Epidemic hepatitis B: a sustained outbreak in a large military population

Molecular evolution and genomics of hepatitis B virus subgenotype C2 strain predominant in the chronic patients in Bangladesh

Evolution of hepatitis B virus (HBV) is a mystery and caused mainly by genomic mutations as well as recombination. Viral evolution may be responsible for increasing disease severity and render resistance to the existing treatment processes. HBV/C2 strain is associated with chronicity, which may progress to the liver cirrhosis and hepatocellular carcinoma. Furthermore, HBV/C2 strain is highly prevalent in the chronic hepatitis B patients in Bangladesh. Hence, the molecular evolution of that strain and its disease pattern need to be uncovered. Herein, the purpose of this study is to determine the potential mutations of HBV complete genome sequences isolated in Bangladesh and the molecular evolution of HBV/C2 strain. Mutation analysis of the total 57 complete genome sequences of HBV in Bangladesh revealed that 42.11%, 12.28%, 7.02% and 3.51% of the strains were vaccine resistant, HBsAg detection escape, HBV immunoglobulin escape, multi-drug resistant respectively. Furthermore, of the vaccine resistant strains, 16.67% were observed resistant to both vaccine, HBsAg detection and immunoglobulin escape. Bayesian skyline analysis with 462 HBV/C2 strains from 2000 to 2017 revealed the evolution of the strain was in nineteenth century with two rapid sharp increases in the genetic diversity at the end of the twentieth century and then a sudden decrease in the early twenty-first century as observed in C and X gene analysis. This study may help researchers and clinicians to get a better knowledge about the emergence and evolution of HBV/C2 strain that may help to find a proper treatment strategy against hepatitis B.

The military and hepatitis B

Hepatitis B virus (HBV) is an important cause of morbidity in military forces. HBV threatens a safe blood supply for mass casualties, contributes to rising health care costs and presents an occupational risk to health care workers. The susceptibility of soldiers reflects that of other residents of their country of origin. In intermediate and high-prevalence regions, infections usually occur in young adults and follow exposure to an HBV carrier through blood or sexual contact. Control of HBV infections must rely on education regarding risk factors, screening of blood donors and immunization. Military populations provide unique opportunities for studying the epidemiology of hepatitis B and carrying out mass vaccination programmes.

Epidemiology of viral hepatitis among US Navy and Marine Corps personnel, 1984-85

Six hundred and twenty-nine cases of viral hepatitis (A, B, and NonA-NonB) were reported among a total of 768,832 United States Navy and Marine Corps personnel during 1984 and 1985 via a passive surveillance system. Cumulative incidence for all three hepatitis types was higher than those reported for the general population at the same time. Hepatitis B was the most common diagnosis within all sex, rank, and race/ethnic description categories. Enlisted medical personnel (hospital corpsmen) had a disproportionately higher incidence of hepatitis B.

A study of street heroin lots for the presence of the hepatitis B surface antigen

Hepatitis B surface antigen (HBsAg) of subtype ay predominates among narcotic addicts infected with hepatitis B virus (HBV) in Europe, Australia and the United States. However, the ad subtype predominates among the non-addict carriers of HBsAg. We investigated the possibility that heroin lots were contaminated with HBV at a source of opium production, the Middle East, a geographical region where HBsAg/ay predominates in the general population. One hundred and nine lots of street heroin were assayed for HBsAg by radioimmunoassay. None of the lots tested was reproduceably HBsAg positive. These results suggest that the heroin itself is not responsible for the high incidence of HBV infection or for the predominance of HBsAg/ay in the addict population. The predominance of HBsAg/ay among addicts in Europe and Australia as well as the United States might be due to extensive needle sharing among a mobile population of drug abusers, although such worldwide dissemination of one subtype by these means is unlikely.

Hepatitis B antigen and antibody in the U.S. Army: prevalence in health care personnel

The prevalence of Hepatitis B surface antigen (HB(S)Ag) and antibody (anti-HB(S)) seropositivity and the association of seropositivity with demographic, personal health, and professional experiences were studied in a cohort of Army Medical Department officer personnel. Serologic evidence of Hepatitis B infection was found in 5.0 per cent of personnel and was associated with age, sex, place of birth, history of hepatitis, history of blood transfusion, and previous overseas assignments. Seropositivity rates were higher for patient care oriented officer personnel, especially for those in surgical specialties, and rose with increasing professional experience. These data present a composite of risk factors operative in the acquisition of Hepatitis B seropositivity and identify a cohort for prospective study.

Persistence of antibody to hepatitis B surface antigen

Sera from military personnel found to have antibodies to hepatitis B surface antigen (anti-HBS) in an epidemiological study of a hepatitis B outbreak were tested for persistence of that antibody 1 year later. Initially, 64% of the anti-HBS-positive sera reacted in passive hemagglutination tests with erythrocytes coated with hepatitis B surface antigen of both ayw and adw subtypes; the remaining sera reacted only with adw-coated erythrocytes (19%) or ayw-coated erythrocytes (17%). After 1 year, anti-HBS was detectable by passive hemagglutination tests in 87% of individuals with initial antibody to both subtypes but in only 41% and 16% (P less than 0.001) of those initially reacting only to adw- or ayw-coated erythrocytes, respectively. Seropositivity for anti-HBS correlated best with history of contact with jaundiced people (20.3%) and duty in Asia.