Epidemiology of occult hepatitis B and C in Africa: A systematic review and meta-analysis

The hidden epidemic of occult hepatitis B and C among injection drug users (IDUs): A call for action

Objective

This study aims to determine the prevalence of Occult Hepatitis B and C Infections among Egyptian injection drug users (IDUs) and identify key risk factors contributing to their occurrence within this high-risk group.

Methods

In this cross-sectional study, 200 Egyptian IDUs were assessed. Participants were negative for Hepatitis B surface antigen and hepatitis C virus (HCV) RNA, with anti-HCV positive patients who achieved sustained virologic response after treatment included. Quantitative polymerase chain reaction (PCR) was used to detect HCV RNA in plasma and peripheral blood mononuclear cells, while HBV DNA was identified via nested PCR. Comparisons were made between Occult Hepatitis B infection (OBI) positive and OBI negative subgroups, as well as between other comprehensive income (OCI) positive and OCI negative subgroups. A significance level of 0.05 was set, with P-values below this indicating statistical significance. Statistical comparisons between OBI and OCI-positive and negative groups were performed using the Mann-Whitney U test and Chi-square test.

Results

OBI was found in 32% of IDUs, while OCI was detected in 42% of IDUs, and was present in 53.6% of seropositive individuals. All OBI patients showed a significant increase in all liver function tests, while OCI patients had significant elevations in alanine transaminase and aspartate transaminase values. HIV coinfection was identified in 39.1% and 26.1% of OBI and OCI cases respectively. OBI and OCI coinfection were detected in 31 patients.

Conclusion

Hidden infections such as OBI and OCI remain an overlooked public health issue in Egypt's IDU population. These findings highlight the need for targeted strategies to address these reservoirs of infection and could inform similar approaches in countries with comparable HBV/HCV epidemiology.

Global prevalence of occult HBV infection in children and adolescents: A systematic review and meta-analysis

INTRODUCTION AND OBJECTIVES

Occult HBV infection (OBI) is a specific form of hepatitis B virus (HBV) infection and has the possibility of developing into hepatocellular carcinoma (HCC) in adults. This study aimed to estimate the global prevalence of occult HBV infection in children and adolescents.

MATERIALS AND METHODS

We systematically searched PubMed, Embase, Web of Science, and Cochrane databases for relevant studies on the prevalence of OBI in children and adolescents. Meta-analysis was performed using STATA 16 software.

RESULTS

Fifty studies were included. The overall prevalence of OBI in children and adolescents was 7.5% (95% CI: 0.050-0.103). In different risk populations, OBI prevalence was remarkably high in the HIV-infected population (24.2%, 95% CI: 0.000-0.788). The OBI prevalence was 0.8% (95% CI:0.000-0.029) in the healthy population, 3.8% (95% CI:0.012-0.074) in the general population, and 6.4% (95% CI: 0.021-0.124) in children born to HBsAg-positive mothers. Based on different serological profiles, the prevalence of OBI in HBsAg-negative and anti-HBc-positive patients was 6.6% (95% CI: 0.016-0.136), 3.0% (95% CI: 0.009-0.059) in HBsAg-negative and anti-HBc-negative patients, 4.6% (95% CI: 0.015-0.088) in HBsAg-negative and anti-HBs-positive patients, and 3.7% (95% CI: 0.001-0.102) in HBsAg-negative and anti-HBs-negative patients.

CONCLUSIONS

Despite HBV vaccination and hepatitis B immunoglobulin (HBIG), OBI is common in children and adolescents in high-risk groups.

A Meta-Analysis of the Association Between Genetic Polymorphisms in IL-12, IL-17, and IL-21 and Risk of Hepatitis B Virus Infection

Cytokine imbalance is an important feature in the occurrence and outcome of hepatitis B virus (HBV). Single nucleotide polymorphisms (SNPs) within cytokine genes may affect the protein expression and eventually contribute to the susceptibility of HBV infection. The association between interleukin (IL)-12, IL-17, or IL-21 and the risk of HBV infection has been extensively studied, but yielding equivocal results. The aim of this meta-analysis was to determine the impact of SNPs in IL-12, IL-17, and IL-21 on the risk of HBV infection. We retrieved studies evaluating whether SNPs in IL-12, IL-17, and IL-21 influenced HBV infection from electronic databases, including PUBMED, Web of Science, EBOCO, OVID, and Embase. Summarized odds ratios (ORs) and confidence intervals (CIs) were calculated using STATA software. Under a homozygous comparison, the IL-12A rs568408 was associated with an increased risk of HBV infection in both overall analysis (OR = 1.68, 95% CI, 1.12-2.53) and Caucasians (OR = 1.80, 95% CI, 1.14-2.84). Under a dominant genetic model, the similarly higher risk was also observed in overall analysis (OR = 3.62, 95% CI, 3.08-4.24), Caucasians (OR = 3.29, 95% CI, 2.67-4.05), high-quality studies (OR = 3.29, 95% CI, 2.61-4.14), and low-quality studies (OR = 3.95, 95% CI, 3.17-4.93). Although no significant association was observed between IL-17A rs2275913 and the risk of HBV infection in overall comparison, subgroup analysis revealed that the IL-17A rs2275913 AA genotype was associated with a reduced risk in Asians (OR = 0.72, 95% CI, 0.57-0.91) and high-quality studies (OR = 0.71, 95% CI, 0.55-0.92). However, no significant association of IL12B rs3212227, IL-17A rs2275913, IL-21 rs2221903, and rs907715 with HBV infection was observed. In conclusion, we provide evidence that IL-12A rs568408 was associated with an increased risk of HBV infection and IL-17A rs2275913 AA genotype was a protective factor against HBV infection in Asians.