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Wang C, Zhang S, Zhao J, Wang M, Lu QB, Liu B, Du J, Cui F. Changes and gaps of global and regional disease burden of hepatitis B infection in children younger than 5 years old between 2015 and 2019: A real-world data review. J Med Virol 2023; 95:e29241. [PMID: 38010806 DOI: 10.1002/jmv.29241] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/11/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023]
Abstract
Hepatitis B virus (HBV) infection has been declared an ongoing health threat, especially infections among children. We compared and updated the disease burden of HBV infection and the effectiveness of vaccination among children younger than 5 years to offer indications for hepatitis B prevention across the world. The country-level data on the prevalence of hepatitis B surface antigen (HBsAg), the coverages of hepatitis B vaccine birth-dose (HepB-BD), three-dose series (HepB3), income level, population density/size, and human development index were collected from open access databases including WHO, UNICEF, and World Bank. Comparison of the prevalence of HBsAg under 5 years old between 2015 and 2019 based on vaccination coverages was conducted by the gamma generalized linear mixed model. Globally, more than 6.3 million HBV infections were estimated in children under 5 years in 2019, compared to 10.1 million in 2015 within the 179 countries involved. The pooled average prevalence of HBsAg among children younger than 5 years decreased from 1.4% (95% confidence interval [CI]: 1.1-1.8) to 0.9% (95% CI: 0.7-1.2). The rate difference or rate ratio was -0.5% (95% CI: -0.6% to -0.3%) or 0.51(95% CI: 0.44-0.58), respectively. Countries from the African region or with lower income/population density/human development indexes bore the most significant disease burden of hepatitis B. Higher coverages of hepatitis B vaccine birth-dose or primary series correlated with significant HBsAg prevalence decreases and much-decreased ratio, independently. Hepatitis B prevention among children under 5 years has significantly been achieved while remaining the most life-threatening disease burden, unequally distributed worldwide. The hepatitis B vaccination should be prioritized for all newborns, especially in those resource-constrained countries or regions.
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Affiliation(s)
- Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
- Global Center for Infectious Disease and Policy Research, Peking University, Beijing, China
| | - Sihui Zhang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Jun Zhao
- Global Center for Infectious Disease and Policy Research, Peking University, Beijing, China
| | - Mingting Wang
- Global Center for Infectious Disease and Policy Research, Peking University, Beijing, China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
- Global Center for Infectious Disease and Policy Research, Peking University, Beijing, China
| | - Juan Du
- Global Center for Infectious Disease and Policy Research, Peking University, Beijing, China
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
- Global Center for Infectious Disease and Policy Research, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, China
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Cacciola I, Pitrone C, Franzè MS, Mazzeo C, Muscianisi M, Porcari S, Pintabona G, Morace C, Basile G, Cucinotta E, Pollicino T, Raimondo G. Prevalence of hepatitis B and C viral infections in hospitalized patients with increased liver enzyme levels and with no known history of hepatic disease. Ann Hepatol 2022; 27 Suppl 1:100578. [PMID: 34752948 DOI: 10.1016/j.aohep.2021.100578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 05/27/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Identification of asymptomatic hepatitis B virus (HBV) and hepatitis C virus (HCV) carriers is fundamental to reach the World Health Organization objective to eradicate viral hepatitis. The aim of this study was to evaluate the HBV and HCV prevalence among patients hospitalized for a non-liver-related disease but showing increased liver enzyme values. PATIENTS AND METHODS All consecutive patients without history of hepatic disease but showing increased amino-transferase and/or gamma-glutamil-transpeptidase levels at admission to the Internal Medicine and Surgery divisions of the Messina University Hospital from 1st January to 31st December 2019 ("study group") were tested for HBV surface antigen (HBsAg) and anti-HCV antibody. Analogously, HBsAg and anti-HCV were tested for in all the individuals with normal liver enzyme values consecutively admitted from October 1st to December 31st, 2019 ("control group"). RESULTS Of the 332 "study group" patients, 13 (3.9%) were anti-HCV positive versus 5/306 (1.6%) patients of the "control group" (p=0.008). HCV RNA was detected in 11/13 and in 0/5 anti-HCV patients of the "study group" and "control group", respectively (p=0.001). HBsAg was detected in 5 (1.5%) "study group" patients and in none of the "control group" (p=0.03). Prevalence of diabetes, arterial hypertension, and dyslipidaemia was comparable between the two groups, whereas 75/332 (22.3%) patients of the "study group" and 34/306 (11.1%) patients of the "control group" drank > 2 alcohol units/day (p < 0.001). CONCLUSION Testing HBsAg and anti-HCV in subjects showing increased liver enzyme values may represent an efficacious tool to identify asymptomatic carriers of hepatitis virus infections.
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Affiliation(s)
- Irene Cacciola
- Department of Clinical and Experimental Medicine, University of Messina and University Hospital of Messina, Italy; Division of Medicine and Hepatology, University of Messina and University Hospital of Messina, Italy
| | - Concetta Pitrone
- Department of Clinical and Experimental Medicine, University of Messina and University Hospital of Messina, Italy; Division of Medicine and Hepatology, University of Messina and University Hospital of Messina, Italy
| | - Maria Stella Franzè
- Department of Clinical and Experimental Medicine, University of Messina and University Hospital of Messina, Italy; Division of Medicine and Hepatology, University of Messina and University Hospital of Messina, Italy
| | - Carmelo Mazzeo
- Division of Emergency Surgery, University of Messina and University Hospital of Messina, Italy
| | - Marco Muscianisi
- Division of Internal Medicine, University of Messina and University Hospital of Messina, Italy
| | - Serena Porcari
- Department of Clinical and Experimental Medicine, University of Messina and University Hospital of Messina, Italy; Division of Medicine and Hepatology, University of Messina and University Hospital of Messina, Italy
| | - Giusy Pintabona
- Division of Emergency Surgery, University of Messina and University Hospital of Messina, Italy
| | - Carmela Morace
- Division of Internal Medicine, University of Messina and University Hospital of Messina, Italy
| | - Giorgio Basile
- Division of Geriatrics, University of Messina and University Hospital of Messina, Italy
| | - Eugenio Cucinotta
- Division of Emergency Surgery, University of Messina and University Hospital of Messina, Italy; Department of Human Pathology, University of Messina and University Hospital of Messina, Italy
| | - Teresa Pollicino
- Department of Human Pathology, University of Messina and University Hospital of Messina, Italy; Laboratory of Molecular Hepatology University of Messina and University Hospital of Messina, Italy.
| | - Giovanni Raimondo
- Department of Clinical and Experimental Medicine, University of Messina and University Hospital of Messina, Italy; Division of Medicine and Hepatology, University of Messina and University Hospital of Messina, Italy.
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Sperle I, Nielsen S, Bremer V, Gassowski M, Brummer-Korvenkontio H, Bruni R, Ciccaglione AR, Kaneva E, Liitsola K, Naneva Z, Perchemlieva T, Spada E, Toikkanen SE, Amato-Gauci AJ, Duffell E, Zimmermann R. Developing and Piloting a Standardized European Protocol for Hepatitis C Prevalence Surveys in the General Population (2016-2019). Front Public Health 2021; 9:568524. [PMID: 34123980 PMCID: PMC8193123 DOI: 10.3389/fpubh.2021.568524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 04/28/2021] [Indexed: 12/09/2022] Open
Abstract
Background: A robust estimate of the number of people with chronic hepatitis C virus (HCV) infection is essential for an appropriate public health response and for monitoring progress toward the WHO goal of eliminating viral hepatitis. Existing HCV prevalence studies in the European Union (EU)/European Economic Area (EEA) countries are heterogeneous and often of poor quality due to non-probability based sampling methods, small sample sizes and lack of standardization, leading to poor national representativeness. This project aimed to develop and pilot standardized protocols for undertaking nationally representative HCV prevalence surveys in the general adult population. Methods: From 2016 to 2019 a team from the Robert Koch-Institute contracted by the European Centre for Disease Prevention and Control synthesized evidence on existing HCV prevalence surveys and survey methodology and drafted a protocol. The methodological elements of the protocol were piloted and evaluated in Bulgaria, Finland and Italy, and lessons learnt from the pilots were integrated in the final protocol. An international multidisciplinary expert group was consulted regularly. Results: The protocol includes three alternative study approaches: a stand-alone survey; a "nested" survey within an existing health survey; and a retrospective testing survey approach. A decision algorithm advising which approach to use was developed. The protocol was piloted and finalized covering minimum and gold standards for all steps to be implemented from sampling, data protection and ethical issues, recruitment, specimen collection and laboratory testing options, staff training, data management and analysis and budget considerations. Through piloting, the survey approaches were effectively implemented to produce HCV prevalence estimates and the pilots highlighted the strengths and limitations of each approach and key lessons learnt were used to improve the protocol. Conclusions: An evidence-based protocol for undertaking HCV prevalence serosurveys in the general population reflecting the different needs, resources and epidemiological situations has been developed, effectively implemented and refined through piloting. This technical guidance supports EU/EEA countries in their efforts to estimate their national hepatitis C burden as part of monitoring progress toward the elimination targets.
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Affiliation(s)
- Ida Sperle
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- Charité, Universitätsmedizin Berlin, Berlin, Germany
| | | | - Viviane Bremer
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Martyna Gassowski
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | - Roberto Bruni
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | | | - Elena Kaneva
- Regional Health Inspectorate, Stara Zagora, Bulgaria
| | - Kirsi Liitsola
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Enea Spada
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | - Salla E. Toikkanen
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Erika Duffell
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Ruth Zimmermann
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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French hepatitis C care cascade: substantial impact of direct-acting antivirals, but the road to elimination is still long. BMC Infect Dis 2020; 20:759. [PMID: 33059617 PMCID: PMC7559725 DOI: 10.1186/s12879-020-05478-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/05/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) elimination by 2030, as targeted by the World Health Organization (WHO), requires that 90% of people with chronic infection be diagnosed and 80% treated. We estimated the cascade of care (CoC) for chronic HCV infection in mainland France in 2011 and 2016, before and after the introduction of direct-acting antivirals (DAAs). METHODS The numbers of people (1) with chronic HCV infection, (2) aware of their infection, (3) receiving care for HCV and (4) on antiviral treatment, were estimated for 2011 and 2016. Estimates for 1) and 2) were based on modelling studies for 2011 and on a virological sub-study nested in a national cross-sectional survey among the general population for 2016. Estimates for 3) and 4) were made using the National Health Data System. RESULTS Between 2011 and 2016, the number of people with chronic HCV infection decreased by 31%, from 192,700 (95% Credibility interval: 150,900-246,100) to 133,500 (95% Confidence interval: 56,900-312,600). The proportion of people aware of their infection rose from 57.7 to 80.6%. The number of people receiving care for HCV increased by 22.5% (representing 25.7% of those infected in 2016), while the number of people on treatment increased by 24.6% (representing 12.1% of those infected in 2016). CONCLUSIONS This study suggests that DAAs substantially impact CoC. However, access to care and treatment for infected people remained insufficient in 2016. Updating CoC estimates will help to assess the impact of new measures implemented since 2016 as part of the goal to eliminate HCV.
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Saberi P. Research in the Time of Coronavirus: Continuing Ongoing Studies in the Midst of the COVID-19 Pandemic. AIDS Behav 2020; 24:2232-2235. [PMID: 32303924 PMCID: PMC7165077 DOI: 10.1007/s10461-020-02868-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Parya Saberi
- Center for AIDS Prevention Studies, University of California San Francisco, UCSF, Box 0886, San Francisco, CA, 94143, USA.
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Screening for Human Immunodeficiency Virus Infection by Use of a Fourth-Generation Antigen/Antibody Assay and Dried Blood Spots: In-Depth Analysis of Sensitivity and Performance Assessment in a Cross-Sectional Study. J Clin Microbiol 2019; 58:JCM.01645-19. [PMID: 31666365 DOI: 10.1128/jcm.01645-19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/24/2019] [Indexed: 12/29/2022] Open
Abstract
We evaluated the performance of a fourth-generation antigen/antibody (Ag/Ab) assay for detecting HIV-1 infection on dried blood spots (DBS) both in a conventional laboratory environment and in an epidemiological survey corresponding to a real-life situation. Although a 2-log loss of sensitivity compared to that with plasma was observed when using DBS in an analytical analysis, the median delay of positivity between DBS and crude serum during the early phase postacute infection was 7 days. The performance of the fourth-generation assay on DBS was approximately similar to that of a third-generation (antibody only) assay using crude serum samples. Among 2,646 participants of a cross-sectional study in a population of men having sex with men, 428 DBS were found reactive, but negative results were obtained from 5 DBS collected from individuals who self-reported a positive HIV status, confirmed by detection of antiretroviral (ARV) drugs in their DBS. The data generated allowed us to estimate a sensitivity of 98.8% of the fourth-generation assay/DBS strategy in a high-risk population, even including a broad majority of individuals on ARV treatment among those HIV positive. Our study brings additional proofs that DBS testing using a fourth-generation immunoassay is a reliable strategy able to provide alternative approaches for both individual HIV testing and surveillance of various populations.
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Brouard C, Saboni L, Gautier A, Chevaliez S, Rahib D, Richard JB, Barin F, Larsen C, Sommen C, Pillonel J, Delarocque-Astagneau E, Lydié N, Lot F. HCV and HBV prevalence based on home blood self-sampling and screening history in the general population in 2016: contribution to the new French screening strategy. BMC Infect Dis 2019; 19:896. [PMID: 31660879 PMCID: PMC6819439 DOI: 10.1186/s12879-019-4493-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/23/2019] [Indexed: 02/07/2023] Open
Abstract
Background The advent of effective direct-acting antivirals (DAAs), has prompted an assessment of the French Hepatitis C virus (HCV) screening strategy, which historically targeted high-risk groups. One of the options put forward is the implementation of combined (i.e., simultaneous) HCV, Hepatitis B virus (HBV) and HIV screening for all adults at least once during their lifetime (“universal combined screening”). However, recent national survey-based data are lacking to guide decision-making regarding which new strategy to implement. Accordingly, we aimed to provide updated data for both chronic hepatitis C (CHC) and B (CHB) prevalence and for HCV and HBV screening history, using data from the BaroTest and 2016 Health Barometer (2016-HB) studies, respectively. Methods 2016-HB was a national cross-sectional phone based health survey conducted in 2016 among 20,032 randomly selected individuals from the general population in mainland France. BaroTest was a virological sub-study nested in 2016-HB. Data collected for BaroTest were based on home blood self-sampling on dried blood spots (DBS). Results From 6945 analyzed DBS, chronic hepatitis C (CHC) and B (CHB) prevalence was estimated at 0.30% (95% Confidence Interval (CI): 0.13-0.70) and 0.30% (95% CI: 0.13-0.70), respectively. The proportion of individuals aware of their status was estimated at 80.6% (95% CI: 44.2-95.6) for CHC and 17.5% (95% CI: 4.9-46.4) for CHB. Universal combined screening would involve testing between 32.6 and 85.3% of 15-75 year olds according to whether we consider only individuals not previously tested for any of the three viruses, or also those already tested for one or two of the viruses. Conclusions Our data are essential to guide decision-making regarding which new HCV screening recommendation to implement in France. They also highlight that efforts are still needed to achieve the WHO’s targets for eliminating these diseases. Home blood self-sampling may prove to be a useful tool for screening and epidemiological studies.
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Affiliation(s)
- Cécile Brouard
- Santé publique France, the national public health agency, HIV, Hepatitis B/C and STI Unit, Saint-Maurice, France.
| | - Leïla Saboni
- Santé publique France, the national public health agency, HIV, Hepatitis B/C and STI Unit, Saint-Maurice, France
| | - Arnaud Gautier
- Santé publique France, the national public health agency, Surveys Unit, Saint-Maurice, France
| | - Stéphane Chevaliez
- National Reference Centre for Viral Hepatitis B, C and Delta, Department of Virology, Henri Mondor University Hospital, Créteil, France.,INSERM U955, Paris-Est University, Créteil, France
| | - Delphine Rahib
- Santé publique France, the national public health agency, Sexual Health Unit, Saint-Maurice, France
| | - Jean-Baptiste Richard
- Santé publique France, the national public health agency, Surveys Unit, Saint-Maurice, France
| | - Francis Barin
- National Reference Centre for HIV, Department of Virology, Bretonneau University Hospital, Tours, France.,INSERM U1259, François-Rabelais University, Tours, France
| | - Christine Larsen
- Santé publique France, the national public health agency, Sexual Health Unit, Saint-Maurice, France
| | - Cécile Sommen
- Santé publique France, the national public health agency, Biostatistics Unit, Saint-Maurice, France
| | - Josiane Pillonel
- Santé publique France, the national public health agency, HIV, Hepatitis B/C and STI Unit, Saint-Maurice, France
| | - Elisabeth Delarocque-Astagneau
- INSERM 1181, Biostatistics, Biomathematics, Pharmacoepidemiology, and Infectious Diseases (B2PHI), Paris, France.,Pasteur Institute, B2PHI, Paris, France.,Versailles Saint-Quentin University UMR 1181, B2PHI, Montigny-le-Bretonneux, France
| | - Nathalie Lydié
- Santé publique France, the national public health agency, Sexual Health Unit, Saint-Maurice, France
| | - Florence Lot
- Santé publique France, the national public health agency, HIV, Hepatitis B/C and STI Unit, Saint-Maurice, France
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Interior Temperature and Relative Humidity of an Envelope During Mail Transport by the Japan Post in the Summer: Preliminary Study for a Stability Test of Dried Blood Spot Samples Sent as Regular Mail. Ther Drug Monit 2019; 41:628-633. [DOI: 10.1097/ftd.0000000000000653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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