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Wang Y, Shu M, Chen J, Shen F, Ren H, Yu Y. Hepatitis B immunization status and risk factors of people aged 1 to 69 in Huangpu District, Shanghai, China. Front Public Health 2023; 11:1302183. [PMID: 38179572 PMCID: PMC10766012 DOI: 10.3389/fpubh.2023.1302183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/28/2023] [Indexed: 01/06/2024] Open
Abstract
Background China has long been with high Hepatitis B Virus(HBV) prevalence in the world. The HBV prevalence of people aged 1-59 decreased to less than 8% in 2006, and by 2020, HBsAg positive rate of children aged <5 decreased to less than <1% which was due to the free three-dose hepatitis B(HepB) immunization for newborns nationwide since 2002. Huangpu district was selected as one of the pilot areas for free Hep B vaccination in newborns since 1986, which formed an early protection in the population from mother-to-child transmission. However, the existed HBV infected people were still needed to be discovered, evaluated whether to receive antiviral therapies and intervened with health education in order to reduce the incidence of viral hepatitis related hepatocellular carcinoma (HCC) and also reach the goal to eliminate public health hazards of viral hepatitis by 2030. Objective To know HepB immunization status among people aged 1 to 69 in Huangpu district of Shanghai, and find out risk factors changes of HBV infection. Methods Cross-sectional study was applied to analyze the HepB immunization status and related risk factors by carrying out survey among 706 participants aged 1 to 69 years old. Blood samples were collected for detection of serological HBV markers including hepatitis B surface antigen(HBsAg), hepatitis B surface antibody(HBsAb) and hepatitis B core antibody(HBcAb). Participants with HBsAg positive were required to complete additional examinations such as alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin, albumin, globulin, liver fibroscan and liver ultrasound. Results For participants aged 1 to 14, the positive rate of HBsAg, HBsAb and HBcAb was 0.00, 50.00 and 30.46%, respectively. The HBsAb positive rate reached a peak of 90.91% at 2 years old, and then showed a significant downward trend (χ2 = 55.612, p < 0.001). All the participants have completed three-dose Hep B vaccination, however for the second dose, those who vaccinated 30 days later than the appointed time(aged one month) got higher HBcAb prevalence than those who vaccinated on time(χ2 = 5.87, p = 0.015). Two mothers were found HBsAg positive, but there was no significant difference in children's HBcAb positive rates regardless of the mothers' HBsAg results. For participants aged 15 to 69, the positive rate of HBsAg, HBsAb and HBcAb was 4.21, 44.25 and 49.23%, respectively. Multivariate analysis for HBcAb positive among people aged 15 to 69 showed that age(50-69) and HBsAb positive were the risk factors for HBcAb positive(p < 0.05). Higher education was the protective factor for HBcAb positive(p < 0.05). After the screening for HBsAg, 22 participants were tested HBsAg positive and required additional examinations, and a total of 12 completed all the examinations. One participant was recognized as active HBV infection without antivirus treatment. Among the 12 participants, 2 have received antiviral treatment before and 4 had a history of HBV infection in family members. Conclusion In this study, HBsAg positive rate of those who aged 1 to 14 was 0.00%, which indicated that the HepB immunization has achieved a lot in protecting children from being infected. However, failing to get timely Hep B vaccination could be an influencing factor for HBcAb positive in children. As a result, additional tests for HBV DNA could be done to specify an HBV infection and more attention should be paid to the timeliness of Hep B vaccination in the next step. The HBcAb positive rate of people aged 1 to 69 was relatively higher than that of other provinces. Despite of the limited participants with full examinations, we should still put emphasis on HBV treatment and the possibility of transmission within families.
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Affiliation(s)
- Yijun Wang
- Department of Viral Hepatitis Prevention and Molecular Biology Laboratory, Huangpu District Center for Disease Control and Prevention, Shanghai, China
| | - Min Shu
- Department of Viral Hepatitis Prevention and Molecular Biology Laboratory, Huangpu District Center for Disease Control and Prevention, Shanghai, China
| | - Jun Chen
- Department of Viral Hepatitis Prevention and Molecular Biology Laboratory, Huangpu District Center for Disease Control and Prevention, Shanghai, China
| | - Fujie Shen
- Department of Viral Hepatitis Prevention and Molecular Biology Laboratory, Huangpu District Center for Disease Control and Prevention, Shanghai, China
| | - Hong Ren
- Department of Viral Hepatitis Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Yongfu Yu
- Department of Biostatistics, Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory for Health Technology Assessment, National Commission of Health, School of Public Health, Fudan University, Shanghai, China
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Zhou YH. Optimal Management in Preventing Mother-to-Infant Transmission of Hepatitis B: More Requires to Be Done. Clin Gastroenterol Hepatol 2020; 18:755-756. [PMID: 32063267 DOI: 10.1016/j.cgh.2019.04.068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 04/29/2019] [Accepted: 04/29/2019] [Indexed: 02/07/2023]
Affiliation(s)
- Yi-Hua Zhou
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
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Wen X, Su H, Wang Y, Pu Z, Gao J, Ji Z, Yuan X, Li X, Zhang W, Zhang L, Long Y, Yan Y, Shao Z. Prevalence and natural course of occult hepatitis B virus infection in residents of 2 communities of Wuwei City, Gansu Province, China. J Viral Hepat 2018; 25:281-288. [PMID: 29032635 DOI: 10.1111/jvh.12805] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 08/02/2017] [Indexed: 12/14/2022]
Abstract
Occult hepatitis B infection (OBI) is characterized by serum hepatitis B surface antigen (HBsAg) negative and hepatitis B virus (HBV) DNA positive (HBsAg-/HBV DNA+). Occult hepatitis B infection in community-based populations has been scarcely investigated, and OBI outcomes remain unclear, especially in Wuwei, a region located in Northwest China. This region is one of the areas in China that has the highest prevalence of chronic HBV infection. A prospective study was performed in the general population of 2 towns of Wuwei from June 2011 to May 2014. A questionnaire was used to collect demographic and medical data, and serum samples were collected from the participants and stored until analysis. DNA was detected using quantitative PCR (qPCR) or nested PCR, the HBV DNA from HBV DNA-positive or possible positive (below the detection limit) subjects was extracted and amplified by nested PCR, and the PCR products were sequenced. Sequence analysis was performed using the Mega 6.0 program and CLC sequence viewer software. Hepatitis B virus DNA was detected in 90 of 3,080 HBsAg-negative subjects, and the prevalence of OBI in the study population was 2.92% (90/3,080, 95% CI: 2.33%-3.51%). Hepatitis B virus genomes in 51 of 80 objects (63.75%) contained mutations in the "a" determinant of HBsAg. After 2 years follow-up, 42 of 90 HBV DNA of OBI subjects remained positive, and the natural clearance rate of OBI subjects was 53.3%. Occult hepatitis B infection prevalence in this cohort was much lower than chronic HBV infection in the same region. HBV DNA was cleared in most OBI subjects during the 2 year period. Our data suggest that some OBI may represent a late stage of resolving the HBV infection process.
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Affiliation(s)
- X Wen
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China
| | - H Su
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China
| | - Y Wang
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China
| | - Z Pu
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China
| | - J Gao
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China
| | - Z Ji
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China
| | - X Yuan
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China
| | - X Li
- Center of disease control Of Wuwei, Gansu province, China
| | - W Zhang
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China
| | - L Zhang
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China
| | - Y Long
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China
| | - Y Yan
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China
| | - Z Shao
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China
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Zhao H, Zhou YH. Revaccination against hepatitis B in late teenagers who received vaccination during infancy: Yes or no? Hum Vaccin Immunother 2017; 14:456-463. [PMID: 29083945 PMCID: PMC5806661 DOI: 10.1080/21645515.2017.1397243] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The significance of vaccination against hepatitis B during infancy is recognized worldwide, however, whether booster or revaccination after a period of time following the primary vaccination is required remains controversial. Recently, cross-sectional epidemiological surveys found that HBsAg prevalence in subjects born after the implementation of mass vaccination was increased with age, which was attributed to waning of anti-HBs over time. However, comprehensive analysis of the closely related cross-sectional surveys showed that the age-specific increased HBsAg prevalence was more likely associated with the carry-over of the infection occurred in early life, likely due to imperfect coverage of hepatitis B vaccination at the beginning of its introduction. Latest studies showed that booster response could be observed in the majority of individuals vaccinated 30 years ago. Moreover, confirmed breakthrough HBV infection with severe consequences in successfully vaccinated individuals is extremely rare. Thus far no compelling evidence has been acquired to support booster vaccination in adolescence. The uncertainty regarding the duration of protection of hepatitis B vaccination, especially beyond 30 years after the primary vaccination, merits a systematically designed study to follow the same cohort of participants longitudinally, which differs from the cross-sectional studies reported previously, can hopefully offer more direct evidence to help us to determine whether revaccination of hepatitis B vaccine is necessary.
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Affiliation(s)
- Hong Zhao
- a Department of Infectious Diseases , The Second Hospital of Nanjing, The Second Affiliated Hospital of Southeast University , Nanjing , Jiangsu , China
| | - Yi-Hua Zhou
- b Departments of Laboratory Medicine and Infectious Diseases , Nanjing Drum Tower Hospital and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School , Nanjing , Jiangsu , China
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Ghoma Linguissi LS, Nkenfou CN. Epidemiology of viral hepatitis in the Republic of Congo: review. BMC Res Notes 2017; 10:665. [PMID: 29197421 PMCID: PMC5712139 DOI: 10.1186/s13104-017-2951-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 11/21/2017] [Indexed: 02/06/2023] Open
Abstract
Objective Considered an endemic zone, Republic of Congo has a high seroprevalence rate of hepatitis B and C virus. To know the extent of hepatitis infection as a public health problem, we reviewed published literature and other sources for reports of these viral infections in the country. Results High seroprevalence of HBV and HCV carriage in blood donors were observed in studies confirming Congo’s place in the hyperendemic area of HBV and HCV infection. These prevalence were compared by Chi square test. We compared the prevalence of three studies conducted in 1996, 2015 and 2016. The statistical results were very significant. HBV genotype E was most prevalent. Very few studies were done on pregnant women. Difficulties in the care and management of patients were also noted because of the high cost of often unavailable treatments. Difficulties arise, however, when an attempt was made to implement the National Hepatitis Control Program. Despite studies conducted on hepatitis prevalence, health interventions are still needed to care and manage these patients and the need to implement the national hepatitis control is more pressing in the Congo.
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Affiliation(s)
| | - Celine Nguefeu Nkenfou
- Chantal Biya International Reference Centre for Research on Prevention and Management on HIV and AIDS, Yaounde, Cameroon.,Higher Teachers Training College, University of Yaounde I, Yaounde, Cameroon
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Zhou S, Li T, Allain JP, Zhou B, Zhang Y, Zhong M, Fu Y, Li C. Low occurrence of HBsAg but high frequency of transient occult HBV infection in vaccinated and HBIG-administered infants born to HBsAg positive mothers. J Med Virol 2017; 89:2130-2137. [PMID: 28543299 DOI: 10.1002/jmv.24861] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 05/01/2017] [Indexed: 01/05/2023]
Affiliation(s)
- Shan Zhou
- Department of Transfusion Medicine; Southern Medical University; Guangzhou China
| | - Tingting Li
- Department of Transfusion Medicine; Southern Medical University; Guangzhou China
| | - Jean-Pierre Allain
- Department of Transfusion Medicine; Southern Medical University; Guangzhou China
- Department of Hematology; University of Cambridge; Cambridge United Kingdom
| | - Bin Zhou
- Department of Infectious Diseases; Nanfang Hospital; Southern Medical University; Guangzhou China
| | - Yuming Zhang
- Department of Paediatrics; Nanfang Hospital; Southern Medical University; Guangzhou China
| | - Mei Zhong
- Department of Obstetrics and Gynecology; Nanfang Hospital; Southern Medical University; Guangzhou China
| | | | - Chengyao Li
- Department of Transfusion Medicine; Southern Medical University; Guangzhou China
- School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou China
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Lin X, Yang J, Lu H, Zhou Y, Zhou G, Wu H, Xu C, Wu Q, Liu J, Chen S, Yang M, Gu G, Hu Y, Zhou YH. Minimization of hepatitis B infection among children in Jiangsu, China, 12years after integration of hepatitis B vaccine into the expanded program on immunization. Vaccine 2016; 34:6458-6463. [PMID: 27866767 DOI: 10.1016/j.vaccine.2016.11.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 10/12/2016] [Accepted: 11/07/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND China has integrated hepatitis B vaccine into the Expanded Program on Immunization since 2002. We aimed to survey the seroprevalence of and immunity to hepatitis B virus (HBV) in children born from 2002 to 2014 in Jiangsu, China. METHODS Totally 3442 children (M:F=2072:1370) at the age of 7months to 12years (5.5±3.6), from five cities and rural areas across Jiangsu province, were enrolled. Blood samples were measured for HBV markers by ELISA and quantitative microparticle enzyme immunoassay. HBV DNA was tested by real-time PCR and S region was amplified by nested PCR. RESULTS Twelve (0.35%) children were positive for hepatitis B surface antigen (HBsAg) and 34 (0.99%) were HBsAg negative and positive for antibody against hepatitis B core antigen (anti-HBc). Totally 2542 (73.85%) children had anti-HBs levels ⩾10mIU/ml and 535 (15.54%) with 2-9.9mIU/ml. All 12 HBsAg-positive children had detectable HBV DNA with a mean level of 6.1±1.7logIU/ml (3.3-8.1logIU/ml); 8 were genotype C and 4 were genotype B. No mutation was detected in the a determinant of HBsAg. HBV DNA was not detected in all the 34 children with positive anti-HBc and negative HBsAg. CONCLUSION HBsAg prevalence among children in Jiangsu born after the introduction of universal vaccination against hepatitis B has significantly decreased. No mutation of S gene is associated with vaccine failure in the cohort of children.
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Affiliation(s)
- Xiaoqian Lin
- Department of Obstetrics and Gynecology, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Jishi Yang
- Department of Obstetrics and Gynecology, Taixing People's Hospital, Taixing 225400, China
| | - Huixia Lu
- Department of Laboratory Medicine, Zhongda Hospital, Southeast University, School of Medicine, Nanjing 210009, China
| | - Yulin Zhou
- Department of Infectious Diseases, Yixing People's Hospital, Yixing 214200, China
| | - Guiping Zhou
- Department of Laboratory Medicine, Yixing Second People's Hospital, Yixing 214221, China
| | - Huiyi Wu
- Department of Laboratory, Lianyungang First People's Hospital, Lianyungang 222002, China
| | - Chenyu Xu
- Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang 212001, China
| | - Qiaozhen Wu
- Department of Obstetrics and Gynecology, Mingji Hospital, Nanjing 210021, China
| | - Jingli Liu
- Department of Experimental Medicine, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Shanshan Chen
- Department of Experimental Medicine, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Muyi Yang
- Department of Obstetrics and Gynecology, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Guangyu Gu
- Department of Experimental Medicine, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Yali Hu
- Department of Obstetrics and Gynecology, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing 210008, China.
| | - Yi-Hua Zhou
- Department of Experimental Medicine, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing 210008, China; Department of Infectious Diseases, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
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Zhou YH. Occult hepatitis B virus infection, or occult cross-contamination, in children of HBsAg-positive mothers. J Viral Hepat 2016; 23:830. [PMID: 27333952 DOI: 10.1111/jvh.12559] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 05/12/2016] [Indexed: 12/09/2022]
Affiliation(s)
- Y-H Zhou
- Departments of Experimental Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China. .,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China.
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