Predictive value of maternal HBeAg, anti-HBcIgM and HBV DNA in perinatal transmission of hepatitis B virus

Profile of hepatitis C virus and the possible modes of transmission of the virus in the Gizan area of Saudi Arabia: a community-based study

The seroprevalence of antibody to hepatitis C virus (anti-HCV) and the possible modes of transmission of HCV were investigated in Gizan, southern Saudi Arabia. The sample size chosen to give an adequate estimate of the seroprevalence, about 1500, was based on the assumption that 5% of the population in Gizan were anti-HCV-positive. Sera from 1482 subjects (705 males, 777 females; aged > or = 10 years) were initially screened for anti-HCV using a commercial, ubiquitin-based enzyme immunoassay. Repeatedly reactive sera were confirmed positive using second-generation immunoassays. Serum samples were also tested by ELISA for hepatitis B surface antigen (HbsAg) and antibodies to this antigen and to the hepatitis B core antigen. Of the subjects tested, 27 (1.8%) were anti-HCV-positive. Exposure to HCV was generally similar in both sexes, age-prevalence curves for anti-HCV peaking in males aged > 49 years (6.2%) and in females aged 40-49 years (5.0%). In the youngest subjects, those aged 10-19 years, the HbsAg carrier rate was significantly higher in males (10.4%) than in females (3.6%). Exposure to the hepatitis B virus was similar in both sexes (31.0% in males v. 28.6% in females). Some 7.4% and 14.8% of the 27 anti-HCV-positive cases had histories of schistosomiasis and blood transfusion, respectively. The corresponding values for the 1455 anti-HCV-negative cases investigated, 1.1% for schistosomiasis and 3.5% for blood transfusion, were much lower. The spouses and other family members of eight anti-HCV-positive index cases were investigated but none was anti-HCV-positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Intrafamilial transmission of hepatitis C virus (HCV): a major mode of spread in the Saudi Arabia population

Age-specific prevalence of antibody to hepatitis C virus (anti-HCV) was studied in 831 Saudis (441 males, 390 females; 1-53 years old) from Al Baha region, south-west Saudi Arabia. There was a gradual exposure to HCV early in life with a gradual increase with age, reaching a peak of 5.3% in the 30-40 years age group. The overall prevalence was 3.6% and 3.1% in males and females, respectively, with no statistical difference. Comparison of positivity in family members of seven anti-HCV-positive index cases (15/44) with those of five anti-HCV-negative index cases (2/44) showed a statistically significant association (chi 2 10.5 with Yates' correction). This points to intrafamilial transmission of HCV as a route of spread among the Saudi population.

Intrafamilial clustering of hepatitis B virus (HBV) infection: study of 10 Saudi families

In order to evaluate the extent of intrafamilial clustering of hepatitis B virus (HBV) infection, serological tests for evidence of HBV infection were performed on family members of 10 Saudi children who were found to be HBs Ag-positive. The overall prevalences of carriers (HBs Ag-positive) and exposure (presence of any HBV marker) in the 89 siblings were 17.9 and 34.8%, respectively. In siblings of families where the mother was a carrier, exposure to HBV (51.6%) was higher (chi 2 = 1.99, P = 0.15) than in siblings of families where only the father was a carrier (31.4%) and significantly higher (chi 2 = 5.24, P = 0.02) than in siblings of families where neither of the parents was a carrier but both had previous exposure to HBV infection (17.4%). Our data indicate that mainly horizontal and perhaps perinatal transmission could account for this relatively high level of intrafamilial clustering of HBV infection in Saudi families. These results are important for the development of a strategy for controlling HBV infection in Saudi Arabia and perhaps in similar HBV endemic areas.

Combined immunoprophylaxis in the prevention of perinatal transmission of hepatitis B and hepatitis D virus infections in Saudi children

The efficacy of the combined immunoprophylaxis approach (passive plus active immunization) was evaluated in babies born to 52 HBsAg-carrier Saudi mothers, of whom seven (13.5%) were HBeAg-positive and seven were anti-HDV-positive. Newborns were given 100 IU of hepatitis B immune globulin (HBIG) from the Hepuman Berna-Swiss Serum and Vaccine Institute, Berne, and hepatitis B vaccine (5 micrograms) within 12 hours of birth, and the vaccine was given again at 1 and 6 months of age (5 micrograms/injection). After 18 months of follow-up, all but one baby had protective levels of antibody to HBsAg and none of the babies born to anti-HDV-positive carrier mothers showed evidence of HDV infection. These results show that the combined immunoprophylaxis approach is quite successful in protecting against perinatal transmission of HBV and HDV in the Saudi population. Furthermore, early vaccination against HBV will also protect against HDV infection later in life.

Baseline seroepidemiology of hepatitis B virus infection in two Saudi high-risk groups: patients on haemodialysis and patients with congenital bleeding disorders

Because background seroepidemiological data are required before nationwide vaccination against hepatitis B virus (HBV) is attempted, the rate of exposure to HBV was investigated in two high-risk Saudi groups: patients on haemodialysis and patients with congenital bleeding disorders. Although the HBsAg carrier rate was higher in patients with congenital bleeding disorders (11.1%) than in patients on haemodialysis (4.6%), the exposure rate to HBV was similar in both groups (38.8%-44.5%). Because of this high exposure rate it seems cost-effective, at least in the Saudi population or in countries which are endemic for HBV, to screen for HBV markers before vaccination against HBV is recommended.

Perinatal transmission of hepatitis B virus-associated hepatitis D virus

Sera from 185 HBsAg carrier, pregnant Saudi women were tested for HBeAg, antibody to HBeAg (anti-HBe) and for antibody to hepatitis D virus (anti-HDV); 9.7% of the carrier mothers were anti-HDV-positive and the majority of them (94.4%) were anti-HBe-positive. Follow-up of 17 infants of anti-HDV-positive carrier mothers until about 7 months of age showed no evidence of perinatal transmission of HDV. Age-specific prevalence of anti-HDV in 280 Saudi carriers showed that infection with HDV is infrequent in infants and is mainly acquired during the second and third decades of life, which suggests that transmission of HDV is predominantly horizontal.