Division of General Academic PediatricsDepartment of PediatricsMassachusetts General HospitalBostonMassachusettsUSA
| | - Karine Lacombe
- Sorbonne Université, IPLESPParisFrance
- Department of Infectious DiseasesSt. Antoine Hospital, AP‐HPParisFrance
| | - Kenneth A. Freedberg
- Medical Practice Evaluation CenterMassachusetts General HospitalBostonMassachusettsUSA
- Division of Infectious DiseasesMassachusetts General HospitalBostonMassachusettsUSA
- Harvard University Center for AIDS ResearchBostonMassachusettsUSA
- Department of General Internal MedicineMassachusetts General HospitalBostonMassachusettsUSA
| | - Anders Boyd
- Stichting HIV MonitoringAmsterdamthe Netherlands
- Department of Infectious DiseasesPublic Health Service of AmsterdamAmsterdamthe Netherlands
- Amsterdam UMC, Infectious DiseasesAmsterdamthe Netherlands
- Amsterdam Institute for Infection and Immunity, Infectious DiseasesAmsterdamthe Netherlands
| | - Patrick Coffie
- Département de Santé PubliqueUFR d'Odonto‐stomatologieUniversité Félix Houphouët BoignyAbidjanCôte d'Ivoire
- Département de Dermatologie et InfectiologieUniversité Félix Houphouët‐BoignyAbidjanCôte d'Ivoire
| | - Emily P. Hyle
- Medical Practice Evaluation CenterMassachusetts General HospitalBostonMassachusettsUSA
- Division of Infectious DiseasesMassachusetts General HospitalBostonMassachusettsUSA
- Harvard University Center for AIDS ResearchBostonMassachusettsUSA
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Asami J, Park JH, Nomura Y, Kobayashi C, Mifune J, Ishimoto N, Uemura T, Liu K, Sato Y, Zhang Z, Muramatsu M, Wakita T, Drew D, Iwata S, Shimizu T, Watashi K, Park SY, Nomura N, Ohto U. Structural basis of hepatitis B virus receptor binding. Nat Struct Mol Biol 2024; 31:447-454. [PMID: 38233573 DOI: 10.1038/s41594-023-01191-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 11/24/2023] [Indexed: 01/19/2024]
Abstract
Hepatitis B virus (HBV), a leading cause of developing hepatocellular carcinoma affecting more than 290 million people worldwide, is an enveloped DNA virus specifically infecting hepatocytes. Myristoylated preS1 domain of the HBV large surface protein binds to the host receptor sodium-taurocholate cotransporting polypeptide (NTCP), a hepatocellular bile acid transporter, to initiate viral entry. Here, we report the cryogenic-electron microscopy structure of the myristoylated preS1 (residues 2-48) peptide bound to human NTCP. The unexpectedly folded N-terminal half of the peptide embeds deeply into the outward-facing tunnel of NTCP, whereas the C-terminal half formed extensive contacts on the extracellular surface. Our findings reveal an unprecedented induced-fit mechanism for establishing high-affinity virus-host attachment and provide a blueprint for the rational design of anti-HBV drugs targeting virus entry.
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Affiliation(s)
- Jinta Asami
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Jae-Hyun Park
- Drug Design Laboratory, Graduate School of Medical Life Science, Yokohama City University, Yokohama, Japan
| | - Yayoi Nomura
- Department of Cell Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Chisa Kobayashi
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Applied Biological Science, Tokyo University of Science, Noda, Japan
| | - Junki Mifune
- Research Center for Drug and Vaccine Development, National Institute of Infectious Diseases, Tokyo, Japan
| | - Naito Ishimoto
- Drug Design Laboratory, Graduate School of Medical Life Science, Yokohama City University, Yokohama, Japan
| | - Tomoko Uemura
- Department of Cell Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kehong Liu
- Department of Cell Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yumi Sato
- Department of Cell Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Zhikuan Zhang
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Masamichi Muramatsu
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takaji Wakita
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - David Drew
- Department of Biochemistry and Biophysics, Stockholm University, Stockholm, Sweden
| | - So Iwata
- Department of Cell Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiyuki Shimizu
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Koichi Watashi
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.
- Department of Applied Biological Science, Tokyo University of Science, Noda, Japan.
- Research Center for Drug and Vaccine Development, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Sam-Yong Park
- Drug Design Laboratory, Graduate School of Medical Life Science, Yokohama City University, Yokohama, Japan.
| | - Norimichi Nomura
- Department of Cell Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Umeharu Ohto
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan.
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84
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Tunçer G, Geyiktepe-Güçlü C, Bayramlar OF, Atasoy-Bozan B, Yücel Ç, Sürme S, Çopur B, Güçlü KG, Mustafayev K, İkizceli T, Uzuner EG, Yıldırım M, Şengöz G, Pehlivanoglu F. Predictors of Significant Histological Hepatic Abnormality in Treatment-Naive Patients Infected with HBeAg-Negative Chronic Hepatitis B. INFECTIOUS DISEASES & CLINICAL MICROBIOLOGY 2024; 6:22-31. [PMID: 38633437 PMCID: PMC11019720 DOI: 10.36519/idcm.2024.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/14/2024] [Indexed: 04/19/2024]
Abstract
Objective This study aimed to determine the predictors for significant hepatic abnormality (SHA), a treatment indication, by assessing demographic, laboratory, and radiological results of chronic hepatitis B (CHB) patients who underwent liver biopsy. Materials and Methods In this retrospective study, individuals with untreated hepatitis B e-antigen (HBeAg)-negative CHB infection were enrolled. Multivariate analysis modeling was conducted with parameters identified as predictors for SHA in univariate analysis. Optimal threshold levels for variables to predict SHA in patients with chronic hepatitis B were determined based on receiver operating characteristic (ROC) curve analysis. Results A total of 566 patients with untreated chronic hepatitis B were included in the cohort; 61% (345/566) were male, and the median age was 41 years (interquartile range [IQR]=34-50). Notably, 36.9% (209/566) had SHA. In the multivariate analysis, utilizing different models, age, gender, HBV-DNA, LDL, ALT, and platelet count were identified as the most reliable predictors for SHA in CHB patients. For predicting SHA, the area under the ROC curve values of HBV-DNA, AST, and ALT were 0.704 (sensitivity=62.8%, specificity=76.2%; p<0.0001), 0.747 (sensitivity=51.9%, specificity=88.9%; p<0.0001), and 0.737 (sensitivity=68.6%, specificity=68.4%; p<0.0001), respectively. Conclusion In our study, age, male gender, ALT, AST, HBV-DNA, LDL cholesterol, platelet count, and FIB-4 score were independent predictors of SHA in HBeAg-negative chronic hepatitis B. The most sensitive parameters for SHA were LDL and ALT. The most specific parameters were age, AST, and APRI score. SHA may occur in patients with high HBV-DNA levels, even if ALT values are normal in HBeAg-negative patients.
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Affiliation(s)
- Gülşah Tunçer
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Ceyda Geyiktepe-Güçlü
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | | | - Burcu Atasoy-Bozan
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Çiğdem Yücel
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Serkan Sürme
- Department of Medical Microbiology, İstanbul University-Cerrahpaşa, İstanbul, Türkiye
| | - Betül Çopur
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Kadir Görkem Güçlü
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Khalis Mustafayev
- Department of Infectious Diseases, Infection Control and Employee Health, University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Türkan İkizceli
- Department of Radiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Esen Gül Uzuner
- Department of Medical Pathology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Mustafa Yıldırım
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Gönül Şengöz
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
| | - Filiz Pehlivanoglu
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training Research Hospital, İstanbul, Türkiye
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85
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Geta M, Yizengaw E, Manyazewal T. Hepatitis B vaccine effectiveness among vaccinated children in Africa: a systematic review and meta-analysis. BMC Pediatr 2024; 24:145. [PMID: 38413906 PMCID: PMC10900737 DOI: 10.1186/s12887-024-04557-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 01/11/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Globally, 257 million people have chronic hepatitis. Even though a safe and effective prophylactic vaccine against HBV infection has been available, it causes significant morbidity and mortality. HBV vaccines were designed to improve or modulate the host immune responses. The effectiveness of the vaccine is determined by measuring serum hepatitis B surface antibody (Anti-HBs) level. Therefore, this systematic review aimed to evaluate the effectiveness of hepatitis B vaccine among vaccinated children. METHODS Preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines was applied for systematically searching of different databases. Only cross-section studies measuring the level of anti-HBs of vaccinated children were included. The seroprotective level with anti-HBs > 10mIU/ml was extracted. The meta-analysis was performed using statistical software for data sciences (STATA) version 14. Effectiveness estimates were reported as a proportion of anti-HBs level. The heterogeneity between studies was evaluated using the I2 test, and I2 > 50% and/or P < 0.10 was considered significant heterogeneity. Significant publication bias was considered when Egger's test P-value < 0.10. The new castle Ottawa scale was used to assess the quality of the studies. RESULTS A pooled sample size of the included papers for meta-analysis was 7430. The pooled prevalence of seroprotected children was 56.95%, with a heterogeneity index (I2) of 99.4% (P < 0.001). 35% of the participants were hypo-responders (10-99mIU/ml) and 21.46% were good responders (> 100mIU/ml). Based on subgroup analysis using country of studies conducted, the highest prevalence of anti-HBs was 87.00% (95% CI: 84.56, 89.44), in South Africa, and the lowest was 51.99% (95% CI: 20.41-83.58), with a heterogeneity index I2 = 70.7% (p = 0.009) in Ethiopia. CONCLUSION AND RECOMMENDATIONS Hepatitis B vaccine seroprotective level in the current pooled analysis have suboptimal, which failed to demonstrate consistent effectiveness for global hepatitis B virus elimination plan in 2030. Using consistent age group may have a significant value for the decision of the HB vaccine effectiveness. A significant heterogeneity was observed both in studies conducted in Ethiopia and Egypt. Therefore, the impact of HB vaccination on the prevention of hepatitis B virus infection should be assessed regularly in those countries. Future meta-analysis is needed to investigate all possible vaccines in a separate way of reviewing, which will lead to a strong conclusion and recommendations.
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Affiliation(s)
- Mekuanint Geta
- Translational Medicine Program, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
- Department of Medical Microbiology, School of Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Endalew Yizengaw
- Department of Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tsegahun Manyazewal
- Translational Medicine Program, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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86
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Toumi M, Wallace J, Cohen C, Marshall C, Kitchen H, Macey J, Pegram H, Slagle AF, Gish RG, Ning Q, Yatsuhashi H, Cornberg M, Brunetto M, van Bömmel F, Xie Q, Lee D, Habuka N, Sbarigia U, Beumont-Mauviel M, Keever AV, Takahashi Y, Lu Y, Liu A, Chen Q, Ito T, Radunz O, Puggina A, Hilgard G, Chan EKH, Wang S. Experience and impact of stigma in people with chronic hepatitis B: a qualitative study in Asia, Europe, and the United States. BMC Public Health 2024; 24:611. [PMID: 38408941 PMCID: PMC10895774 DOI: 10.1186/s12889-023-17263-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/19/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND People with chronic hepatitis B (CHB) commonly experience social and self-stigma. This study sought to understand the impacts of CHB-related stigma and a functional cure on stigma. METHODS Adults with CHB with a wide range of age and education were recruited from 5 countries and participated in 90-minute qualitative, semi-structured interviews to explore concepts related to CHB-associated stigma and its impact. Participants answered open-ended concept-elicitation questions regarding their experience of social and self-stigma, and the potential impact of reduced CHB-related stigma. RESULTS Sixty-three participants aged 25 to 71 years (15 from the United States and 12 each from China, Germany, Italy, and Japan) reported emotional, lifestyle, and social impacts of living with CHB, including prejudice, marginalization, and negative relationship and work experiences. Self-stigma led to low self-esteem, concealment of CHB status, and social withdrawal. Most participants stated a functional cure for hepatitis B would reduce self-stigma. CONCLUSIONS CHB-related social and self-stigma are widely prevalent and affect many aspects of life. A functional cure for hepatitis B may reduce social and self-stigma and substantially improve the health-related quality of life of people with CHB. Incorporating stigma into guidelines along with infectivity considerations may broaden the patient groups who should receive treatment.
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Affiliation(s)
- Mondher Toumi
- Aix-Marseille University, Jardin du Pharo, 58 bd Charles Livon, Marseille, 13284 Cedex 07, France.
- Department of Public Health, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille, 13385, France.
| | - Jack Wallace
- Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - Chari Cohen
- Hepatitis B Foundation, 3805 Old Easton Rd, Doylestown, PA, 18902, USA
| | - Chris Marshall
- Clarivate (formerly DRG Abacus), 70 St Mary Axe, London, EC3A 8BE, UK
| | - Helen Kitchen
- Clarivate (formerly DRG Abacus), 70 St Mary Axe, London, EC3A 8BE, UK
| | - Jake Macey
- Clarivate (formerly DRG Abacus), 70 St Mary Axe, London, EC3A 8BE, UK
| | - Hannah Pegram
- Clarivate (formerly DRG Abacus), 70 St Mary Axe, London, EC3A 8BE, UK
| | - Ashley F Slagle
- Aspen Consulting, LLC, 625 S Lincoln Ave #101, Steamboat Springs, CO, 80487, USA
| | - Robert G Gish
- Hepatitis B Foundation, 3805 Old Easton Rd, Doylestown, PA, 18902, USA
| | - Qin Ning
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Hankou, Wuhan, 430030, China
| | - Hiroshi Yatsuhashi
- National Hospital Organization (NHO) Nagasaki Medical Center, 2-1001-1, Kubara, Omura, Nagasaki, 856-8562, Japan
- Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, 852-8520, Japan
| | - Markus Cornberg
- Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Maurizia Brunetto
- University Hospital of Pisa, Lungarno Pacinotti 43, Pisa, 56126, Italy
| | - Florian van Bömmel
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Liebigstrasse 20, 04103, Leipzig, Germany
| | - Qing Xie
- Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, 227 South Chongqing Road, Shanghai, 20025, China
| | - Dee Lee
- Inno Community Development Organisation, Room 208, Dengzheng Business Center, #57, Dengzhengnan Rd, Yuexiu District, Guangzhou, Guangdong, China
| | - Noriyuki Habuka
- Janssen Pharmaceutical K.K, 3-5-2 Nishi-kanda, Chiyoda-ku, Tokyo, 101-0065, Japan
| | - Urbano Sbarigia
- Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse, B-2340, Belgium
| | - Maria Beumont-Mauviel
- Janssen Research & Development, LLC, 1125 Trenton Harbourton Rd, Titusville, NJ, 08560, USA
| | | | - Yasushi Takahashi
- Janssen Pharmaceutical K.K, 3-5-2 Nishi-kanda, Chiyoda-ku, Tokyo, 101-0065, Japan
| | - Yiwei Lu
- Janssen China, 14F, Tower 3, China Central Place, No.77, Jian Guo Road, Chaoyang District, Beijing, 100025, China
| | - Ao Liu
- Janssen China, 14F, Tower 3, China Central Place, No.77, Jian Guo Road, Chaoyang District, Beijing, 100025, China
| | - Qiaoqiao Chen
- Janssen China, 14F, Tower 3, China Central Place, No.77, Jian Guo Road, Chaoyang District, Beijing, 100025, China
| | - Tetsuro Ito
- Janssen Health Economics & Market Access (EMEA), 50-100 Holmers Farm Way, High Wycombe, Buckinghamshire, HP12 4EG, UK
| | - Olaf Radunz
- Janssen Germany, Johnson-u.-Johnson-Platz 1, 41470, Neuss, Nordrhein-Westfalen, Germany
| | - Anna Puggina
- Janssen Italy, Via Michelangelo Buonarroti, 23, Cologno Monzese, 20093, Italy
| | - Gudrun Hilgard
- Janssen Germany, Johnson-u.-Johnson-Platz 1, 41470, Neuss, Nordrhein-Westfalen, Germany
| | - Eric K H Chan
- Janssen Global Services, LLC, 1000 US 202, Raritan, NJ, 08869, USA.
| | - Su Wang
- Hepatitis B Foundation, 3805 Old Easton Rd, Doylestown, PA, 18902, USA
- Cooperman Barnabas Medical Center, 222 Columbia Turnpike, Florham Park, NJ, 07932, USA
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Tan R, Zhu X, Sun Y, Yang S, Peng C, Feng X, Chen Z, Yimamu Y, Liao G, Yang L. The association of HBV infection and head and neck cancer: a systematic review and meta-analysis. BMC Cancer 2024; 24:225. [PMID: 38365701 PMCID: PMC10874002 DOI: 10.1186/s12885-024-11967-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 02/06/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infections is an important public health problem worldwide and closely affect extrahepatic cancer. Several recent studies have investigated the relationship between HBV infection and head and neck cancer (HNC), but their findings were inconsistent.In order to address the limitations of small sample sizes, we conducted a meta-analysis to assess the association between HBV and HNC. METHODS We systematically searched PubMed, Web of Science, Embase, Scopus, Cochrane Library, and China National Knowledge Infrastructure from inception to August 2023. Original articles published as a case-control or cohort study were included. HBV infection was identified by HBsAg, HBV DNA or ICD codes. Review articles, meeting abstracts, case reports, communications, editorials and letters were excluded, as were studies in a language other than English or Chinese. According to the MOOSE guidelines, frequencies reported for all dichotomous variables were extracted by two reviewers independently. Similarly, the outcomes of OR, RR or HR, and 95% CIs after adjusting for age and gender were collected. RESULTS Thirteen relevant studies and 58,006 patients with HNC were included. Our analysis revealed a positive correlation between HBV and HNC (OR = 1.50; 95% CI: 1.28-1.77). After adjusting for age and gender, the similar result (OR = 1.30; 95% CI: 1.10-1.54) was obtained. Subgroup analysis further demonstrated a significant association between HBV infection and oral cancer (OR = 1.24; 95% CI: 1.05-1.47), as well as nasopharyngeal carcinoma (OR = 1.41; 95% CI: 1.26-1.58). However, due to the limited number of studies included, the statistical significance was not reached for cancer of the oropharynx (OR = 1.82; 95% CI: 0.66-5.05), hypopharynx (OR = 1.33; 95% CI: 0.88-2.00), and larynx (OR = 1.25; 95% CI: 0.69-2.24) after adjusting for age and gender. When excluding the interference of HIV/HCV, smoking and alcohol use, the final outcome (OR = 1.17; 95% CI: 1.01-1.35) got the same conclusion. CONCLUSIONS Our study confirmed a positive relationship between HNC, specifically oral cancer and nasopharyngeal carcinoma, and HBV infection. However, further investigation is required at the molecular level to gather additional evidence in HNC.
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Affiliation(s)
- Rukeng Tan
- Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, 510055, Guangzhou, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, 510080, Guangzhou, Guangdong, China
| | - Xinyu Zhu
- Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, 510055, Guangzhou, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, 510080, Guangzhou, Guangdong, China
| | - Yutong Sun
- Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, 510055, Guangzhou, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, 510080, Guangzhou, Guangdong, China
| | - Shihao Yang
- Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, 510055, Guangzhou, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, 510080, Guangzhou, Guangdong, China
| | - Chao Peng
- Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, 510055, Guangzhou, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, 510080, Guangzhou, Guangdong, China
| | - Xinkai Feng
- Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, 510055, Guangzhou, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, 510080, Guangzhou, Guangdong, China
| | - Zengyu Chen
- Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, 510055, Guangzhou, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, 510080, Guangzhou, Guangdong, China
| | - Yiliyaer Yimamu
- The First People's Hospital of Kashi Area, Xinjiang Uygur Autonomous Region, No.120, Yingbin Avenue, Kashi, People's Republic of China
| | - Guiqing Liao
- Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, 510055, Guangzhou, Guangdong, China.
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, 510080, Guangzhou, Guangdong, China.
| | - Le Yang
- Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, 510055, Guangzhou, Guangdong, China.
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, 510080, Guangzhou, Guangdong, China.
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Olakunde BO, Itanyi IU, Onyeka TC, Paintsil E, Torpey K, Lasebikan N, Chigbu CO, Ezeanolue EE. Hepatitis B vaccine birth dose coverage among hepatitis B-exposed and hepatitis B-unexposed infants: evidence from the Healthy Beginning Initiative program in Benue State, Nigeria. Pan Afr Med J 2024; 47:67. [PMID: 38681098 PMCID: PMC11055182 DOI: 10.11604/pamj.2024.47.67.40466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 01/16/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction Nigeria offers universal hepatitis B birth-dose vaccine (HepB-BD) for the prevention and control of hepatitis B (HepB). While prior studies suggest low coverage of HepB-BD in Nigeria, there is a paucity of evidence on the association between the uptake of HepB-BD and maternal HepB status. This study aimed to determine HepB-BD coverage and the associated factors among infants of HepB-positive and -negative women in Nigeria. Methods the study was a secondary analysis of data from the Healthy Beginning Initiative program conducted between June 2016 and October 2018 in Benue State, Nigeria. The analysis was restricted to data from a cohort of 6269 mothers who had HepB screening during pregnancy and completed the HepB infant immunization question in the post-delivery survey. The association between the coverage of HepB-BD and maternal HepB status, sociodemographic characteristics, and obstetric factors were determined using crude and adjusted relative risks. Results about 10% of the women tested HepB positive. The coverage of HepB-BD was 64% (63.2% among infants of HepB-positive mothers and 63.8% among HepB-negative mothers). The likelihood of infants of HepB-positive mothers receiving HepB-BD was not significantly different from infants of HepB-negative mothers (aRR=0.97, 95%CI= 0.92-1.04). Among HepB-positive mothers, infants of mothers younger than 20 years (aRR=1.49, 95%CI=1.03-2.16) or those who received antenatal care (aRR=1.41, 95%CI=1.16-1.71) were more likely to receive HepB-BD, while mothers with no previous pregnancies (aRR=0.73, 95%CI=0.59-0.91) were less likely to receive HepB-BD. Among HepB-negative mothers, infants of less-educated mothers were less likely to receive HepB-BD (aRR=0.96, 95%CI=0.92-0.99), whereas infants of mothers who received antenatal care (aRR=1.23, 95%CI=1.16-1.31) or had an institutional delivery were more likely (aRR=1.29, 95%CI=1.23-1.36) to receive HepB-BD. Conclusion: our findings highlight the need to improve HepB-BD uptake, particularly among HepB-exposed infants who are at risk of perinatal transmission of HepB.
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Affiliation(s)
- Babayemi Oluwaseun Olakunde
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
- Center for Translation and Implementation Research, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Ijeoma Uchenna Itanyi
- Center for Translation and Implementation Research, University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Community Medicine, College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Tonia Chinyelu Onyeka
- Center for Translation and Implementation Research, University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Anesthesia/Pain and Palliative Care Unit, College of Medicine, University of Nigeria, Nsukka, Nigeria
| | - Elijah Paintsil
- Department of Pediatrics, Yale School of Medicine, New Haven, CT 06510, USA
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, USA
- Department of Pharmacology, Yale School of Medicine, New Haven, CT, USA
| | - Kwasi Torpey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon-Accra, Ghana
| | - Nwamaka Lasebikan
- Center for Translation and Implementation Research, University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Radiation Medicine, College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Chibuike Ogwuegbu Chigbu
- Center for Translation and Implementation Research, University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Echezona Edozie Ezeanolue
- Center for Translation and Implementation Research, University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Paediatrics, College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
- Healthy Sunrise Foundation, Nevada, USA
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El-Mowafy M, Elegezy M, El-Mesery M, Elgaml A. Characterization of a breakthrough vaccine escape strain associated with overt hepatitis B virus infection. Virus Genes 2024:10.1007/s11262-024-02055-w. [PMID: 38349448 DOI: 10.1007/s11262-024-02055-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/22/2024] [Indexed: 03/02/2024]
Abstract
Hepatitis B virus (HBV) vaccine is composed of the purified hepatitis B surface antigen (HBsAg) that is produced by recombinant DNA technology. The neutralizing antibodies induced by vaccination target mainly the "a" determinant, aa124-147, of the outer viral envelope (HBsAg). In the present work, we demonstrate a case study for vaccinated patient that is infected with a vaccine escape HBV strain (Eg200). Characterization of the isolate Eg200 showed that it belongs to the genotype D and an uncommon sub-genotype in Egypt; D9. The DNA sequence encoding HBsAg was sequenced. Mutational analysis of the HBsAg showed a double mutation in the "a" determinant of this HBV isolate; T125M and P127T. However, such substitutions were found to be conserved to the detected serotype, ayw3, of Eg200 isolate. This case report indicates that continuous characterization of breakthrough vaccine escape strains of HBV is essential to develop the immunization strategies against HBV infection.
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Affiliation(s)
- Mohammed El-Mowafy
- Department of Microbiology and Immunology, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Mohamed Elegezy
- Department of Endemic Hepatology and Gastroenterology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Department of Tropical Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed El-Mesery
- Department of Biochemistry, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Abdelaziz Elgaml
- Department of Microbiology and Immunology, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt.
- Department of Microbiology and Immunology, Faculty of Pharmacy, Horus University, New Damietta, Egypt.
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90
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Demirchyan A, Dudareva S, Sahakyan S, Aslanyan L, Muradyan D, Musheghyan L, Mozalevskis A, Sargsyants N, Ghukasyan G, Petrosyan V. Prevalence of hepatitis B virus infection among general population of Armenia in 2021 and factors associated with it: a cross-sectional study. BMJ Open 2024; 14:e080281. [PMID: 38326250 PMCID: PMC10860008 DOI: 10.1136/bmjopen-2023-080281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/11/2024] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVES This study sought to determine the prevalence and associated factors of hepatitis B virus (HBV) infection ever in life and chronic HBV infection in Armenia. DESIGN A population-based cross-sectional seroprevalence study combined with a phone survey of tested individuals. SETTING All administrative units of Armenia including 10 provinces and capital city Yerevan. PARTICIPANTS The study frame was the general adult population of Armenia aged ≥18 years. PRIMARY AND SECONDARY OUTCOME MEASURES The participants were tested for anti-HBV core antibodies (anti-HBc) and HBV surface antigen (HBsAg) using third-generation enzyme immunoassays. In case of HBsAg positivity, HBV DNA and hepatitis D virus (HDV) RNA PCR tests were performed. Risk factors of HBV infection ever in life (anti-HBc positivity) and chronic HBV infection (HBsAg positivity) were identified through fitting logistic regression models. RESULTS The seroprevalence study included 3838 individuals 18 years and older. Of them, 90.7% (3476 individuals) responded to the phone survey. The prevalence of anti-HBc positivity was 14.1% (95% CI 13.1% to 15.2%) and HBsAg positivity 0.8% (95% CI 0.5% to 1.1%). The viral load was over 10 000 IU/mL for 7.9% of HBsAg-positive individuals. None of the participants was positive for HDV. Risk factors for HBsAg positivity included less than secondary education (aOR=6.44; 95% CI 2.2 to 19.1), current smoking (aOR=2.56; 95% CI 1.2 to 5.6), and chronic liver disease (aOR=8.44; 95% CI 3.0 to 23.7). In addition to these, risk factors for anti-HBc positivity included age (aOR=1.04; 95% CI 1.04 to 1.05), imprisonment ever in life (aOR=2.53; 95% CI 1.41 to 4.56), and poor knowledge on infectious diseases (aOR=1.32; 95% CI 1.05 to 1.67), while living in Yerevan (vs provinces) was protective (aOR=0.74; 95% CI 0.59 to 0.93). CONCLUSION This study provided robust estimates of HBV markers among general population of Armenia. Its findings delineated the need to revise HBV testing and treatment strategies considering higher risk population groups, and improve population knowledge on HBV prevention.
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Affiliation(s)
- Anahit Demirchyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Sandra Dudareva
- Department for Infectious Disease Epidemiology, Robert Koch Institut, Berlin, Germany
| | - Serine Sahakyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Lusine Aslanyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Diana Muradyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Lusine Musheghyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Antons Mozalevskis
- Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Narina Sargsyants
- National Institute of Health named after academician Suren Avdalbekyan, Yerevan, Armenia
| | - Gayane Ghukasyan
- World Health Organization Country Office in Armenia, Yerevan, Armenia
| | - Varduhi Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
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91
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Faghihi SH, Azarbakhsh H, Piraee E. Epidemiological study of hepatitis B and hepatitis C infection in Kohgiluyeh and Boyer-Ahmad province (Iran) from 2008 to 2021: A cross-sectional study. Health Sci Rep 2024; 7:e1812. [PMID: 38328787 PMCID: PMC10848580 DOI: 10.1002/hsr2.1812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/19/2023] [Accepted: 12/24/2023] [Indexed: 02/09/2024] Open
Abstract
Background and Aims Viral hepatitis is one of the top five reasons people die from infections all around the world. The present study aimed to assess the epidemiological features of hepatitis B and hepatitis C infections in Kohgiluyeh and Boyer-Ahmad province. Methods The data were obtained via the census method from the registered hepatitis B and hepatitis C data in the reportable disease care system of Yasuj University of Medical Sciences. The collected data are the result of serological tests. The χ 2 test was used to evaluate the important risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. The joinpoint regression was performed to investigate the trend of HBV and HCV in recent years. Results Here, 1270 cases of hepatitis B and C were identified and reported in Kohgiluyeh and Boyer-Ahmad province from 2008 to 2021. The median age of patients was 38 (interquartile range: 31-51), varying significantly according to the type of hepatitis. The most common hepatitis in males was hepatitis C and in females, hepatitis B. Regarding the place of residence, HBV and HCV were both more prevalent in urban areas. The age group of 25-34 years has the highest prevalence of HBV and HCV. According to the joinpoint regression analysis, there is a decrease in the 14-year trend of incidence rate due to total hepatitis B and C: the annual percent change was -5.2% (95% confidence interval [CI]: -8.4 to -1.9, p = 0.005) for hepatitis B and -0.2% (95% CI: -10.7 to 11.6, p = 0.976) for hepatitis C. Conclusion This study shows the incidence rate of hepatitis B has been decreasing during the years of study but this trend has been stable for hepatitis C. Also, the highest number of cases of hepatitis B and C were reported in the age groups of 25-34 years. Hence, preventive interventions are vital in reducing the burden of these diseases.
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Affiliation(s)
- Sayed H. Faghihi
- Department of Epidemiology, Faculty of Health, Social Determinants of Health Research CenterYasuj University of Medical SciencesYasujIran
| | - Habibollah Azarbakhsh
- Department of Epidemiology, Faculty of HealthAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Elahe Piraee
- Department of Epidemiology, Faculty of Health, Social Determinants of Health Research CenterYasuj University of Medical SciencesYasujIran
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92
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Rui F, Yeo YH, Xu L, Zheng Q, Xu X, Ni W, Tan Y, Zeng QL, He Z, Tian X, Xue Q, Qiu Y, Zhu C, Ding W, Wang J, Huang R, Xu Y, Chen Y, Fan J, Fan Z, Qi X, Huang DQ, Xie Q, Shi J, Wu C, Li J. Development of a machine learning-based model to predict hepatic inflammation in chronic hepatitis B patients with concurrent hepatic steatosis: a cohort study. EClinicalMedicine 2024; 68:102419. [PMID: 38292041 PMCID: PMC10827491 DOI: 10.1016/j.eclinm.2023.102419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 02/01/2024] Open
Abstract
Background With increasingly prevalent coexistence of chronic hepatitis B (CHB) and hepatic steatosis (HS), simple, non-invasive diagnostic methods to accurately assess the severity of hepatic inflammation are needed. We aimed to build a machine learning (ML) based model to detect hepatic inflammation in patients with CHB and concurrent HS. Methods We conducted a multicenter, retrospective cohort study in China. Treatment-naive CHB patients with biopsy-proven HS between April 2004 and September 2022 were included. The optimal features for model development were selected by SHapley Additive explanations, and an ML algorithm with the best accuracy to diagnose moderate to severe hepatic inflammation (Scheuer's system ≥ G3) was determined and assessed by decision curve analysis (DCA) and calibration curve. This study is registered with ClinicalTrials.gov (NCT05766449). Findings From a pool of 1,787 treatment-naive patients with CHB and HS across eleven hospitals, 689 patients from nine of these hospitals were chosen for the development of the diagnostic model. The remaining two hospitals contributed to two independent external validation cohorts, comprising 509 patients in validation cohort 1 and 589 in validation cohort 2. Eleven features regarding inflammation, hepatic and metabolic functions were identified. The gradient boosting classifier (GBC) model showed the best performance in predicting moderate to severe hepatic inflammation, with an area under the receiver operating characteristic curve (AUROC) of 0.86 (95% CI 0.83-0.88) in the training cohort, and 0.89 (95% CI 0.86-0.92), 0.76 (95% CI 0.73-0.80) in the first and second external validation cohorts, respectively. A publicly accessible web tool was generated for the model. Interpretation Using simple parameters, the GBC model predicted hepatic inflammation in CHB patients with concurrent HS. It holds promise for guiding clinical management and improving patient outcomes. Funding This research was supported by the National Natural Science Foundation of China (No. 82170609, 81970545), Natural Science Foundation of Shandong Province (Major Project) (No. ZR2020KH006), Natural Science Foundation of Jiangsu Province (No.BK20231118), Tianjin Key Medical Discipline (Specialty), Construction Project, TJYXZDXK-059B, Tianjin Health Science and Technology Project key discipline special, TJWJ2022XK034, and Research project of Chinese traditional medicine and Chinese traditional medicine combined with Western medicine of Tianjin municipal health and Family Planning Commission (2021022).
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Affiliation(s)
- Fajuan Rui
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Infectious Disease, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Yee Hui Yeo
- Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Liang Xu
- Clinical School of the Second People's Hospital, Tianjin Medical University, Tianjin, China
- Department of Hepatology, Tianjin Second People's Hospital, Tianjin, China
- Tianjin Research Institute of Liver Diseases, Tianjin, China
| | - Qi Zheng
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Xiaoming Xu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Infectious Disease, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Wenjing Ni
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Infectious Disease, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Youwen Tan
- Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, Zhenjiang, Jiangsu, China
| | - Qing-Lei Zeng
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zebao He
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Xiaorong Tian
- School of Computer Science, China University of Geosciences, Wuhan, Hubei, China
- Hubei Key Laboratory of Intelligent Geo-Information Processing, China University of Geosciences, Wuhan, Hubei, China
| | - Qi Xue
- Department of Infectious Disease, Shandong Provincial Hospital Affiliated to Shandong Frist Medical University, Ji'nan, Shandong, China
| | - Yuanwang Qiu
- Department of Infectious Diseases, The Fifth People's Hospital of Wuxi, Wuxi, Jiangsu, China
| | - Chuanwu Zhu
- Department of Infectious Diseases, The Affiliated Infectious Diseases Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Weimao Ding
- Department of Hepatology, Huai'an No.4 People's Hospital, Huai'an, Jiangsu, China
| | - Jian Wang
- Department of Infectious Disease, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Rui Huang
- Department of Infectious Disease, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Yayun Xu
- Department of Infectious Disease, Shandong Provincial Hospital, Shandong University, Ji'nan, Shandong, China
| | - Yunliang Chen
- School of Computer Science, China University of Geosciences, Wuhan, Hubei, China
- Hubei Key Laboratory of Intelligent Geo-Information Processing, China University of Geosciences, Wuhan, Hubei, China
| | - Junqing Fan
- School of Computer Science, China University of Geosciences, Wuhan, Hubei, China
- Hubei Key Laboratory of Intelligent Geo-Information Processing, China University of Geosciences, Wuhan, Hubei, China
| | - Zhiwen Fan
- Department of Pathology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Xiaolong Qi
- Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical of School, Southeast University, Nanjing, Jiangsu, China
| | - Daniel Q. Huang
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Qing Xie
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Junping Shi
- Department of Infectious & Hepatology Diseases, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Chao Wu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Infectious Disease, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Jie Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Infectious Disease, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
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Li J, Lin Y, Wang X, Lu M. Interconnection of cellular autophagy and endosomal vesicle trafficking and its role in hepatitis B virus replication and release. Virol Sin 2024; 39:24-30. [PMID: 38211880 PMCID: PMC10877419 DOI: 10.1016/j.virs.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/06/2024] [Indexed: 01/13/2024] Open
Abstract
Hepatitis B virus (HBV) produces and releases various particle types, including complete virions, subviral particles with envelope proteins, and naked capsids. Recent studies demonstrate that HBV exploits distinct intracellular membrane trafficking pathways, including the endosomal vesicle trafficking and autophagy pathway, to assemble and release viral and subviral particles. Herein, we summarize the findings about the distinct roles of autophagy and endosomal membrane trafficking and the interaction of both pathways in HBV replication, assembly, and release.
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Affiliation(s)
- Jia Li
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, 45122, Germany
| | - Yong Lin
- Key Laboratory of Molecular Biology of Infectious Diseases (Chinese Ministry of Education), Chongqing Medical University, Chongqing, 400016, China
| | - Xueyu Wang
- The Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310000, China
| | - Mengji Lu
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, 45122, Germany.
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Yin X, Wang W, Chen H, Mao Q, Han G, Yao L, Gao Q, Gao Y, Jin J, Sun T, Qi M, Zhang H, Li B, Duan C, Cui F, Tang W, Chan P, Liu Z, Hou J. Real-world implementation of a multilevel interventions program to prevent mother-to-child transmission of HBV in China. Nat Med 2024; 30:455-462. [PMID: 38297093 PMCID: PMC10878969 DOI: 10.1038/s41591-023-02782-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/19/2023] [Indexed: 02/02/2024]
Abstract
Reducing hepatitis B virus (HBV) mother-to-child transmission (MTCT) is a fundamental step toward the HBV elimination goal. The multicentred, multilevel SHIELD program aimed to use an intense intervention package to reduce HBV MTCT in China. This study was conducted in diverse health settings across China, encompassing 30,109 pregnant women from 178 hospitals, part of the interim analysis of stage II of the SHIELD program, and 8,642 pregnant women from 160 community-level health facilities in stage III of the SHIELD program. The study found that the overall MTCT rate was 0.23% (39 of 16,908; 95% confidence interval (CI): 0.16-0.32%) in stage II and 0.23% (12 of 5,290; 95% CI: 0.12-0.40%) in stage III. The MTCT rate was lower among participants who were compliant with the interventions (stage II: 0.16% (95% CI: 0.10-0.26%); stage III: 0.03% (95% CI: 0.00-0.19%)) than among those who were noncompliant (3.16% (95% CI: 1.94-4.85%); 1.91% (95% CI: 0.83-3.73%); P < 0.001). Our findings demonstrate that the comprehensive interventions among HBV-infected pregnant women were feasible and effective in dramatically reducing MTCT.
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Affiliation(s)
- Xueru Yin
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China, Ministry of Education; Guangdong Provincial Key Laboratory of Viral Hepatitis Research; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology, Guangzhou, China
| | - Wei Wang
- Department of Health Care, Shenzhen Bao'an Women's and Children's Hospital, Shenzhen, China
| | - Hui Chen
- Department of Hepatology, Hepatobiliary Hospital of Jilin, Changchun, China
| | - Qing Mao
- Department of Infectious Diseases, Southwest Hospital, Army Medical University, Chongqing, China
| | - Guorong Han
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of the Southeast University, Nanjing, China
| | - Lyufeng Yao
- Department of Hepatology, Mengchao Hepatobiliary Hospital, Fujian Medical University, Fuzhou, China
| | - Qingwei Gao
- Department of Hepatology, The Sixth People's Hospital of Dalian, Dalian, China
| | - Yunfei Gao
- Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jie Jin
- Department of Infectious Disease, The First People's Hospital of Hangzhou, Hangzhou, China
| | - Tong Sun
- Department of Hepatology, The Fifth People's Hospital of Wuxi, Wuxi, China
| | - Minghua Qi
- Department of Infectious Diseases, Peking University Shenzhen Hospital, Shenzhen, China
| | - Hua Zhang
- Department of Gynecology and Obstetrics, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Baijun Li
- Department of Hepatology, The Sixth People's Hospital of Shenyang, Shenyang, China
| | - Chongyang Duan
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Fuqiang Cui
- School of Public Health, Peking University, Beijing, China
| | - Weiming Tang
- Dermatology Hospital of South Medical University, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Polin Chan
- World Health Organization South-East Asia Regional Office, New Delhi, India
| | - Zhihua Liu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.
- State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China, Ministry of Education; Guangdong Provincial Key Laboratory of Viral Hepatitis Research; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology, Guangzhou, China.
| | - Jinlin Hou
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.
- State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China, Ministry of Education; Guangdong Provincial Key Laboratory of Viral Hepatitis Research; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology, Guangzhou, China.
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Hu JL, Huang AL. Classifying hepatitis B therapies with insights from covalently closed circular DNA dynamics. Virol Sin 2024; 39:9-23. [PMID: 38110037 PMCID: PMC10877440 DOI: 10.1016/j.virs.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023] Open
Abstract
The achievement of a functional cure for chronic hepatitis B (CHB) remains limited to a minority of patients treated with currently approved drugs. The primary objective in developing new anti-HBV drugs is to enhance the functional cure rates for CHB. A critical prerequisite for the functional cure of CHB is a substantial reduction, or even eradication of covalently closed circular DNA (cccDNA). Within this context, the changes in cccDNA levels during treatment become as a pivotal concern. We have previously analyzed the factors influencing cccDNA dynamics and introduced a preliminary classification of hepatitis B treatment strategies based on these dynamics. In this review, we employ a systems thinking perspective to elucidate the fundamental aspects of the HBV replication cycle and to rationalize the classification of treatment strategies according to their impact on the dynamic equilibrium of cccDNA. Building upon this foundation, we categorize current anti-HBV strategies into two distinct groups and advocate for their combined use to significantly reduce cccDNA levels within a well-defined timeframe.
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Affiliation(s)
- Jie-Li Hu
- Key Laboratory of Molecular Biology on Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.
| | - Ai-Long Huang
- Key Laboratory of Molecular Biology on Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.
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Hosking K, De Santis T, Vintour-Cesar E, Wilson PM, Bunn L, Garambaka Gurruwiwi G, Wurrawilya S, Bukulatjpi SM, Nelson S, Ross C, Stuart-Carter KA, Ngurruwuthun T, Dhagapan A, Binks P, Sullivan R, Ward L, Schroder P, Tate-Baker J, Davis JS, Connors C, Davies J. "Putting the power back into community": A mixed methods evaluation of a chronic hepatitis B training course for the Aboriginal health workforce of Australia's Northern Territory. PLoS One 2024; 19:e0288577. [PMID: 38266007 PMCID: PMC10807824 DOI: 10.1371/journal.pone.0288577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/20/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Chronic hepatitis B (CHB) is endemic in the Aboriginal and Torres Strait Islander population of Australia's Northern Territory. Progression to liver disease can be prevented if holistic care is provided. Low health literacy amongst health professionals is a known barrier to caring for people living with CHB. We co-designed and delivered a culturally safe "Managing hepatitis B" training course for the Aboriginal health workforce. Here, we present an evaluation of the course. OBJECTIVES 1. To improve course participants CHB-related knowledge, attitudes, and clinical practice. 2. To evaluate the "Managing hepatitis B" training course. 3. To enable participants to have the skills and confidence to be part of the care team. METHODS We used participatory action research and culturally safe principles. We used purpose-built quantitative and qualitative evaluation tools to evaluate our "Managing hepatitis B" training course. We integrated the two forms of data, deductively analysing codes, grouped into categories, and assessed pedagogical outcomes against Kirkpatrick's training evaluation framework. RESULTS Eight courses were delivered between 2019 and 2023, with 130 participants from 32 communities. Pre- and post-course questionnaires demonstrated statistically significant improvements in all domains, p<0.001 on 93 matched pairs. Thematic network analysis demonstrated high levels of course acceptability and significant knowledge acquisition. Other themes identified include cultural safety, shame, previous misinformation, and misconceptions about transmission. Observations demonstrate improvements in post-course engagement, a deep understanding of CHB as well as increased participation in clinical care teams. CONCLUSIONS The "Managing hepatitis B" training course led to a sustained improvement in the knowledge and attitudes of the Aboriginal health workforce, resulting in improved care and treatment uptake for people living with CHB. Important non-clinical outcomes included strengthening teaching and leadership skills, and empowerment.
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Affiliation(s)
- Kelly Hosking
- Public Health Directorate, Office of the Chief Health Officer, Northern Territory Health, Northern Territory, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Teresa De Santis
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Emily Vintour-Cesar
- Public Health Directorate, Office of the Chief Health Officer, Northern Territory Health, Northern Territory, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Phillip Merrdi Wilson
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Linda Bunn
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - George Garambaka Gurruwiwi
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Shiraline Wurrawilya
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | | | - Sandra Nelson
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Cheryl Ross
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kelly-Anne Stuart-Carter
- Centre for Disease Control, Northern Territory Health, Alice Springs, Northern Territory, Australia
| | - Terese Ngurruwuthun
- Miwatj Aboriginal Health Corporation, Nhulunbuy, East Arnhem Land, Northern Territory, Australia
| | - Amanda Dhagapan
- Miwatj Aboriginal Health Corporation, Nhulunbuy, East Arnhem Land, Northern Territory, Australia
| | - Paula Binks
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Richard Sullivan
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- UNSW School of Clinical Medicine, St George & Sutherland Campus, Jannali, NSW, Australia
| | - Linda Ward
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Phoebe Schroder
- Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, Sydney, NSW, Australia
| | - Jaclyn Tate-Baker
- Department of Infectious Diseases, Royal Darwin and Palmerston Hospital, Northern Territory Health, Darwin, Northern Territory, Australia
| | - Joshua S. Davis
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Christine Connors
- Public Health Directorate, Office of the Chief Health Officer, Northern Territory Health, Northern Territory, Australia
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Jane Davies
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Department of Infectious Diseases, Royal Darwin and Palmerston Hospital, Northern Territory Health, Darwin, Northern Territory, Australia
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97
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Alemayehu T, Daba MD, Buonsenso D. Long-Term Hepatitis B Vaccine Immunity in Ethiopian Children That Received a Pentavalent Vaccine Series: A Retrospective Cohort Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:136. [PMID: 38275446 PMCID: PMC10814694 DOI: 10.3390/children11010136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Chronic hepatitis B affects close to 300 million people globally with 1.5 million new infections per year. It causes the highest numbers of cirrhosis and liver cancer diagnoses each year. In children, perinatal transmission and contact with infected blood or body fluids remain the main methods of transmission. There are increasing reports of breakthrough hepatitis B infections in fully vaccinated children born to hepatitis B-negative mothers, especially in low- and middle-income countries. Our study aimed to measure the adequacy of hepatitis B surface antibody levels among children and adolescents who received three rounds of hepatitis B vaccination during infancy and delivered to hepatitis B-negative mothers in Addis Ababa, Ethiopia. METHOD This was a retrospective cohort study analyzing results of paired serology tests for hepatitis B surface antibody and antigen tests performed for children aged 1-18 years from July 2022 to June 2023. All recorded data were transferred to SPSS version 29.0. The prevalence of adequate hepatitis B surface antibody levels was determined and sub-group analysis conducted using descriptive statistics, frequencies and tables. The magnitude of association between different variables and vaccine-induced hepatitis B immunity was assessed using logistic regression. Statistically significant differences were taken at p < 0.05. RESULTS A total of 256 children were included in the study (mean age: 7.53 years). Six children (2.3%) had breakthrough hepatitis B infections. Overall, 37 children (14.4%) were categorized as having optimal hepatitis B surface antibody levels (vaccine-induced antibody titers of >10 IU/mL), while 219 (85.6%) had low titers of <10 IU/mL. Nearly all (97.4%) of the sub-group aged 10 years and above had below-par antibody levels, with adolescents (11-18 years) being ten times more likely to have low seroprotection than those aged less than 5 years. CONCLUSIONS Our study showed markedly low vaccine-induced hepatitis B surface antibody levels among the study population, especially adolescents. The presence of breakthrough infections may suggest a genuine lack of response and not just a mere drop in antibody titers and thus could highlight a significant public health problem in Ethiopia. Further immunologic studies and a thorough analysis of vaccine storage and administration should be conducted to inform prevention programs.
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Affiliation(s)
- Tinsae Alemayehu
- Department of Pediatrics and Adolescent Health, University of Botswana, Private Bag UB, Gaborone 00713, Botswana;
- Department of Pediatrics and Adolescent Health, St. Paul’s Hospital Millennium Medical College, Addis Ababa P.O. Box 1271, Ethiopia;
| | - Million Dechassa Daba
- Department of Pediatrics and Adolescent Health, St. Paul’s Hospital Millennium Medical College, Addis Ababa P.O. Box 1271, Ethiopia;
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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98
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Yang L, Xie N, Yao Y, Wang C, Tian M, Wang K. Hepatitis B time series in Xinjiang, China (2006-2021): change point detection based on the Mann-Kendall-Sneyers test. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2024; 21:2458-2469. [PMID: 38454691 DOI: 10.3934/mbe.2024108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Hepatitis B is a major global challenge, but there is a lack of epidemiological research on hepatitis B incidence from a change point perspective. This study aimed to fill this gap by identifying significant change points and trends in hepatitis time series in Xinjiang, China. The datasets were obtained from the Xinjiang Information System for Disease Control and Prevention. The Mann-Kendall-Sneyers (MKS) test was used to detect change points and trend changes on the hepatitis B time series of 14 regions in Xinjiang, and the effectiveness of this method was validated by comparing it with the binary segmentation (BS) and segment regression (SR) methods. Based on the results of change point analysis, the prevention and control policies and measures of hepatitis in Xinjiang were discussed. The results showed that 8 regions (57.1%) with at least one change fell within the 95% confidence interval (CI) in all 14 regions by the MKS test, where five regions (Turpan (TP), Hami (HM), Bayingolin (BG), Kyzylsu Kirgiz (KK), Altai (AT)) were identified at one change point, two change points existed for two regions (Aksu (AK), Hotan (HT)) and three change points was detected in 1 region (Bortala (BT)). Most of the change points occurred at both ends of the sequence. More change points indicated an upward trend in the front half of the sequence, while in the latter half, many change points indicated a downward trend prominently. Finally, in comparing the results of the three change point tests, the MKS test showed a 61.5% agreement (8/13) with the BS and SR.
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Affiliation(s)
- Liping Yang
- College of Public Health, Xinjiang Medical University, Urumqi 830017, China
| | - Na Xie
- Department of Immunization Programme, Xinjiang Center for Disease Control and Prevention, Urumqi 830054, China
| | - Yanru Yao
- College of Science, Shihezi University, Shihezi 832000, China
| | - Chunxia Wang
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi 830017, China
| | - Maozai Tian
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi 830017, China
| | - Kai Wang
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi 830017, China
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99
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Corona-Mata D, Rivero-Juárez A, Camacho Á, Ruiz-Torres L, Ruiz-Cáceres I, Pérez AB, de la Fuente Darder B, Cáceres-Anillo D, Castro-Granados MDG, Lizaur-Barbudo M, Cabrera-Gisbert MV, Redondo-Écija J, Aparicio-Aparicio A, Manchado-López L, Cobos L, Pérez-Valero I, Rivero A. Comparison of hepatitis B and SARS-CoV2 vaccination rates in people who attended Drugs and Addiction Centres. Front Public Health 2024; 11:1258095. [PMID: 38292385 PMCID: PMC10824845 DOI: 10.3389/fpubh.2023.1258095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024] Open
Abstract
Background and aims Persons with substance use disorder are at increased risk for hepatitis B virus (HBV) infection. Although most of them are attached to social health centers, the vaccination rate in this group is low. In this context, we designed a study to evaluate the prevalence of users of drug addiction centers (DAC) not immunized against hepatitis B and to compare the rate of vaccination against hepatitis B with the rate of immunization against SARS-Cov-2 in 2 years of follow-up. Design Retrospective study that included individuals attended at DAC. Patients were screened at baseline (June 2020-January 2021) for HBV immunization. Individuals with HBsAb < 10 IU/mL were recommended to receive hepatitis B vaccine, during follow-up (January 2021-October 2022). At the end of follow-up, the HBV vaccination rate among candidates was determined and compared with the vaccination rate against SARS-Cov-2 in this population in the same period. Findings A total of 325 subjects were surveyed and tested. At baseline, the 65% (211/325) of were candidates to initiate vaccination and were advisor to HBV vaccination. During the follow-up 15 individuals received at least one dose of HBV vaccine, supposing a vaccination rate of 7.2%. In the same period, 186 individuals received at least one dose against SARS-Cov-2, representing a vaccination rate of 83%. The comparison between vaccination rates reached statistically significant (p < 0.001). Conclusion Our study manifests a low rate of immunization against HBV in DAC users, despite a high level of immunization for SARS-Cov-2 during the same period in the same population. Consequently, the lack of immunization against HVB in this population might be related with health policy issue more than to individuals linked to care and awareness. A similar approach for vaccination intended for SARS-CoV2 should be applied in high-risk population to warrant the success of immunization program against other preventable diseases such as HBV.
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Affiliation(s)
- Diana Corona-Mata
- Infectious Diseases Department, Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital of Córdoba, University of Córdoba, Córdoba, Spain
- CIBERINFEC, ISCIII – CIBER of Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Rivero-Juárez
- Infectious Diseases Department, Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital of Córdoba, University of Córdoba, Córdoba, Spain
- CIBERINFEC, ISCIII – CIBER of Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | - Ángela Camacho
- Infectious Diseases Department, Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital of Córdoba, University of Córdoba, Córdoba, Spain
- CIBERINFEC, ISCIII – CIBER of Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Ruiz-Torres
- Infectious Diseases Department, Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital of Córdoba, University of Córdoba, Córdoba, Spain
| | - Inmaculada Ruiz-Cáceres
- Infectious Diseases Department, Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital of Córdoba, University of Córdoba, Córdoba, Spain
| | - Ana Belén Pérez
- CIBERINFEC, ISCIII – CIBER of Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain
- Microbiology Unit, Reina Sofía University Hospital of Córdoba, Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), Córdoba, Spain
| | - Bartolomé de la Fuente Darder
- Unidad de Drogas y Adicciones-CPD (UDA-CPD), Instituto Provincial Bienestar Social, Diputación Córdoba, Córdoba, Spain
| | | | - María de Guía Castro-Granados
- Unidad de Drogas y Adicciones-CPD (UDA-CPD), Instituto Provincial Bienestar Social, Diputación Córdoba, Córdoba, Spain
| | - María Lizaur-Barbudo
- Unidad de Drogas y Adicciones-CPD (UDA-CPD), Instituto Provincial Bienestar Social, Diputación Córdoba, Córdoba, Spain
| | | | - Justa Redondo-Écija
- Unidad de Drogas y Adicciones-CPD (UDA-CPD), Instituto Provincial Bienestar Social, Diputación Córdoba, Córdoba, Spain
| | - Ana Aparicio-Aparicio
- Unidad de Drogas y Adicciones-CPD (UDA-CPD), Instituto Provincial Bienestar Social, Diputación Córdoba, Córdoba, Spain
| | - Leticia Manchado-López
- Unidad de Drogas y Adicciones-CPD (UDA-CPD), Instituto Provincial Bienestar Social, Diputación Córdoba, Córdoba, Spain
| | - Luciano Cobos
- Unidad de Drogas y Adicciones-CPD (UDA-CPD), Instituto Provincial Bienestar Social, Diputación Córdoba, Córdoba, Spain
| | - Ignacio Pérez-Valero
- Infectious Diseases Department, Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital of Córdoba, University of Córdoba, Córdoba, Spain
- CIBERINFEC, ISCIII – CIBER of Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Rivero
- Infectious Diseases Department, Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital of Córdoba, University of Córdoba, Córdoba, Spain
- CIBERINFEC, ISCIII – CIBER of Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain
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Mohareb AM, Kim AY, Boyd A, Noubary F, Kouamé MG, Anglaret X, Coffie PA, Eholie SP, Freedberg KA, Hyle EP. Virological, serological and clinical outcomes in chronic hepatitis B virus infection: development and validation of the HEPA-B simulation model. BMJ Open 2024; 14:e073498. [PMID: 38216186 PMCID: PMC10806737 DOI: 10.1136/bmjopen-2023-073498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 12/21/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVES Detailed simulation models are needed to assess strategies for prevention and treatment of hepatitis B virus (HBV) infection, the world's leading cause of liver disease. We sought to develop and validate a simulation model of chronic HBV that incorporates virological, serological and clinical outcomes. METHODS We developed a novel Monte Carlo simulation model (the HEPA-B Model) detailing the natural history of chronic HBV. We parameterised the model with epidemiological data from the Western Pacific and sub-Saharan Africa. We simulated the evolution of HBV DNA, 'e' antigen (HBeAg) and surface antigen (HBsAg). We projected incidence of HBeAg loss, HBsAg loss, cirrhosis, hepatocellular carcinoma (HCC) and death over 10-year and lifetime horizons. We stratified outcomes by five HBV DNA categories at the time of HBeAg loss, ranging from HBV DNA<300 copies/mL to >106 copies/mL. We tested goodness of fit using intraclass coefficients (ICC). RESULTS Model-projected incidence of HBeAg loss was 5.18% per year over lifetime (ICC, 0.969 (95% CI: 0.728 to 0.990)). For people in HBeAg-negative phases of infection, model-projected HBsAg loss ranged from 0.78% to 3.34% per year depending on HBV DNA level (ICC, 0.889 (95% CI: 0.542 to 0.959)). Model-projected incidence of cirrhosis was 0.29-2.09% per year (ICC, 0.965 (95% CI: 0.942 to 0.979)) and HCC incidence was 0.06-1.65% per year (ICC, 0.977 (95% CI: 0.962 to 0.986)). Over a lifetime simulation of HBV disease, mortality rates were higher for people with older age, higher HBV DNA level and liver-related complications, consistent with observational studies. CONCLUSIONS We simulated HBV DNA-stratified clinical outcomes with the novel HEPA-B Model and validated them to observational data. This model can be used to examine strategies of HBV prevention and management.
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Affiliation(s)
- Amir M Mohareb
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Arthur Y Kim
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Anders Boyd
- Division of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
- Stichting HIV Monitoring, Amsterdam, The Netherlands
| | - Farzad Noubary
- Department of Health Sciences, Northeastern University - Boston Campus, Boston, Massachusetts, USA
| | | | - Xavier Anglaret
- Research Institute for Sustainable Development (IRD) EMR 271, University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Bordeaux, France
| | - Patrick A Coffie
- Programme PAC-CI, Abidjan, Côte d'Ivoire
- Département de Médecines et Spécialités Médicales, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Serge Paul Eholie
- Universite Felix Houphouet-Boigny Unite de Formation et de Recherche des Sciences Medicales, Abidjan, Côte d'Ivoire
| | - Kenneth A Freedberg
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Emily P Hyle
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
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