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Domínguez A, Avellón A, Hernando V, Soldevila N, Borràs E, Martínez A, Izquierdo C, Torner N, Pericas C, Rius C, Godoy P. Impact of the Universal Implementation of Adolescent Hepatitis B Vaccination in Spain. Vaccines (Basel) 2024; 12:488. [PMID: 38793738 PMCID: PMC11125626 DOI: 10.3390/vaccines12050488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024] Open
Abstract
The aim of this study was to analyse the impact of the introduction of universal adolescent HBV vaccination on the incidence of acute hepatitis B virus (HBV) infections. Acute HBV cases reported to the Spanish National Epidemiological Surveillance Network between 2005 and 2021 were included. For regions starting adolescent vaccination in 1991-1993 and in 1994-1996, HBV incidence rates were compared by calculating the incidence rate ratio (IRR) and 95% confidence interval (CI). We also analysed the 2017 Spanish national seroprevalence survey data. The overall acute HBV incidence per 100,000 persons was 1.54 in 2005 and 0.64 in 2021 (p < 0.001). The incidence in 2014-2021 was lower for regions that started adolescent vaccination in 1991-1993 rather than in 1994-1996 (IRR 0.76; 95% CI 0.72-0.83; p < 0.001). In the 20-29 age group, incidence in regions that started adolescent vaccination in 1991-1993 was also lower (IRR 0.87; 95% CI 0.77-0.98; p = 0.02 in 2005-2013 and IRR 0.71; 95% CI 0.56-0·90; p < 0.001 in 2014-2021). Anti-HBc prevalence in the 35-39 age group was lower in the regions that started vaccination earlier, although the difference was not statistically significant (p = 0.09). Acute HBV incidence decreased more in the young adult population in regions that began adolescent vaccination earlier. Maintaining high universal vaccination coverage in the first year of life and in at-risk groups is necessary to achieve HBV elimination by 2030.
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Affiliation(s)
- Angela Domínguez
- Department of Medicine, Universidad de Barcelona, 08036 Barcelona, Spain; (A.D.); (E.B.); (N.T.); (C.P.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.A.); (A.M.); (C.R.); (P.G.)
| | - Ana Avellón
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.A.); (A.M.); (C.R.); (P.G.)
- Hepatitis Unit, National Centre of Microbiology, Instituto de Salud Carlos III, 28222 Madrid, Spain
| | - Victoria Hernando
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- CIBER Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Núria Soldevila
- Department of Medicine, Universidad de Barcelona, 08036 Barcelona, Spain; (A.D.); (E.B.); (N.T.); (C.P.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.A.); (A.M.); (C.R.); (P.G.)
| | - Eva Borràs
- Department of Medicine, Universidad de Barcelona, 08036 Barcelona, Spain; (A.D.); (E.B.); (N.T.); (C.P.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.A.); (A.M.); (C.R.); (P.G.)
- Agència de Salut Pública de Catalunya, 08005 Barcelona, Spain;
| | - Ana Martínez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.A.); (A.M.); (C.R.); (P.G.)
- Agència de Salut Pública de Catalunya, 08005 Barcelona, Spain;
| | | | - Núria Torner
- Department of Medicine, Universidad de Barcelona, 08036 Barcelona, Spain; (A.D.); (E.B.); (N.T.); (C.P.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.A.); (A.M.); (C.R.); (P.G.)
| | - Carles Pericas
- Department of Medicine, Universidad de Barcelona, 08036 Barcelona, Spain; (A.D.); (E.B.); (N.T.); (C.P.)
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
- Institut de Recerca de l‘Hospital de la Santa Creu i Sant Pau (IRB Sant Pau), 08041 Barcelona, Spain
| | - Cristina Rius
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.A.); (A.M.); (C.R.); (P.G.)
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
- Institut de Recerca de l‘Hospital de la Santa Creu i Sant Pau (IRB Sant Pau), 08041 Barcelona, Spain
| | - Pere Godoy
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.A.); (A.M.); (C.R.); (P.G.)
- Institut de Recerca Biomédica de Lleida (IRBLleida), 25006 Lleida, Spain
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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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Agbesanwa TA, Aina FO, Ibrahim AO. Knowledge and Awareness of Hepatitis B Infection Among Young Adults in Ekiti, Nigeria: Implications for Education and Vaccination. Cureus 2023; 15:e49778. [PMID: 38161573 PMCID: PMC10757744 DOI: 10.7759/cureus.49778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Aim Hepatitis B is a preventable infection with transmission of the virus through sex, by blood and from mother to child during childbirth. Young adults are prone to some of these risk factors, yet data on awareness and knowledge of hepatitis B among them is still limited in Nigeria and none from our locality. The purpose of this study was to assess the knowledge and awareness of hepatitis B among young adults attending a tertiary health institution in Nigeria with the aim of giving recommendations based on the findings. Methods A total of 223 young adults who attended the adolescent and young adult clinic of the Family Medicine Department of the Ekiti State University Teaching Hospital, Ado Ekiti between 1 March and 31 May 2023 were analyzed using a predesigned self-administered questionnaire. Knowledge of hepatitis B was assessed by asking 12 questions relating to awareness of the disease, basic knowledge, route of transmission, the seriousness of the disease when compared to human immunodeficiency virus (HIV), complications from the disease, their vaccination status and the number of doses received by the participants. Results The prevalence of awareness of hepatitis B among respondents was 88 (39.5%). Of the 223 respondents studied, 158 (70.9%) had a poor knowledge score of the disease. There was a significant association between the highest educational background of the respondents and awareness of hepatitis B (p=0.05). Awareness of hepatitis B was also associated with previous participation in any health screening (p=0.04) and vaccine awareness (p=<0.001). The majority of the respondents with good knowledge scores of hepatitis B preferred social media for disseminating information about their health (p=0.03). Out of all the participants studied, only one (0.4%) had completed the three doses of the hepatitis B vaccine with 11 (4.9%) of them yet to get fully vaccinated. Conclusion Efforts are needed to target social media platforms with information about hepatitis B and vaccination. With awareness campaigns of hepatitis B directed at various social media platforms, this population at risk could be educated about the disease and the benefits of vaccination. The low vaccination state among the respondents brought to the fore the urgent need for the government to ensure the provision of appropriate interventions for viral hepatitis among young adults.
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Affiliation(s)
| | - Felix O Aina
- Family Medicine, Ekiti State University, Ado Ekiti, NGA
| | - Azeez O Ibrahim
- Family Medicine, Federal Teaching Hospital Ido Ekiti, Ido Ekiti, NGA
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Stroffolini T, Stroffolini G. Five Decades of HBV Infection in Italy: A Continuous Challenge. BIOLOGY 2023; 12:1075. [PMID: 37626961 PMCID: PMC10451692 DOI: 10.3390/biology12081075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023]
Abstract
In Italy, Hepatitis B virus (HBV) infection has been characterized by several changes over the last five decades. In 2019, the incidence of acute HBV among subjects targeted by the vaccination campaign was 0 cases in the age group 0-14 years and 0.1/100,000 in the age group 15-24. Nowadays, the burden of different stages of HBV-related chronic liver diseases is minimal. Intravenous drug use is no longer a risk factor (O.R. 0.7; 95% C.I. 0.5-1.02) for acquiring acute HBV; the proportion of cases reporting this exposure fell from 29.8% to 3.3% over the last two decades. The key public health intervention has been the compulsory vaccination campaign started in 1991 for infants 3 months old and 1-2 years old (the latter group for the first 12 years of the campaign). Moreover, non-immunogenic factors and the availability of effective oral antiviral drugs have played and continue to play a prominent role. The potential availability of new oral antiviral drugs with the inherent ability to eliminate the genomic HBV reservoirs may represent a further crucial step in the elimination of the virus in people that are already infected.
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Affiliation(s)
- Tommaso Stroffolini
- Department of Tropical and Infectious Diseases, Policlinico Umberto I, 00186 Rome, Italy;
| | - Giacomo Stroffolini
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni, 5, Negrar, 37024 Verona, Italy
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Farmer PF, Boyle B, Hill I, Kiel A, Ediger T. Single-Center Analysis of Essential Laboratory Testing in Patients with Newly Diagnosed Celiac Disease. J Pediatr 2023; 259:113487. [PMID: 37201683 DOI: 10.1016/j.jpeds.2023.113487] [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: 04/04/2023] [Revised: 04/25/2023] [Accepted: 05/08/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVE To analyze laboratory testing results from pediatric patients newly diagnosed with celiac disease to determine the usefulness of each test derived from recommended guidelines. METHODS Serological testing at the time of diagnosis from patients enrolled in our celiac disease registry from January 2018 through December 2021 was reviewed. The incidence of abnormal laboratory results, routinely obtained as per the recommendations of Snyder et al and our institution's Celiac Care Index, was assessed. Rates of abnormal laboratory values and estimated costs associated with these screening measures were analyzed. RESULTS Our data demonstrated abnormalities in all serological testing obtained at celiac diagnosis. Hemoglobin, alanine aminotransferase, ferritin, iron, and vitamin D screening were found to be abnormal with notable frequency. Only 7% of patients had an abnormal thyroid-stimulating hormone and <0.1% had an abnormal free T4. Nonresponse to hepatitis B vaccination was prominent, with 69% of patients considered nonimmune. Screening protocols as currently outlined in our Celiac Care Index resulted in an estimated cost of approximately $320 000 during our study. CONCLUSIONS Review of screening laboratory results at our center reveals that abnormal values for several recommended measures are uncommon. Thyroid screening was infrequently abnormal and the usefulness of screening for hepatitis B at diagnosis is uncertain. Similarly, our data suggest that iron deficiency screening may be condensed effectively into hemoglobin and ferritin testing, eliminating the need for initial iron studies. Decreasing baseline screening measures could safely decrease the burden of testing on patients and overall healthcare expenditures.
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Affiliation(s)
- Peter F Farmer
- Division of Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH.
| | - Brendan Boyle
- Division of Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH
| | - Ivor Hill
- Division of Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH
| | - Ashley Kiel
- Division of Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH
| | - Tracy Ediger
- Division of Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH
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Reilly-Evans B, Dudzik B, Costlow DJ, Hartmann C, Khalsa AM, Kassis C, Zmarlicka MT. Observational Study Evaluating the Seroprotection of HepB-alum Vaccine and HepB-CpG Vaccine in People With HIV. Open Forum Infect Dis 2023; 10:ofad267. [PMID: 37389224 PMCID: PMC10300634 DOI: 10.1093/ofid/ofad267] [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: 02/28/2023] [Accepted: 05/15/2023] [Indexed: 07/01/2023] Open
Abstract
Background Hepatitis B virus (HBV) vaccine seroprotection rates with conventional aluminum adjuvanted recombinant HBV vaccines, Engerix-B (HepB-alum) vaccine, among people with HIV (PWH) are varied. Heplisav-B (HepB-CpG) vaccine, a novel adjuvanted recombinant HBV vaccine, has shown higher seroprotection rates in immunocompetent patients but is not well studied in PWH. There are no published studies comparing seroprotection rates between HepB-alum and HepB-CpG in PWH. This study aims to evaluate and compare the seroprotection incidence of HepB-alum vs HepB-CpG in PWH at least 18 years of age. Methods This retrospective, observational cohort study included adults diagnosed with HIV who received a complete series of HepB-alum or HepB-CpG at a community health center in Phoenix, Arizona. Patients had a hepatitis B surface antibody <10 IU/L at the time of the first vaccine dose. The primary outcome was a comparison of seroconversion incidence between HepB-CpG and HepB-alum. Secondary outcomes included identifying factors associated with likelihood of response to HBV vaccination. Results A total of 120 patients were included in this study, 59 in the HepB-alum cohort and 61 in the HepB-CpG cohort. In the HepB-alum cohort, 57.6% achieved seroconversion, compared with 93.4% in the HepB-CpG cohort (P < .001). Those without diabetes were more likely to have response to a vaccine. Conclusions Among PWH at a single community health center, HepB-CpG provided a statistically higher incidence of seroprotection against HBV compared with HepB-alum.
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Affiliation(s)
- Brenna Reilly-Evans
- Correspondence: Monika T. Zmarlicka, PharmD, Department of Pharmacy, Valleywise Health Medical Center, 2601 E Roosevelt St, Phoenix, AZ 85008 (); or Brenna Reilly-Evans, PharmD, Department of Pharmacy, Regional One Health, 877 Jefferson Ave, Memphis, TN 38103 ()
| | - Beatrix Dudzik
- Department of Student Research, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA
| | - David J Costlow
- Department of Pharmacy, Valleywise Health, Phoenix, Arizona, USA
| | - Carlos Hartmann
- Department of Medicine, Ochsner Health, Covington, Louisiana, USA
| | - Ann M Khalsa
- Department of Medicine, Ochsner Health, Covington, Louisiana, USA
| | - Christelle Kassis
- Department of Medicine, Ochsner Health, Covington, Louisiana, USA
- Department of Medicine, Valleywise Health, Phoenix AZ, USA
| | - Monika T Zmarlicka
- Correspondence: Monika T. Zmarlicka, PharmD, Department of Pharmacy, Valleywise Health Medical Center, 2601 E Roosevelt St, Phoenix, AZ 85008 (); or Brenna Reilly-Evans, PharmD, Department of Pharmacy, Regional One Health, 877 Jefferson Ave, Memphis, TN 38103 ()
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Immunological Findings in a Group of Individuals Who Were Poor or Non-Responders to Standard Two-Dose SARS-CoV-2 Vaccines. Vaccines (Basel) 2023; 11:vaccines11020461. [PMID: 36851338 PMCID: PMC9963224 DOI: 10.3390/vaccines11020461] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been declared a pandemic. However, data on the poor or non-responders to SARS-CoV-2 vaccines in the general population are limited. The objective of this study was to comprehensively compare the immunological characteristics of poor or non-responders to SARS-CoV-2 vaccines in the 18-59-year group with those in the ≥60-year group using internationally recognized cut-off values. The main outcome was effective seroconversion characterized by an anti-SARS-CoV-2 spike IgG level of at least a four-fold increase from baseline. Profiling of naïve immune cells was analyzed prior to vaccination to demonstrate baseline immunity. The outcomes of effective seroconversion in patients aged 18-59 years with those in patients aged ≥60 years were compared. The quantitative level of anti-spike IgG was significantly lower in individuals aged ≥60 and men aged 18-59 years. There were 7.5% of poor or non-responders among the 18-59 years and 11.7% of poor or non-responders in the ≥60 years using a four-fold increase parameter. There were 37.0-58.1% with low lymphocyte count (<1000/mm3), 33.3-45.2% with low CD4 cell counts (<500/mm3), and 74.1-96.8% with low B cell counts (<100/mm3) in the non-seroconversion group. An individual with an anti-SARS-CoV-2 spike IgG titer below 50 BAU/mL might be considered a poor or non-responder between 14 and 90 days after the last vaccine dose. Booster vaccination or additional protective measures should be recommended to poor or non-responders as soon as possible to reduce disease severity and mortality.
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Post-Vaccination and Post-Infection Immunity to the Hepatitis B Virus and Circulation of Immune-Escape Variants in the Russian Federation 20 Years after the Start of Mass Vaccination. Vaccines (Basel) 2023; 11:vaccines11020430. [PMID: 36851307 PMCID: PMC9962567 DOI: 10.3390/vaccines11020430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
A neonatal vaccination against the Hepatitis B virus (HBV) infection was initiated in Russia 20 years ago, with catch-up immunization for adolescents and adults under the age of 60 years launched in 2006. Here, we have assessed the humoral immunity to HBV in different regions of Russia, as well as the infection frequency following 20 years of a nationwide vaccination campaign. We have also evaluated the role of immune-escape variants in continuing HBV circulation. A total of 36,149 healthy volunteers from nine regions spanning the Russian Federation from west to east were tested for HBV surface antigen (HBsAg), antibodies to HBV capsid protein (anti-HBc), and antibodies to HBsAg (anti-HBs). HBV sequences from 481 chronic Hepatitis B patients collected from 2018-2022 were analyzed for HBsAg immune-escape variants, compared with 205 sequences obtained prior to 2010. Overall, the HBsAg detection rate was 0.8%, with this level significantly exceeded only in one study region, the Republic of Dagestan (2.4%, p < 0.0001). Among the generation vaccinated at birth, the average HBsAg detection rate was below 0.3%, ranging from 0% to 0.7% depending on the region. The anti-HBc detection rate in subjects under 20 years was 7.4%, indicating ongoing HBV circulation. The overall proportion of participants under 20 years with vaccine-induced HBV immunity (anti-HBs positive, anti-HBc negative) was 41.7% but below 10% in the Tuva Republic and below 25% in the Sverdlovsk and Kaliningrad regions. The overall prevalence of immune-escape HBsAg variants was 25.2% in sequences obtained from 2018-2022, similar to the prevalence of 25.8% in sequences collected prior to 2010 (p > 0.05). The population dynamics of immune-escape variants predicted by Bayesian analysis have remained stable over the last 20 years, indicating the absence of vaccine-driven positive selection. In contrast, the wild-type HBV population size experienced a rapid decrease starting in the mid-1990s, following the introduction of mass immunization, but it subsequently began to recover, reaching pre-vaccination levels by 2020. Taken together, these data indicate that it is gaps in vaccination, and not virus evolution, that may be responsible for the continued virus circulation despite 20 years of mass vaccination.
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Wong NS, Chan DPC, Poon CM, Chan CP, Lau LHW, Yeoh EK, Lee SS. Hepatitis B burden and population immunity in a high endemicity city - a geographically random household epidemiology study for evaluating achievability of elimination. Epidemiol Infect 2023; 151:e22. [PMID: 36628568 PMCID: PMC9990397 DOI: 10.1017/s095026882300002x] [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] [Indexed: 01/12/2023] Open
Abstract
This study aimed to provide reference for evaluating the achievability of hepatitis B virus (HBV) elimination in a high endemicity city with universal neonatal vaccination in place for over 30 years. Between September 2018 and October 2020, 2085 citizens from 1143 geographically random households in Hong Kong completed a questionnaire and had blood-testing for HBV markers (anti-HBs, HBsAg, anti-HBc, HBeAg). We evaluated the epidemiology and examined factors associated with HBV exposure, vaccination and chronic diseases. The proportion of households with HBsAg positive index participants was 9.2% (95% CI 7.5%-10.9%). The age- and sex-adjusted HBsAg prevalence was 6.3% (95% CI 5.3%-7.4%), compared to >10% in those born in 1960-1970 and among non-local born citizens, and <1% in people born after introduction of neonatal vaccination. Among 155 HBsAg positive participants, 59% were aware of their infection status with 10% on treatment and 10/150 (6.7%) HBeAg positive. More than 40% (872/2064) tested negative for both HBsAg and anti-HBs, contributed by the lack of immunity in older adults and the waning immunity of vaccines. Hong Kong has remained at high-intermediate HBV endemicity state. The moderate level of anti-HBs positivity and very low treatment coverage (10%) among HBsAg positive participants pose challenges for achieving the HBV elimination target.
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Affiliation(s)
- Ngai Sze Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Denise Pui Chung Chan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Chin Man Poon
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Chin Pok Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Leonia Hiu Wan Lau
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Eng-Kiong Yeoh
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Shui Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
- Author for correspondence: Shui Shan Lee, E-mail:
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Fernández-Nieto MI, Valero-Cedeño NJ, Hidalgo-Ramírez KJ, Toapanta-Figueroa CE. Anticuerpos anti gliadina como factor asociado a la falta de respuesta a la vacunación anti hepatitis B en adultos. KASMERA 2022. [DOI: 10.56903/kasmera.5035706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
La hepatitis B es una enfermedad que afecta a 350 millones de personas en el mundo. Existen factores como la edad, el sexo, sobrepeso, enfermedades inmunológicas, diabetes mellitus, entre otros, que impiden la correcta respuesta inmunitaria a la vacunación anti hepatitis B. El objetivo de la investigación fue analizar la presencia de anticuerpos antigliadina y la falta de respuesta a la vacunación anti hepatitis B en adultos. La metodología de diseño descriptivo-no experimental, de tipo prospectivo, transversal y explicativo, incluyó 235 adultos seleccionados sin distinción de sexo o etnia con antecedentes de vacunación al virus de hepatitis B en cuyas muestras de suero se determinaron los anticuerpos anti antígeno de superficie del virus hepatitis B. El análisis estadístico se realizó con el programa Graph Pad Prism 8.0®. Los anticuerpos anti antígeno de superficie del virus hepatitis B estuvieron presentes en el 76% de la población estudiada. El 35,5% resultó con anticuerpos antigliadina elevados asociado a una hipo-respuesta frente a la vacuna virus hepatitis B. Factores como el índice de masa corporal y los antecedentes familiares de diabetes mellitus tipo 1 y 2 en los adultos estudiados, resultaron significativamente asociados a la falta de respuesta inmunitaria en individuos no respondedores
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Affiliation(s)
| | - Nereida Josefina Valero-Cedeño
- Universidad Estatal del Sur de Manabí. Facultad de Ciencias de la Salud. Carrera de Laboratorio Clínico. Jipijapa-Manabí. Ecuador
| | | | - Carlos Eduardo Toapanta-Figueroa
- Universidad Estatal del Sur de Manabí. Facultad de Ciencias de la Salud. Carrera de Laboratorio Clínico. Jipijapa-Manabí. Ecuador
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11
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Hall EW, Gounder P, Angles J, Nelson NP, Rosenberg ES, Weng MK. Evaluating the cost-effectiveness of hepatitis B vaccination strategies in high-impact settings for adults. J Viral Hepat 2022; 29:1115-1126. [PMID: 36200313 DOI: 10.1111/jvh.13759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/14/2022] [Accepted: 09/21/2022] [Indexed: 12/29/2022]
Abstract
Adults at increased risk for hepatitis B virus (HBV) infection are recommended to receive vaccination. We conducted a cost utility analysis to evaluate approaches for implementing that recommendation in selected high-risk settings: community outreach events with a large proportion of immigrants, syringe service programs, substance use treatment centres, sexually transmitted infection (STI) clinics, tuberculosis (TB) clinics and jails. We utilized a decision tree framework with a Markov disease progression model to compare quality adjusted life-years and cost in 2021 United States dollars from four strategies: a 3-dose vaccination regimen with prevaccination screening and testing (PVST; baseline comparison); PVST at the initial encounter followed by a 2-dose series (Intervention 1); PVST with the first dose of a 2-dose vaccination series at the initial encounter (Intervention 2); and a 2-dose vaccination series without PVST (Intervention 3). In all settings, Intervention 1 resulted in worse health outcomes compared with the baseline strategy. Intervention 2 averted incident chronic HBV infections in all settings (range -9.4% in TB clinics, -14.8% in syringe service programs) and was a cost-saving approach in settings with higher risk of infection (i.e. jails, -$266 per person; syringe service programs, -$597; substance use treatment centres, -$130). Providing a 2-dose vaccination series without any screening (Intervention 3) averted incident HBV infections and was cost-saving in all settings but resulted in more HBV-related deaths in settings with higher HBV prevalence. These results demonstrate a 2-dose vaccine series is a cost-effective approach in these high-impact settings, even if prevaccination testing is not possible.
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Affiliation(s)
- Eric W Hall
- School of Public Health, Oregon Health & Science University, Portland, Oregon, USA
| | - Prabhu Gounder
- Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - John Angles
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, New York, USA
| | - Noele P Nelson
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia, USA
| | - Eli S Rosenberg
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, New York, USA.,New York State Department of Health, Albany, New York, USA
| | - Mark K Weng
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia, USA
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12
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A Novel Dry-Stabilized Whole Blood Microsampling and Protein Extraction Method for Testing of SARS-CoV-2 Antibody Titers. Vaccines (Basel) 2022; 10:vaccines10101760. [DOI: 10.3390/vaccines10101760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/07/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has revealed a crucial need for rapid, straightforward collection and testing of biological samples. Serological antibody assays can analyze patient blood samples to confirm immune response following mRNA vaccine administration or to verify past exposure to the SARS-CoV-2 virus. While blood tests provide vital information for clinical analysis and epidemiology, sample collection is not trivial; this process requires a visit to the doctor’s office, a professionally trained phlebotomist to draw several milliliters of blood, processing to yield plasma or serum, and necessitates appropriate cold chain storage to preserve the specimen. A novel whole blood collection kit (truCOLLECT) allows for a lancet-based, decentralized capillary blood collection of metered low volumes and eliminates the need for refrigerated transport and storage through the process of active desiccation. Anti-SARS-CoV-2 spike (total and neutralizing) and nucleocapsid protein antibody titers in plasma samples obtained via venipuncture were compared to antibodies extracted from desiccated whole blood using Adaptive Focused Acoustics (AFA). Paired plasma versus desiccated blood extracts yields Pearson correlation coefficients of 0.98; 95% CI [0.96, 0.99] for anti-SARS-CoV-2 spike protein antibodies, 0.97; 95% CI [0.95, 0.99] for neutralizing antibodies, and 0.97; 95% CI [0.94, 0.99] for anti-SARS-CoV-2 nucleocapsid protein antibodies. These data suggest that serology testing using desiccated and stabilized whole blood samples can be a convenient and cost-effective alternative to phlebotomy.
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13
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de Wit JBF, Adam PCG, den Daas C, Jonas K. Sexually transmitted infection prevention behaviours: health impact, prevalence, correlates, and interventions. Psychol Health 2022; 38:675-700. [PMID: 35748408 DOI: 10.1080/08870446.2022.2090560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Sexually transmitted infections (STIs) remain a major public health threat, disproportionately affecting young people, and men who have sex with men. In this narrative review of the current state of behavioural science research on STI prevention, we consider the definition, health impacts, correlates and determinants, and interventions to promote STI prevention behaviour. Research on STI prevention behaviour has extended from a focus on abstinence, partner reduction and condom use, to also include novel preventive behaviours, notably treatment-as-prevention, pre-exposure prophylaxis (i.e., the preventive use of medicines by uninfected people), and vaccination for some STIs. Social-cognitive factors specified by, for instance the theory of planned behaviour, are critical proximal determinants of STI prevention behaviours, and related interventions can effectively promote STI prevention behaviours. Social-ecological perspectives highlight that individual-level determinants are embedded in more distal environmental influences, with social stigma especially affecting STI prevention behaviours and requiring effective intervention. Further to providing a major domain of application, STI prevention also poses critical challenges and opportunities for health psychology theory and research. We identify a need for health behaviour theory that addresses the processes linking multiple levels of influence on behaviour and provides practical guidance for multi-level behaviour change interventions adapted to specific contexts.
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Affiliation(s)
- John B. F. de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
| | - Philippe C. G. Adam
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
- Institute for Prevention and Social Research, Bangkok, Thailand
| | - Chantal den Daas
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland
| | - Kai Jonas
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
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14
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He WQ, Guo GN, Li C. The impact of hepatitis B vaccination in the United States, 1999-2018. Hepatology 2022; 75:1566-1578. [PMID: 34855999 DOI: 10.1002/hep.32265] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/07/2021] [Accepted: 11/25/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Hepatitis B vaccine has been included in the infant immunization schedule since 1991 in the United States. We aimed to assess its effectiveness against HBV infection and its impact on mortality. APPROACH AND RESULTS The study population was participants aged 6+ years with an HBV vaccination history and an HBV serologic test from the National Health and Nutrition Examination Survey, 1999-2018. Participants aged 18+ years with linked mortality records from 1999-2014 were followed for mortality analysis. Multivariable logistic regression was used to compute vaccine effectiveness (VE) overall, by year of birth, and by age. Cox regression was used to estimate HRs for all-cause, cancer-related, and cardiovascular disease-related mortality. A total of 64,107 participants were included in the main analysis, with 29,600 (40.7%) having completed HBV vaccination (three or more doses, vaccinated). The highest vaccination uptake was found among those born after 1991, at 86.5%. Vaccinated participants had higher prevalence of vaccine-induced immunity than the unvaccinated (47.2% vs. 7.4%). Among those born after 1991, VE was found at 58% (95% CI, 18%-79%) overall and 85% for those aged ≥20 years (mean age, 22), whereas no effect was found among those born prior to 1990. HBV vaccination was associated with reduced risk of all-cause mortality (HR, 0.78; 95% CI, 0.68-0.90) and cancer-related mortality (HR, 0.76; 95% CI, 0.58-1.00) but not for cardiovascular disease-related mortality. CONCLUSIONS In the universal infant vaccination era, the HBV vaccine has shown substantial effectiveness against HBV infection and maintained strong protection for 20 years. It was also associated with reduced risk of all-cause and cancer-related mortality.
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Affiliation(s)
- Wen-Qiang He
- School of Population HealthUniversity of New South Wales SydneySydneyAustralia
| | - Guan Nan Guo
- School of Population HealthUniversity of New South Wales SydneySydneyAustralia
- National Research and DataCancer AustraliaSydneyAustralia
| | - Chenxi Li
- School of Population HealthUniversity of New South Wales SydneySydneyAustralia
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15
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Yu S, Zi X, Zhu Q, Zheng Y, Wu C, Ren H, Liu X, Liu Z, Li Y, Pan Q, Zheng YJ. Accelerating Decreases in the Incidences of Hepatocellular Carcinoma at a Younger Age in Shanghai Are Associated With Hepatitis B Virus Vaccination. Front Oncol 2022; 12:855945. [PMID: 35444933 PMCID: PMC9014260 DOI: 10.3389/fonc.2022.855945] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background Routine vaccination of infants for protecting against hepatitis B virus (HBV) infection and its serious consequences, including hepatocellular cancer (HCC), has been carried out in Shanghai, China, since 1986. We therefore have examined the trend of HBV infection and HCC incidences before and after HBV vaccination over decades to assess the potential influences of the Shanghai HBV vaccination program. Methods Data on incidences of HBV infection and HCC were collected from the Shanghai Cancer Registry and the Shanghai HBV vaccination follow-up study. Joint-point regression and the Bayesian age-period-cohort statistical analysis methods were used. Results The incidences of HBV infection dramatically declined from 23.09 and 1.13 per 100,000 for males and females in 2000 to 3.24 (-85.97%) and 0.22 (-80.53%) per 100,000 in 2014, respectively. Sero-epidemiological data from the sampling surveys during 20 years of follow-up showed that less than 1% of people undergoing HBV vaccination have a positive serum HBsAg. Consistently, the annual adjusted standardization rates (ASR) of HCC steadily fell from 33.38 and 11.65 per 100,000 for males and females in 1973 to 17.34 (-49.2%) and 5.60 (-51.9%) per 100,000 in 2014, respectively. The annual percentage change in overall HCC incidences is about -2%. HCC incidences in males at younger age groups (age <50 years old), particularly in those with age <34 groups, showed an accelerating decrease over time, whereas HCC incidences significantly declined in the female population across all age groups except for those under 19 years of age. The results supported that the universal HBV vaccination in newborns is easy to implement with high coverages and is effective for preventing both HBV infection and HCC in populations.
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Affiliation(s)
- Shunzhang Yu
- School of Public Health, Fudan University, Shanghai, China
| | - Xiaolin Zi
- Departments of Urology and Pharmacology, University of California, Irvine, Irvine, CA, United States
| | - Qirong Zhu
- Children's Hospital, Fudan University, Shanghai, China
| | - Ying Zheng
- Cancer Prevention and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Chunxiao Wu
- Cancer Prevention and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Hong Ren
- Cancer Prevention and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xing Liu
- School of Public Health, Fudan University, Shanghai, China
| | - Zhenqiu Liu
- School of Public Health, Fudan University, Shanghai, China
| | - Yanting Li
- Cancer Prevention and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Qichao Pan
- Cancer Prevention and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ying-Jie Zheng
- School of Public Health, Fudan University, Shanghai, China
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16
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Universal Hepatitis B Antibody Screening and Vaccination in Pregnancy: A Cost-Effectiveness Analysis. Obstet Gynecol 2022; 139:357-367. [PMID: 35115449 DOI: 10.1097/aog.0000000000004652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/04/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To evaluate the cost effectiveness of universal screening for hepatitis B immunity and vaccination among pregnant women in the United States. METHODS We designed a decision-analytic model to evaluate the outcomes, costs, and cost effectiveness associated with universal hepatitis B virus (HBV) immunity screening in pregnancy with vaccination of susceptible individuals compared with no screening. A theoretical cohort of 3.6 million women, the approximate number of annual live births in the United States, was used. Outcomes included cases of HBV, hepatocellular carcinoma, decompensated cirrhosis, liver transplant and death, in addition to cost and quality-adjusted life-years (QALYs). Model inputs were derived from the literature, and the willingness-to-pay threshold was $50,000 per QALY. Univariate sensitivity analyses and Monte Carlo simulation models were performed to evaluate the robustness of the results. RESULTS In a theoretical cohort of 3.6 million women, universal HBV immunity screening and vaccination resulted in 1,702 fewer cases of HBV, seven fewer cases of decompensated cirrhosis, four fewer liver transplants, and 11 fewer deaths over the life expectancy of a woman after pregnancy. Universal screening and vaccination were found to be cost effective, with an incremental cost-effectiveness ratio of $1,890 per QALY. Sensitivity analyses demonstrated the model was robust even when the prevalence of HBV immunity was high and the annual risk of HBV acquisition low. CONCLUSION Among pregnant women in the United States, universal HBV immunity screening and vaccination of susceptible persons is cost effective compared with not routinely screening and vaccinating.
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Effectiveness of Hepatitis B Vaccination Campaign in Italy: Towards the Control of HBV Infection for the First Time in a European Country. Viruses 2022; 14:v14020245. [PMID: 35215839 PMCID: PMC8875306 DOI: 10.3390/v14020245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/19/2022] [Accepted: 01/22/2022] [Indexed: 12/17/2022] Open
Abstract
Background: In 1991, a mass immunization campaign against the hepatitis B virus (HBV) for children and teenagers was introduced in Italy. This study evaluated the impact of the immunization campaign on the incidence and modes of HBV transmission. Method: Acute HBV cases of viral hepatitis were reported to the National Surveillance System (SEIEVA). Hepatitis A cases reported to the same system were used as controls to calculate the adjusted odds ratios and the population attributable risk for potential risk factors. Results: The incidence of acute HBV declined from 5.0 in 1990 to 0.4 in 2019 per 100,000 population. The fall was almost total in people targeted by the campaign: in 2019, zero cases (100% reduction) in the age-group 0–14 years and 0.1 cases per 100,000 population (99.4% reduction) in the age-group 15–24 years were reported. In the decade 2010–2019, nearly one-fifth (19.3%) of cases occurred in foreigners. Intravenous drug use is no longer a risk factor (OR = 0.7; 95% CI = 0.5–1.02). Beauty treatments, risky sexual exposure, and household contact with an HBsAg carrier were found to be independent predictors of acute hepatitis B. Conclusions: The HB vaccination campaign proved effective in minimising acute HBV in Italy. Control of the infection is close to being reached for the first time in Europe.
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18
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Cross-Sectional Association of Urinary Bisphenol A and Vaccine-Induced Immunity against Hepatitis B Virus: Data from the 2003–2014 National Health and Nutrition Examination Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031103. [PMID: 35162124 PMCID: PMC8834708 DOI: 10.3390/ijerph19031103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/01/2022] [Accepted: 01/15/2022] [Indexed: 11/17/2022]
Abstract
Hepatitis B virus (HBV) infection poses a serious health burden; bisphenol A (BPA), a commonly used plasticizer for consumer products, is a potential immune disruptor. However, epidemiologic studies revealing the association between BPA exposure and immunity are limited. This study investigates the association between environmental BPA exposure and immune response following HBV vaccination in a nationally representative sample population. Using National Health and Nutrition Examination Survey data from six cycles, we analyzed the data of 6134 participants, classified as susceptible to HBV infection (n = 3086) or as having vaccine-induced immunity (n = 3048). Associations between BPA level and HBV susceptibility were assessed using multivariable logistic regression and expressed as odds ratios (ORs) of the pooled data and data for each cycle. There was a significant association in the pooled data after adjusting for potential confounders (adjusted OR (aOR): 1.14, 95% confidence interval (CI): 1.05–1.23). However, the associations between BPA concentration and HBV susceptibility were inconsistent across the survey cycles and tended to decrease in more recent cycles. Although this study preliminarily suggests that BPA attenuates the immune response to hepatitis B vaccination, further prospective studies are warranted to elucidate the discrepancies observed.
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19
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AlAteeq MA, AlEnazi LM, AlShammari MS, AlAnazi EE, Al-Hababi FH, Alateeq AM. Long-term Immunity Against Hepatitis B Virus After Routine Immunization Among Adults Visiting Primary Care Centers in Riyadh, Saudi Arabia. Cureus 2022; 14:e21266. [PMID: 35178320 PMCID: PMC8842465 DOI: 10.7759/cureus.21266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 11/17/2022] Open
Abstract
Objective This study aimed to determine the persistence of induced immunity against hepatitis B virus (HBV) among adults routinely vaccinated during their infancy and correlate the level of induced immunity with participant characteristics. Methodology This was a cross-sectional study conducted among visitors to primary care centers of the Ministry of Health (MOH) in Riyadh, the Kingdom of Saudi Arabia (KSA) during the period from August 2020 to January 2021. The study population included healthy adults of both genders who had received full doses of the HBV vaccine in infancy. Data related to participant characteristics were collected using a self-administered questionnaire. A blood sample was then taken from each participant to measure the serum level of hepatitis B surface antigen (HBsAg), antibodies against HBsAg (anti-HBs), and antibodies against hepatitis B core antigen (ani-HBc). Results A total of 400 subjects participated in the study; the mean age of the cohort was 25 years. Almost all of them were Saudis (99.30%), and more than half (57.50%) were males. Only 24.30% had an anti-HBs antibodies level of ≥10 IU/L, and all respondents were negative for HBs antigen. No significant association between participant characteristics and anti-HBs antibody levels was found. Conclusion A decline in immunity many years after HBV vaccinations taken in infancy has been well-documented. However, for low-risk populations, the boosting of HBV vaccines is probably unnecessary since the immune memory provides sufficient protection despite low or undetectable anti-HBs antibodies.
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20
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Beard K, Sriwastava S. Insight in booster COVID-19 vaccine and disease modifying therapy in multiple sclerosis. J Neurol Sci 2021; 430:120034. [PMID: 34688988 PMCID: PMC8523307 DOI: 10.1016/j.jns.2021.120034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/07/2021] [Accepted: 10/15/2021] [Indexed: 01/04/2023]
Affiliation(s)
- Katherine Beard
- School of Medicine, West Virginia University, United States of America,Department of Neurology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States of America
| | - Shitiz Sriwastava
- School of Medicine, West Virginia University, United States of America,Department of Neurology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States of America,West Virginia Clinical and Translational Science Institute, United States of America,Corresponding author at: Department of Neurology, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV 26506, United States of America
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21
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Loyal J, Aragona E. Trends in and Documentation of Refusal of Common Routine Newborn Interventions: 2013-2019. Hosp Pediatr 2021; 11:962-967. [PMID: 34380669 DOI: 10.1542/hpeds.2021-005977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Refusals of intramuscular (IM) vitamin K, ocular prophylaxis, and hepatitis B vaccine (HBV) during the birth hospitalization continue to occur. Refusal of IM vitamin K increases the risk of life-threatening vitamin K deficiency bleeding. Trends in refusal rates and how well clinicians document IM vitamin K refusal is unknown. METHODS We reviewed charts of livebirths admitted to 5 well newborn units from 2013 to 2019. We report trends in rates of refusal and documentation of no IM vitamin K by clinicians during the birth hospitalization and within the first 6 months of life at emergency department (ED) visits. RESULTS Of 67 750 live births, 283 (0.4%) did not receive IM vitamin K, and 1645 (2.4%) did not receive ocular prophylaxis. Rates of IM vitamin K refusal increased slightly over time (P < .05). For HBV, 7551 (11.1%) did not receive the birth dose, but refusal rates decreased from 16.1% to 8.7% (P < .0001). Of 283 newborns who did not receive IM vitamin K, refusal was documented in 49.8% of discharge summaries, 17 (6%) had an invasive procedure without documentation of IM vitamin K administration, and 30 (10.6%) infants <6 months old had ED visits. A total of 4 infants were evaluated for potential bleeding, and there was no documentation about IM vitamin K prophylaxis. CONCLUSION Refusal rates of IM vitamin K and ocular prophylaxis remained low, and uptake of HBV increased over time. Documentation of IM vitamin K refusal by clinicians during the birth hospitalization, before invasive procedures, and in ED visits can be improved.
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Affiliation(s)
- Jaspreet Loyal
- Department of Pediatrics, School of Medicine, Yale University, New Haven, Connecticut
| | - Elena Aragona
- Department of Pediatrics, School of Medicine, Yale University, New Haven, Connecticut
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22
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Gonzalez HC, Trudeau S, Gordon SC. Editorial: Changing trends in the US prevalence of hepatitis B core antibody provide important perspectives into future screening and vaccination strategies. J Infect Dis 2021; 224:747-748. [PMID: 33903913 DOI: 10.1093/infdis/jiab225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Humberto C Gonzalez
- Division of Gastroenterology and Hepatology, Henry Ford Health System, Detroit, Michigan, USA.,Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Sheri Trudeau
- Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA
| | - Stuart C Gordon
- Division of Gastroenterology and Hepatology, Henry Ford Health System, Detroit, Michigan, USA.,Wayne State University School of Medicine, Detroit, Michigan, USA
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23
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Kyuregyan KK, Kichatova VS, Isaeva OV, Potemkin IA, Malinnikova EY, Lopatukhina MA, Karlsen AA, Asadi Mobarhan FA, Mullin EV, Slukinova OS, Ignateva ME, Sleptsova SS, Oglezneva EE, Shibrik EV, Isaguliants MG, Mikhailov MI. Coverage with Timely Administered Vaccination against Hepatitis B Virus and Its Influence on the Prevalence of HBV Infection in the Regions of Different Endemicity. Vaccines (Basel) 2021; 9:vaccines9020082. [PMID: 33498794 PMCID: PMC7912110 DOI: 10.3390/vaccines9020082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 01/26/2023] Open
Abstract
Universal hepatitis B vaccination of newborns was implemented in Russia starting from 1998. From 1998 to 2019, the incidence of acute hepatitis B reduced from 43.8 to 0.57 cases per 100,000 population. Here, we assessed the timely coverage of newborns with the birth dose (HepB-BD), second dose (HepB-2nd), and three vaccine doses (HepB3) in two remote regions of Russia with low (Belgorod Oblast) and high (Yakutia) levels of hepatitis B virus (HBV) endemicity. Vaccination data were obtained from the medical records of 1000 children in Yakutia and 2182 children in Belgorod Oblast. Sera of healthy volunteers from Belgorod Oblast (n = 1754) and Yakutia (n = 1072) across all age groups were tested for serological markers of HBV to assess the infection prevalence and herd immunity. Average HepB-BD coverage was 99.2% in Yakutia and 89.4% in Belgorod Oblast (p < 0.0001) and in both regions varied significantly, from 66% to 100%, between medical centers. The principal reason for the absence of HepB-BD was parent refusal, which accounted for 63.5% of cases of non-vaccination (83/123). While timely HepB-2nd coverage was only 55.4%–64.7%: HepB3 coverage by the age of one year exceeded 90% in both study regions. HBV surface antigen (HBsAg) prevalence in the 1998–2019 birth cohort was 0.2% (95% CI: 0.01–1.3%) in Belgorod Oblast and 3.2% (95% CI: 1.9–5.2%) in Yakutia. The proportion of persons testing negative for both antibodies to HBsAg (anti-HBs) and antibodies to HBV core antigen (anti-HBc) in the 1998–2019 birth cohort was 26.2% (125/481) in Belgorod Oblast and 32.3% (162/501) in Yakutia. We also assessed the knowledge of and attitude towards vaccination among 782 students and teachers of both medical and non-medical specialties from Belgorod State University. Only 60% of medical students knew that hepatitis B is a vaccine-preventable disease. Both medical and nonmedical students, 37.8% and 31.3%, respectively, expressed concerns about safety and actual necessity of vaccination. These data indicate the need to introduce a vaccine delivery audit system, improve medical education with respect to vaccination strategies and policies, and reinforce public knowledge on the benefits of vaccination.
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Affiliation(s)
- Karen K. Kyuregyan
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
- Correspondence:
| | - Vera S. Kichatova
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Olga V. Isaeva
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Ilya A. Potemkin
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Elena Yu. Malinnikova
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Maria A. Lopatukhina
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Anastasia A. Karlsen
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Fedor A. Asadi Mobarhan
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Eugeniy V. Mullin
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Olga S. Slukinova
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Margarita E. Ignateva
- The Sakha Republic (Yakutia) Regional Department of Rospotrebnadzor, 677027 Yakutsk, Russia;
| | - Snezhana S. Sleptsova
- Medical Institute, M.K. Ammosov North-Eastern Federal University, 677010 Yakutsk, Russia;
| | - Elena E. Oglezneva
- Belgorod Regional Department of Rospotrebnadzor, 308023 Belgorod, Russia;
- Medical Faculty, Belgorod State National Research University, 308015 Belgorod, Russia
| | - Elena V. Shibrik
- Department of Health and Social Protection of the Population of Belgorod Region, 308005 Belgorod, Russia;
| | - Maria G. Isaguliants
- Department of Microbiology, Tumor and Cell Biology, Biomedicum, Karolinska Institute, 17165 Solna, Sweden;
- Laboratory of Molecular Pathogenesis of Chronic viral Infections, NF Gamaleja Research Center of Epidemiology and Microbiology, 123098 Moscow, Russia
- Research Department, Riga Stradins University, LV-1007 Riga, Latvia
| | - Mikhail I. Mikhailov
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
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