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Safadi R. The liver in Greco-Arabic and Islamic medicine. Clin Liver Dis (Hoboken) 2024; 23:e0137. [PMID: 38576470 PMCID: PMC10994509 DOI: 10.1097/cld.0000000000000137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/09/2023] [Indexed: 04/06/2024] Open
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Hamdiui N, Buskens V, van Steenbergen JE, Kretzschmar MEE, Rocha LEC, Thorson AE, Timen A, Wong A, van den Muijsenbergh M, Stein ML. Clustering of chronic hepatitis B screening intentions in social networks of Moroccan immigrants in the Netherlands. BMC Public Health 2020; 20:344. [PMID: 32183757 PMCID: PMC7077096 DOI: 10.1186/s12889-020-8438-x] [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: 07/26/2019] [Accepted: 02/28/2020] [Indexed: 12/05/2022] Open
Abstract
Background Early detection, identification, and treatment of chronic hepatitis B through screening is vital for those at increased risk, e.g. born in hepatitis B endemic countries. In the Netherlands, Moroccan immigrants show low participation rates in health-related screening programmes. Since social networks influence health behaviour, we investigated whether similar screening intentions for chronic hepatitis B cluster within social networks of Moroccan immigrants. Methods We used respondent-driven sampling (RDS) where each participant (“recruiter”) was asked to complete a questionnaire and to recruit three Moroccans (“recruitees”) from their social network. Logistic regression analyses were used to analyse whether the recruiters’ intention to request a screening test was similar to the intention of their recruitees. Results We sampled 354 recruiter-recruitee pairs: for 154 pairs both participants had a positive screening intention, for 68 pairs both had a negative screening intention, and the remaining 132 pairs had a discordant intention to request a screening test. A tie between a recruiter and recruitee was associated with having the same screening intention, after correction for sociodemographic variables (OR 1.70 [1.15–2.51]). Conclusions The findings of our pilot study show clustering of screening intention among individuals in the same network. This provides opportunities for social network interventions to encourage participation in hepatitis B screening initiatives.
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Affiliation(s)
- Nora Hamdiui
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, RIVM/LCI, Postbus 1 (Postbak 13), 3720, BA, Bilthoven, The Netherlands. .,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. .,Radboud University Medical Center, Radboud Institute for Health Sciences , Department of Primary and Community Care, Nijmegen, The Netherlands.
| | - Vincent Buskens
- Department of Sociology/ICS, Utrecht University, Utrecht, The Netherlands
| | - Jim E van Steenbergen
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, RIVM/LCI, Postbus 1 (Postbak 13), 3720, BA, Bilthoven, The Netherlands.,Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
| | - Mirjam E E Kretzschmar
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Luis E C Rocha
- Department of Economics & Department of Physics and Astronomy, Ghent University, Ghent, Belgium
| | - Anna E Thorson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Aura Timen
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, RIVM/LCI, Postbus 1 (Postbak 13), 3720, BA, Bilthoven, The Netherlands.,Athena Institute for Research on Innovation and Communication in Health and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Albert Wong
- Department of Statistics, Informatics and Modeling, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Maria van den Muijsenbergh
- Pharos: Dutch Centre of Expertise on Health Disparities, Program Prevention and Care, Utrecht, The Netherlands.,Radboud University Medical Center, Radboud Institute for Health Sciences , Department of Primary and Community Care, Nijmegen, The Netherlands
| | - Mart L Stein
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, RIVM/LCI, Postbus 1 (Postbak 13), 3720, BA, Bilthoven, The Netherlands
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Abstract
Abstract
Background: The risk of mother to child transmission of hepatitis B virus (HBV) is recognized worldwide, a reason for which the World Health Organization aims to reduce this public health issue of major concern in the next ten years. The aim of our study was to detect circulating HBV genotypes in a selected population of pregnant women, as scientific evidence to recommend personalized antiviral therapy and to obtain updated epidemiological information.
Methods: HBsAg positive pregnant women were selected by the National Institute of Public Health Romania. Blood samples were collected after signing the informed consent. The HBV genotypes were tested by INNO LiPA HBV genotyping method.
Results. The D genotype was detected in 9/18 (50%) patients, genotype A in 3/18 (16.7%), and genotype F in 3/18 (16.7%) patients. Three patients had double infection, 11 had unique infection, and 4 had no detectable genotype.
Conclusion. This study confirmed the results of previous studies regarding HBV genotype circulation in our country, with the mention that F genotype was a new one for our area. These data are useful from an epidemiological point of view and also for therapeutical reasons, as it is known that therapy should be genotype guided.
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Hamdiui N, Stein ML, van der Veen YJJ, van den Muijsenbergh METC, van Steenbergen JE. Hepatitis B in Moroccan-Dutch: a qualitative study into determinants of screening participation. Eur J Public Health 2019; 28:916-922. [PMID: 29346542 PMCID: PMC6148971 DOI: 10.1093/eurpub/cky003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Chronic hepatitis B (HBV) leads to an increased risk for liver cirrhosis and liver cancer. In the Netherlands, chronic HBV prevalence in the general population is 0.20%, but 3.77% in first generation immigrants. Our aim was to identify determinants associated with the intention to participate in HBV testing among first generation Moroccan immigrants, one of the two largest immigrant groups targeted for screening. Methods Semi-structured interviews were held with first (n = 9) and second generation (n = 10) Moroccan-Dutch immigrants, since second generation immigrants frequently act as their parents’ brokers in healthcare. Results Most participants had little knowledge about hepatitis B, but had a positive attitude towards screening. Facilitators for screening intention were perceived susceptibility to and severity of disease, positive attitude regarding prevention, wishing to know their hepatitis B status and to prevent potential hepatitis B transmission to others. Additional cultural facilitators included fear (of developing cancer), and existing high health care utilization; a religious facilitator was the responsibility for one’s own health and that of others. Barriers included lack of awareness and knowledge, practical issues, not having symptoms, negative attitude regarding prevention, fear about the test result and low-risk perception. A cultural barrier was shame and stigma, and a religious barrier was fatalism. Conclusion We identified important facilitators and barriers, which we found, can be interpreted differently. Specific and accurate information should be provided, accompanied by strategies to address shame and stigma, in which Islamic religious leaders could play a role in bringing information across.
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Affiliation(s)
- Nora Hamdiui
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mart L Stein
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Maria E T C van den Muijsenbergh
- Program Prevention and Care, Pharos: Dutch Centre of Expertise on Health Disparities, Utrecht, The Netherlands.,Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jim E van Steenbergen
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
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5
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Kmet Lunaček N, Poljak M, Matičič M. Distribution of hepatitis B virus genotypes in Europe and clinical implications: a review. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2018. [DOI: 10.15570/actaapa.2018.28] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hamdiui N, Stein ML, Timen A, Timmermans D, Wong A, van den Muijsenbergh METC, van Steenbergen JE. Hepatitis B in Moroccan-Dutch: a quantitative study into determinants of screening participation. BMC Med 2018; 16:47. [PMID: 29598817 PMCID: PMC5877391 DOI: 10.1186/s12916-018-1034-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 03/09/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND In November 2016, the Dutch Health Council recommended hepatitis B (HBV) screening for first-generation immigrants from HBV endemic countries. However, these communities show relatively low attendance rates for screening programmes, and our knowledge on their participation behaviour is limited. We identified determinants associated with the intention to request an HBV screening test in first-generation Moroccan-Dutch immigrants. We also investigated the influence of non-refundable costs for HBV screening on their intention. METHODS Offline and online questionnaires were distributed among first- and second/third-generation Moroccan-Dutch immigrants using respondent-driven sampling. Random forest analyses were conducted to determine which determinants had the greatest impact on (1) the intention to request an HBV screening test on one's own initiative, and (2) the intention to participate in non-refundable HBV screening at €70,-. RESULTS Of the 379 Moroccan-Dutch respondents, 49.3% intended to request a test on their own initiative, and 44.1% were willing to attend non-refundable screening for €70,-. Clarity regarding infection status, not having symptoms, fatalism, perceived self-efficacy, and perceived risk of having HBV were the strongest predictors to request a test. Shame and stigma, fatalism, perceived burden of screening participation, and social influence of Islamic religious leaders had the greatest predictive value for not intending to participate in screening at €70,- non-refundable costs. Perceived severity and possible health benefit were facilitators for this intention measure. These predictions were satisfyingly accurate, as the random forest method retrieved area under the curve scores of 0.72 for intention to request a test and 0.67 for intention to participate in screening at €70,- non-refundable costs. CONCLUSIONS By the use of respondent-driven sampling, we succeeded in studying screening behaviour among a hard-to-reach minority population. Despite the limitations associated with correlated data and the sampling method, we recommend to (1) incorporate clarity regarding HBV status, (2) stress the risk of an asymptomatic infection, (3) emphasise mother-to-child transmission as the main transmission route, and (4) team up with Islamic religious leaders to help decrease elements of fatalism, shame, and stigma to enhance screening uptake of Moroccan immigrants in the Netherlands.
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Affiliation(s)
- Nora Hamdiui
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. .,Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Mart L Stein
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Aura Timen
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Danielle Timmermans
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands.,National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Albert Wong
- Department of Statistics, Informatics and Mathematical Modelling, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Maria E T C van den Muijsenbergh
- Pharos: Dutch Centre of Expertise on Health Disparities, Program Prevention and Care, Utrecht, The Netherlands.,Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jim E van Steenbergen
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
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Roman S, Panduro A. HBV endemicity in Mexico is associated with HBV genotypes H and G. World J Gastroenterol 2013; 19:5446-5453. [PMID: 24023487 PMCID: PMC3761097 DOI: 10.3748/wjg.v19.i33.5446] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 06/15/2013] [Accepted: 07/19/2013] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B virus (HBV) genotypes have distinct genetic and geographic diversity and may be associated with specific clinical characteristics, progression, severity of disease and antiviral response. Herein, we provide an updated overview of the endemicity of HBV genotypes H and G in Mexico. HBV genotype H is predominant among the Mexican population, but not in Central America. Its geographic distribution is related to a typical endemicity among the Mexicans which is characterized by a low hepatitis B surface antigen seroprevalence, apparently due to a rapid resolution of the infection, low viral loads and a high prevalence of occult B infection. During chronic infections, genotype H is detected in mixtures with other HBV genotypes and associated with other co-morbidities, such as obesity, alcoholism and co-infection with hepatitis C virus or human immunodeficiency virus. Hepatocellular carcinoma prevalence is low. Thus, antiviral therapy may differ significantly from the standard guidelines established worldwide. The high prevalence of HBV genotype G in the Americas, especially among the Mexican population, raises new questions regarding its geographic origin that will require further investigation.
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Hepatitis B screening: who to target? A French sexually transmitted infection clinic experience. J Hepatol 2013; 58:690-7. [PMID: 23220369 DOI: 10.1016/j.jhep.2012.11.044] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 11/21/2012] [Accepted: 11/28/2012] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Hepatitis B virus (HBV) infection is a major public health burden in France and worldwide. Routine screening for hepatitis B is not currently recommended in France. Medical experts and public health agencies opinions can differ concerning targeting criteria. Our study aims at developing a risk assessment strategy for identifying possible hepatitis B cases among the patients consulting in a French Sexually Transmitted Infection (STI) clinic. METHODS 6194 asymptomatic patients requesting an STI screening were also screened for hepatitis B infection. The association between hepatitis B surface antigen (HBsAg) positivity and/or total hepatitis B core antibody (anti-HBc) positivity and self-reported risk factors for hepatitis were analysed. RESULTS Only male gender, lack of employment, and birth, in medium or high endemic country, were independently associated with HBsAg positivity in multivariate analysis. Sexual behaviour or self-reported vaccination status is therefore not necessary to target high-risk populations. These three simple criteria could save 25% of unnecessary tests and 6-16% undiagnosed hepatitis B compared to usual targeting criteria. CONCLUSIONS To detect HBsAg carriers, only three simple targeting criteria, without taking into account the self-reported vaccination status or sexual behaviour, could improve screening efficiency and save unnecessary testing.
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Mota A, Guedes F, Areias J, Pinho L, Cardoso MF. Perfil epidemiológico e genotípico da infecção pelo vírus da hepatite B no Norte de Portugal. Rev Saude Publica 2010; 44:1087-93. [DOI: 10.1590/s0034-89102010000600014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Accepted: 05/02/2010] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVO: Descrever o perfil epidemiológico e genotípico da infecção crônica pelo vírus da hepatite B na Região Norte de Portugal. MÉTODOS: Foram incluídos 358 indivíduos oriundos das consultas de especialidade que apresentavam resultados positivos para o antígeno da hepatite B durante pelo menos seis meses em dois hospitais do Norte de Portugal em 2008 e 2009. Os dados foram obtidos a partir dos processos clínicos, determinações laboratoriais feitas quando da genotipagem do vírus, ecografia e/ou ultra-sonografia e biópsia hepática. As características demográficas, marcadores víricos, carga viral e genótipos, e severidade da doença hepática foram avaliadas e comparadas entre sexos. RESULTADOS: Os genótipos A e D predominaram. A transmissão intrafamiliar ocorreu predominantemente nas mulheres. Um terço das mulheres apresentava ingestão alcoólica superior a 20 g/dia, aumentando para 58,9% nos homens. A ausência do AgHBe foi semelhante nos dois sexos (p = 0,662). Os parâmetros bioquímicos em geral apresentaram-se com valores mais altos nos homens, assim como nos estágios necro-inflamatório e de esteatose hepática (p = 0,003). CONCLUSÕES: As diferenças relativas às vias de transmissão da infecção pelo vírus da hepatite B entre homens e mulheres podem ser conseqüência de comportamentos de risco associadas ao género. A ingestão excessiva de álcool é predominante nos indivíduos do sexo masculino, assim como maior severidade da doença hepática em relação às mulheres.
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Affiliation(s)
- Ana Mota
- Universidade do Porto, Portugal; Hospital de Santo António, Portugal
| | | | - Jorge Areias
- Hospital de Santo António, Portugal; Universidade do Porto, Portugal
| | - Luciana Pinho
- Hospital de Santo António, Portugal; Universidade do Porto, Portugal
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Servant-Delmas A, Mercier M, El Ghouzzi MH, Girault A, Bouchardeau F, Pillonel J, Laperche S. National survey of hepatitis B virus (HBV) polymorphism in asymptomatic HBV blood donors from 1999 to 2007 in France. Transfusion 2010; 50:2607-18. [DOI: 10.1111/j.1537-2995.2010.02725.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Veldhuijzen IK, Toy M, Hahné SJM, De Wit GA, Schalm SW, de Man RA, Richardus JH. Screening and early treatment of migrants for chronic hepatitis B virus infection is cost-effective. Gastroenterology 2010; 138:522-30. [PMID: 19879275 DOI: 10.1053/j.gastro.2009.10.039] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Revised: 10/09/2009] [Accepted: 10/19/2009] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIMS Persons with chronic hepatitis B virus (HBV) infection are at risk of developing cirrhosis and hepatocellular carcinoma. Early detection of chronic HBV infection through screening and treatment of eligible patients has the potential to prevent these sequelae. We assessed the cost-effectiveness in The Netherlands of systematically screening migrants from countries that have high and intermediate HBV infection levels. METHODS Epidemiologic data of the expected numbers of patients with active chronic HBV infection in the target population and information about the costs of a screening program were used in a Markov model and used to determine costs and quality-adjusted life years (QALY) for patients who were and were not treated. RESULTS Compared with the status quo, a 1-time screen for HBV infection can reduce mortality of liver-related diseases by 10%. Using base case estimates, the incremental cost-effectiveness ratio (ICER) of screening, compared with not screening, is euros (euro) 8966 per QALY gained. The ICER ranged from euro7936 to euro11,705 based on univariate sensitivity analysis, varying parameter values of HBV prevalence, participation rate, success in referral, and treatment compliance. Using multivariate sensitivity analysis for treatment effectiveness, the ICER ranged from euro7222 to euro15,694; for disease progression, it ranged from euro5568 to euro60,418. CONCLUSIONS Early detection and treatment of people with HBV infection can have a large impact on liver-related health outcomes. Systematic screening for chronic HBV infection among migrants is likely to be cost-effective, even using low estimates for HBV prevalence, participation, referral, and treatment compliance.
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Affiliation(s)
- Irene K Veldhuijzen
- Division of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands.
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12
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Abstract
Hepatitis B virus (HBV) is one of the most widely distributed viruses that infect humankind. Distinct clinical and virological characteristics of the HBV-infection have been reported in different geographical parts of the world and are increasingly associated with genetic diversity of the infecting virus. HBV is classified into genotypes and subgenotypes that are associated with ethnicity and geography. The genetic diversity of HBV in its various aspects has been the subject of extensive investigations during the last few decades. Since molecular epidemiology research tools have become widely available, the number of new publications in this field has grown exponentially. This review summarises the recent publications on the geographical distribution of genetic variants of HBV, and proposes updated criteria for the identification of new genotypes and subgenotypes of the virus.
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Affiliation(s)
- Fuat Kurbanov
- Department of Clinical Molecular Informative Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
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13
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Mota A, Guedes F, Areias J, Pinho L, Cardoso MF. Epidemiological study of genotypes of hepatitis B virus in northern Portugal. J Med Virol 2009; 81:1170-6. [DOI: 10.1002/jmv.21526] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Hahne S, Wormann T, Kretzschmar M. Migrants and hepatitis B: new strategies for secondary prevention needed. Eur J Public Health 2009; 19:439. [DOI: 10.1093/eurpub/ckp066] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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15
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Vorsters A, Van Herck K, Van Damme P. The clock is running,…. Vaccine 2009; 27:2905-6. [DOI: 10.1016/j.vaccine.2009.01.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Accepted: 01/29/2009] [Indexed: 10/21/2022]
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16
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Veldhuijzen IK, Mes THM, Mostert MC, Niesters HGM, Pas SD, Voermans J, de Man RA, Götz HM, van Doornum GJJ, Richardus JH. An improved approach to identify epidemiological and phylogenetic transmission pairs of source and contact tracing of hepatitis B. J Med Virol 2009; 81:425-34. [PMID: 19152416 DOI: 10.1002/jmv.21413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The transmission of infectious diseases can be traced using epidemiological and molecular information. In the current study, the congruence was assessed between sequence data of the hepatitis B virus (HBV) and epidemiological information resulting from source and contact tracing of patients seen at the Municipal Public Health Service in Rotterdam between 2002 and 2005. HBV genotypes A-G were present in 62 acute and 334 chronic HBV patients. At the sequence level, the identical sequences of members of epidemiological transmission pairs and the rarity of such pairs provided strong support for correctness of the hypothesized transmission routes. The molecular support for epidemiological transmission pairs derived from source and contact tracing was further assessed by using topological constraints in parsimony analyses in agreement with epidemiological information, and by taking the presence of polymorphic sites of HBV within patients into account. This, in principle, allows mutations in epidemiological clusters. Of 22 epidemiological clusters, six could be refuted, four clusters received support from the molecular analysis, and support for the remaining twelve clusters was ambiguous. Two of the four epidemiological pairs that received molecular support had diverged (by 3 and 15 mutations). These results show that levels of divergence cannot be used simply as an indicator of the likelihood that groups of sequences constitute transmission pairs. Instead, to confirm or refute transmission pairs, it is necessary to assess the likelihood of a common origin of HBV variants in epidemiologically defined transmission groups relative to the HBV diversity in the local community.
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Affiliation(s)
- Irene K Veldhuijzen
- Division of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands.
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Kretzschmar M, Mangen MJ, van de Laar M, de Wit A. Model based analysis of hepatitis B vaccination strategies in the Netherlands. Vaccine 2009; 27:1254-60. [DOI: 10.1016/j.vaccine.2008.12.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2008] [Revised: 12/03/2008] [Accepted: 12/09/2008] [Indexed: 10/21/2022]
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18
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Sonder GJB, van Rijckevorsel GGC, van den Hoek A. Risk of hepatitis B for travelers: is vaccination for all travelers really necessary? J Travel Med 2009; 16:18-22. [PMID: 19192123 DOI: 10.1111/j.1708-8305.2008.00268.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Behavioral studies in travelers suggest that 33% to 76% of all travelers to hepatitis B virus (HBV)-endemic countries are at risk for HBV infection. We study the incidence and risk factors for HBV infection in travelers. METHODS Retrospective analysis of the characteristics and risk factors of all reported acute HBV patients in Amsterdam, the Netherlands, from January 1, 1992, until December 31, 2003. RESULTS The estimated incidence in travelers from Amsterdam to HBV-endemic countries is 4.5/100,000 travelers. Two thirds of these patients were immigrants who lived in Amsterdam and who had visited their friends and relatives in their country of origin. In 12 years, only three Dutch short-term tourists contracted HBV while traveling, all by heterosexual contacts. CONCLUSIONS Dutch tourists who travel to HBV-endemic countries run a very low risk of contracting HBV. Vaccination of short-term Dutch tourists is not necessary. Immigrants run a higher risk irrespective of travel or duration of travel. This group should be advised vaccination.
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Affiliation(s)
- Gerard J B Sonder
- Public Health Service Amsterdam, Department of Infectious Diseases, Amsterdam, The Netherlands.
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19
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Panessa C, Hill WD, Giles E, Yu A, Harvard S, Butt G, Andonov A, Krajden M, Osiowy C. Genotype D amongst injection drug users with acute hepatitis B virus infection in British Columbia. J Viral Hepat 2009; 16:64-73. [PMID: 19192159 DOI: 10.1111/j.1365-2893.2008.01045.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The eight genotypes of hepatitis B virus (HBV) exhibit distinct geographical distributions. This study identified HBV genotypes and transmission modes associated with acute infection in British Columbia (BC), Canada, from 2001 to 2005. Seventy cases of acute HBV in BC were identified from laboratory reports using a standardized case definition. Interviews for risk factors and hepatitis history were conducted for each case. HBV genotypes were determined by BLAST comparison analysis of the surface (S) or preS gene sequence. To illustrate the distribution of genotypes identified amongst acute cases in BC, an annotated map was produced showing the global occurrence of HBV genotypes. The majority of acute HBV cases occurred in Caucasian, Canadian-born males, with 30% of cases reporting injection drug use (IDU) and 21% reporting incarceration. The most common genotype observed was genotype D (62.9%), followed by genotypes A (18.6%), C (11.4%), B (4.3%), and E (1.4%). A significant association was observed between Genotype D and IDU (P = 0.0025) and previous incarceration (P = 0.0067). Phylogenetic analysis of the S gene sequence demonstrated identical or high genetic relatedness amongst genotype D viral strains (86% sub-genotype D3), thus verifying transmission clustering amongst BC injection drug users. The association between acute HBV genotype and reported transmission modes has not been previously described in North America. Tracking of genotypes can help identify disease transmission patterns and target at-risk populations for preventive immunization.
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Affiliation(s)
- C Panessa
- BC Centre for Disease Control, Vancouver, BC, Canada
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Abstract
OBJECTIVES A representative serosurveillance study (1995) resulted in an estimate of 0.2% for the HBsAg prevalence in the Netherlands. Some risk groups, especially migrants, were not well represented in the study, which probably led to an underestimation of the true HBsAg prevalence. The aim of this study was to calculate an adjusted HBsAg prevalence estimate for the total Dutch population including these risk groups. METHODS According to their country of origin first-generation migrants (FGM) were classified into groups with low, intermediate and high prevalence using data from the WHO and Statistics Netherlands. The number of chronic HBsAg carriers in different age and population groups was estimated based on studies about age-specific prevalence in different countries. The number of carriers in the indigenous population was estimated using the serosurveillance study. A combination of these estimates led to an estimate of the total prevalence rate in the Netherlands. RESULTS Nearly 10% of the Dutch population are FGM. Of these, about 18% were born in low-endemic, 71% in middle-endemic and 11% in high-endemic countries. The overall prevalence of HBsAg in FGM is estimated to be at 3.77%. Combining these results with the results of the serosurveillance study the HBsAg prevalence in the Dutch population is estimated to be between 0.32 and 0.51%, and when including injecting drug users and mentally handicapped persons the prevalence rates are 0.36 and 0.55%, respectively. CONCLUSION Our results show the high importance of targeting migrants and their close contacts adequately in screening programmes, vaccination and treatment for chronic hepatitis B.
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