New data concerning the epidemiology of Hepatitis B virus infection in Greece

Microbiota and Gut-Liver Axis: An Unbreakable Bond?

The gut microbiota, amounting to approximately 100 trillion (1014) microbes represents a genetic repertoire that is bigger than the human genome itself. Evidence on bidirectional interplay between human and microbial genes is mounting. Microbiota probably play vital roles in diverse aspects of normal human metabolism, such as digestion, immune modulation, and gut endocrine function, as well as in the genesis and progression of many human diseases. Indeed, the gut microbiota has been most closely linked to various chronic ailments affecting the liver, although concrete scientific data are sparse. In this narrative review, we initially discuss the basic epidemiology of gut microbiota and the factors influencing their initial formation in the gut. Subsequently, we delve into the gut-liver axis and the evidence regarding the link between gut microbiota and the genesis or progression of various liver diseases. Finally, we summarise the recent research on plausible ways to modulate the gut microbiota to alter the natural history of liver disease.

Prevalence of Hepatitis B Serum Markers in Young Military Recruits in Greece: A Comparison Study between 2005 and 2019 Cohorts

Background: The prevalence of hepatitis B varies (HBV) among countries. Although an overall reduction has been described in Greece, data are limited. Methods: We reviewed the HBsAg/anti-HBc/anti-HBs seroprevalence among military recruits and compared data between 2005 and 2019. The study included 2001 (group 1) and 1629 (group 2) male recruits in 2019 and 2005, respectively. Age and descent were recorded. Results: The prevalence of HBsAg, anti-HBc and anti-HBs positivity in group1 vs. group 2 was estimated as: 0.2%, 1.3% and 67% vs. 0.4%, 1.6% and 62%, respectively. Only anti-HBs positivity achieved a statistically significant difference between the two groups (p = 0.007). HBsAg and anti-HBc were more frequently positive in non-Greeks than in Greeks (9/237 (4%) vs. 2/3393 (0.06%), p < 0.001), (26/237 (11%) vs. 26/3393 (0.8%), p < 0.001 respectively), while anti-HBs was more frequently positive in Greeks than in non-Greeks (84/164 (51%) vs. 1461/2213 (66%), p < 0.001). Conclusions: Our data suggest a further reduction in HBV prevalence in Greece about 20 years after the adoption of the National HBV Immunization Program, with Greek participants experiencing a more effective HBV Immunization Program than non-Greeks.

New strains of hepatitis B virus genotype E circulating in Nigeria

OBJECTIVE

Hepatitis B virus (HBV) is not uncommon among persons infected with human immunodeficiency virus (HIV). Severity of HBV infection and treatment outcome are associated with specific HBV genotypes. No study has reported the types of HBV genotypes circulating among HIV-infected subjects in Nigeria. This study was designed to determine the prevalence of HBV, as well as its genotypic distribution among HIV-infected subjects in Benin City, Nigeria.

METHODS

Whole blood was collected from a total of 564 HIV-infected and 250 apparently healthy HIV-negative subjects. Serodiagnosis of HBV infection was done using an immunochromatographic kit. Detection of HBV-DNA and sequencing of amplicons were done using standard molecular techniques.

RESULTS

HIV status was not significantly associated with HBV seroinfection (HIV vs. non-HIV: 4.6% vs. 4.0%; odds ratio = 1.168, 95% confidence interval = 0.550, 2.444, and P = 0.854). HIV-infected subjects were observed to have an insignificantly (P = 0.645) higher prevalence of true HBV infection than their non-HIV-infected counterparts (HIV positive vs. HIV negative: 23.1% vs. 10.0%). All patients with true HBV infection were found to harbor HBV genotype E, which did not cluster around other HBV genotype E.

CONCLUSION

This study reports novel strains of HBV genotype E circulating in Nigeria.

Hepatitis B immunopathogenesis and immunotherapy

Worldwide there are over 248 million chronic carriers of HBV of whom about a third eventually develop severe HBV-related complications. Due to the major limitations of current therapeutic approaches, the development of more effective strategies to improve therapeutic outcomes in chronic hepatitis B (CHB) patients seems crucial. Immune activation plays a critical role in spontaneous viral control; therefore, new modalities based on stimulation of the innate and adaptive immune responses could result in the resolution of infection and are promising approaches. Here, we summarize the HBV immunopathogenesis, and discuss the encouraging results obtained from the promising immune-based innovations, such as therapeutic vaccination, cytokine therapy, cell-based therapies and blocking inhibitory receptors, as current and future immunotherapeutic interventions.

Hepatitis B virus infection and waste collection: prevalence, risk factors, and infection pathway

BACKGROUND

Waste collectors have a potential risk of infectious diseases. The aim of the study was to assess; the prevalence of hepatitis B (HBV), risk factors for infection and possible ways of virus transmission among municipal solid waste workers (MSWWs) in a municipality of central Greece.

METHODS

A cross-sectional study was conducted among the employees of a municipality in Central Greece. The prevalence of an HBV infection biological marker (anti-Hbc) and its association with exposure to waste, socio-demographic factors, and history of occupational injuries with sharp objects/needle sticks was examined among 208 employees.

RESULTS

The prevalence of HBV infection among the municipal waste collectors was 23%. Logistic regression analysis showed that exposure to waste (OR = 4.05;95%CI = 1.23-13.33) and age (OR = 5.22;95% CI = 1.35-20.1) were independently associated with the anti-Hbc positivity. Moreover, waste collectors who reported occupational injuries with needle sticks were at higher risk of HBV infection (RR = 2.64; 95% CI = 1.01-6.96).

CONCLUSIONS

Occupational exposure to waste is a possible risk factor for HBV infection. Occupational injury with sharp instruments could be a means of hepatitis B virus transmission. Immunization of MSWWs and adoption of more safe ways for waste collection could be considered in order to control the risk of HBV infection.

Hepatitis B and C among women with illegal social behavior in Isfahan, Iran: Seroprevalence and associated factors

BACKGROUND

In Iran, there is limited evidence on the prevalence of hepatitis B and C viruses (HBV and HCV) among females who engage in illegal sexual behavior.

OBJECTIVES

To determine the prevalence of HBV and HCV infections and their associated factors in this population in Isfahan-Iran.

PATIENTS AND METHODS

In this cross-sectional study, 100 females who engaged in illegal sexual behavior during 2009-2010 in Isfahan were recruited from welfare to the DIC for women, and referrals were made among those who knew others who engaged in prostitution. Markers for HBV and HCV-Ab were measured by ELISA, and recombinant immunoblot assay was used for confirmation of HCV infection. Also, a questionnaire on demographics and prostitution-associated risk data in a face-to-face interview was completed for each participant. Chi-square and multivariate logistic regression models were used for data analysis.

RESULTS

Of the 100 samples collected, 91 were sufficient for testing. The mean age and time spent in sex work were 30.84 ± 9.34 years and 36 ± 28.5 months, respectively. HBsAg was detected in 1 (1.1%), anti-HBc in 4 (4.4%), anti-HBs in 60 (65.9%), and HCV Ab in 9 (9.9%) subjects. The evidence of vaccination was seen in 54 subjects (59.3%). There were no significant differences in the prevalence of HBV or HCV infection by estimated risk factors, and there was no independent risk factor for these infections.

CONCLUSIONS

The high prevalence of HCV infection in this study indicates the need to implement preventive interventions for female sex workers and, perhaps more importantly, to involve their male clients.

Prevalence of occult hepatitis B virus infection in haemodialysis patients from central Greece

AIM: To assess the hepatitis B virus (HBV)-DNA and the prevalence of occult HBV infection in end-stage renal failure (ESRF) patients from Central Greece.

METHODS: Sera from 366 ESRF patients attending five out of six dialysis units from Central Greece were investigated for HBV-DNA by real-time polymerase chain reaction. Only serum samples with repeatedly detectable HBV-DNA were considered positive. IgG antibodies to hepatitis C virus (anti-HCV) were tested by a third generation enzyme linked immunosorbent assay (ELISA), while IgG antibodies to hepatitis E virus (anti-HEV) were tested by two commercially available ELISAs.

RESULTS: HBV-DNA was detected in 15/366 patients (4.1%) and HBsAg in 20/366 (5.5%). The prevalence of occult HBV infection was 0.9% (3/346 HBsAg-negative patients). Occult HBV was not associated with a specific marker of HBV infection or anti-HCV or anti-HEV reactivity. There was no significant difference in HBV-DNA titres, demographic and biochemical features, between patients with occult HBV infection and those with HBsAg-positive chronic HBV infection.

CONCLUSION: In central Greece, 4% of ESRF patients had detectable HBV-DNA, though in this setting, the prevalence of occult HBV seems to be very low (0.9%).