Prevalence of Hepatitis B Virus (HBV) Among Blood Donors in Eastern Saudi Arabia: Results From a Five-Year Retrospective Study of HBV Seromarkers

Correlation of serological and molecular markers in the screening for hepatitis B virus in blood bank in northern Brazil

INTRODUCTION

In Brazil, the blood donor screening for hepatitis B virus (HBV) includes laboratory testing for serological (HBsAg and Anti-HBc) and molecular (HBV DNA) markers. This study aims to correlate serology reactive results with HBV DNA detection among blood donors with at least one HBV infection marker detected in a blood bank in northern Brazil.

METHOD

A retrospective search for HBV reactive blood donor data from January 2017 to December 2019 was performed. Serological screening was performed by chemiluminescent microparticle immunoassays Architect HBsAg and Architect Anti-HBc, whereas molecular screening was performed by the HBV nucleic acid test (HBV NAT).

MAIN RESULTS

A total of 556 HBsAg reactive results were detected, between positive (47.66%) and inconclusive (52.34%). A total of 3,658 Anti-HBc reactive results were detected, between positive (83.71%) and inconclusive (16.29%). None of the inconclusive results were associated with HBV DNA detection. The HBV DNA detection rates were 47.55% among HBsAg positive samples and 4.08% among Anti-HBc positive samples. The signal-to-cutoff (S/CO) ratio median of HBV NAT positive samples was superior in comparison to HBV NAT negative samples (p < 0.0001). The thresholds found to optimize sensitivity and specificity were 404.15 for Architect HBsAg and 7.77 for Architect Anti-HBc. Three blood donors were in the window period and 1 occult HBV infection case was detected.

CONCLUSION

High S/CO ratios were more predictive of HBV DNA detection. However, a number of HBV NAT positive samples gave low values, while some HBV NAT negative samples showed high values, reaffirming the significance of molecular testing to enhance transfusion safety.

Prevalence of Hepatitis B Virus, Hepatitis C Virus, and HIV Infections in Hemodialysis Patients at Kano Kidney Center

Background Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections are more prevalent in hemodialysis patients compared to the general population. The objective of this study was to evaluate the prevalence of HBV, HCV, and HIV infections in hemodialysis patients dialyzing regularly at Kano Kidney Center (KKC) in the Eastern Health Cluster of Saudi Arabia in 2022. Methods This retrospective study included all hemodialysis patients who were dialyzed regularly at KKC during 2022. Their electronic medical records were reviewed for the results of HBV, HCV, and HIV along with the patient's demographics, comorbid conditions, and dialysis history. The study was approved and monitored by the Institutional Review Board of Dammam Medical Complex. Results A total of 239 regular hemodialysis patients were included, consisting of 142 males and 97 females (59.41% and 40.59%, respectively), with a mean age of 52.71±15.83 years. Most of the patients were Saudis (156 patients, 65.27%) with the non-Saudi patients being composed mostly of Arabian patients. Nine patients (3.77%) tested positive for hepatitis B surface antigen (HBsAg), the serologic hallmark of HBV infection. Two patients (0.84%) had resolved HBV infections as evidenced by positive hepatitis B core antibody (anti-HBc) and hepatitis B surface antibody (anti-HBs). However, the majority (226 patients, 94.56%) were never tested for anti-HBc. Anti-HBs, which can imply long-term immunity against HBV from prior immunizations or infections, were positive in 165 patients (69.04%). A protective anti-HBs level of ≥ 10 IU/L was detected in 158 patients (66.11%) including 104 patients (43.51%) having ≥ 100 IU/L. Eighteen patients (7.53%) had reactive HCV antibodies. Four patients (1.67%) had chronic HCV infection as they had detectable HCV RNA. The remaining 14 patients (5.86%) cleared HCV either spontaneously (seven patients, 2.93%) or by medications (seven patients, 2.93%). HIV screening tests were negative in all 239 patients (100%). HBsAg-positive patients did not have any statistically significant differences from HBsAg-negative patients. On the other hand, the patients who were positive for HCV antibodies were older than the patients who were negative for HCV antibodies (60.66 vs 52.05 years on average, p-value <0.05). They also contained a statistically larger proportion of non-Saudi patients than the patients with no evidence of prior infections (61.11% vs 32.13%, p-value <0.05). Conclusions The study found that the prevalence of HBV and HCV infections among hemodialysis patients in KKC at 3.77% and 1.67%, respectively, is higher than that reported in the general population in Saudi Arabia, with non-Saudis having a higher prevalence rate of HCV infection than Saudis. However, the current prevalence rate is lower compared to the previous studies that were conducted in Saudi Arabia in the first decade of the 21st century, and there were no cases of HIV infections. Nevertheless, a significant proportion of patients had unprotective or negative anti-HBs antibody titers, indicating the need for strict vaccination protocols and monitoring of antibody titers to ensure optimal protection.

Development and clinical validation of a one-step pentaplex real-time reverse transcription PCR assay for detection of hepatitis virus B, C, E, Treponema pallidum, and a human housekeeping gene

BACKGROUND

With the safety of blood transfusion being a major public health concern, the development of a rapid, sensitive, specific, and cost-effective multiplex PCR assay for simultaneous detection of hepatitis B virus(HBV), hepatitis C virus (HCV), hepatitis E virus (HEV), and Treponema pallidum(T. pallidum) in blood is crucial.

METHODS

Five primer pairs and probes were designed towards conserved regions of target genes and used to establish a one-step pentaplex real-time reverse transcription PCR(qRT-PCR) assay for simultaneous detection of HBV, HCV, HEV, T. pallidum, and RNase P(housekeeping gene), providing sample quality check. The clinical performance of the assay was further determined with 2400 blood samples from blood donors and patients in Zhejiang province, and compared the results with commercial singleplex qPCR and serological assays.

RESULTS

The 95% limit of detection(LOD) of HBV, HCV, HEV, and T. pallidum were 7.11 copies/µL, 7.65 copies/µL, 8.45 copies/µL, and 9.06 copies/µL, respectively. Moreover, the assay has good specificity and precision. Compared to the singleplex qPCR assay, the novel assay for detecting HBV, HCV, HEV, and T. pallidum presented 100% clinical sensitivity, specificity, and consistency. Several discrepant results between serological and pentaplex qRT-PCR assays were found. Of 2400 blood samples, there were 2(0.08%) HBsAg positive samples, 3(0.13%) anti-HCV positive samples, 29(1.21%) IgM anti-HEV positive samples and 6(0.25%) anti-T. pallidum positive samples proven negative in nucleic acid detection. 1(0.04%) HBV DNA positive sample and 1(0.04%) HEV RNA positive sample were detected negative by serological testing.

CONCLUSIONS

The developed pentaplex qRT-PCR is the first assay on simultaneous, sensitive, specific, and reproducible detection of HBV, HCV, HEV, T. pallidum, and RNase P in a single tube. It could detect pathogens in blood during the window period of infection and is a good tool for effectively screening blood donors and early clinical diagnosis.

Prevalence of Hepatitis B Virus infection in the Gulf Cooperation Council: a systematic review and meta-analysis

Background

Hepatitis B virus (HBV) infection is a global public-health problem. Since the introduction of an effective vaccine, the epidemiology of HBV infection is changing. We aimed to estimate the prevalence of HBV infection in the Gulf Cooperation Council (GCC) region and delineate any variation in member-countries, special sub-groups, and over time.

Methods

This is a systematic review and meta-analysis to review studies of HBV prevalence in the GCC region. Databases were searched and all studies from inception to July 31st, 2021, were considered for inclusion. The pooled HBV prevalence was analyzed using the random-effect model after assessment for heterogeneity. True prevalence was adjusted using the Rogan-Gladen estimator. Pre-defined subgroup analysis was performed, and publication bias was assessed.

Results

Overall, 99 studies (n = 1,944,200 participants) met the inclusion criteria. The overall HBV apparent prevalence was 3.05% (95% CI 2.60, 3.52) and the true prevalence was 1.67% (95% CI 1.66, 1.68). The apparent prevalence varied between subgroups. Over time, the apparent prevalence of HBV infection has declined from 9.38% (95% CI 7.26, 11.74) before 1990 to 1.56% (95% CI 1.07, 2.12) during the period 2010 to 2020.

Conclusion

Over the last four decades the overall prevalence of HBV infection in the GCC region has decreased from high- to low-endemicity level. However, due to poor methodology of the included studies, further high-quality community-based studies are needed to obtain more precise estimate of HBV infection in this region.

Seroprevalence of Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) among Blood Donors from Bahir Dar, Ethiopia

Background. Hepatitis B virus (HBV), a highly contagious virus, is a circular partial double-stranded DNA virus. Hepatitis C virus (HCV) is an enveloped, single-stranded RNA virus with a major blood-borne infection worldwide. Infection of HBV and HCV among blood donors is an important public health problem. Objective. To assess the seroprevalence of hepatitis B and C viruses and associated factors among blood donors at Bahir Dar Blood Bank, Northwest Ethiopia. Method. Institutional-based cross-sectional study was conducted at Bahir Dar Blood Bank from May 18, 2020 to July 27, 2020. A systematic random sampling technique was used to select 426 participants. Variables having a $p$ value of <0.05 with 95% CI and AOR were considered statistically significant. Results. From 426 proposed participants, 418 (98.1%) of them completed the face-to-face interview. The seroprevalence of HBV and HCV among study participants was 4.07% and 0.48%, respectively. Having multiple sexual partners (AOR = 10.356: 95% CI: (2.277–47.099)), having a family history of hepatitis (AOR = 8.106: 95% CI: (1.278–51.403)), and having sharp materials sharing experience (AOR = 11.313, 95% CI: (1.144–111.864)) have a significant association with HBV infection. No risk factors were found for HCV infectious markers. Conclusion and Recommendations. This study showed that the seroprevalence of HBV and HCV infections confirmed with positive tests among voluntary blood donors in Bahir Dar Blood Bank was 4.07% and 0.48%, respectively. HBV seroprevalence among blood donors in this study has remained stable when compared to a study done in 2013 in the same population. Strict donor selection, safe sex practice, using proper safety precautions when offering care to a family member, and immunization of people at risk could constitute an important package of a prevention program.

Genotyping and sero-virological characterization of hepatitis B virus-infected blood donors in Central Eritrea

Aim: To determine the serological markers and genotype profiles of hepatitis B virus (HBV) isolates in Central Eritrea. Materials & methods: A total of 191 hepatitis B surface antigen (HBsAg)-positive sera were randomly selected for the study. ELISA was used to perform HBV seromarker screening, genotypes were determined using multiplex-nested PCR. Results: Of 191, 77.5% (148/191) were positive for HBcAb (total), among which 99.3% (147/148) and 0.7% (1/148) were positive for HBsAg and hepatitis B surface antibody, respectively. Of the 147 positive HBcAb/HBsAg, 16 (10.9%) and 131 (77.9%) were positive for HBeAg and HBeAb, respectively. A total of 73 HBV isolates were successfully genotyped: 39 (53.4%) D; 10 (13.7%) E; 6 (8.2%) A; 6 (8.2%) C/D; 4 (5.5%) C; 3 (4.1%) C/D/E; 2 (2.7%) A/D; 2 (2.7%) D/E; and 1 (1.4%) B/D. Conclusion: HBV genotype D is the predominant genotype among blood donors in Eritrea.

Patterns of Hepatitis B, Hepatitis C and HIV Among Blood Donors in Samtah-Jazan Region

BACKGROUND AND OBJECTIVE

Transfusion-transmitted infectious agents are amongst the major health burden worldwide. The purpose of this study was to evaluate the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among blood donors in Samtah General Hospital, Jazan region, Saudi Arabia.

MATERIAL AND METHODS

In this retrospective study, blood donation records of all blood donors recruited between January 2019 and August 2020 were included for data acquisition. A total of 4977 blood donors' records were reviewed and data were analysed.

RESULTS

Hepatitis B profile showed 0.60% blood donors positive for hepatis B surface antigen (HBsAg). Nucleic acid testing (NAT) showed the presence of HBV-DNA in 0.4% of the blood donors. Anti-HBs and anti-HBc antibodies were reactive in 3.34% and 7.31% blood donors' units, respectively. Anti-HCV antibodies were reactive among 54 (1.09%) blood donors. Upon reviewing the NAT analysis results, 0.16% (08) blood donors showed the presence of HCV-RNA in their blood units. Anti-HIV antibodies were reactive in 8 (0.16%) blood donors.

CONCLUSION

It is concluded that the frequency of HBsAg is comparatively lower while anti-HCV positivity is higher in Samtah, Jazan as a region compared to other regions of the country. Further studies are warranted to evaluate the cause of HCV infection in this area. Frequency of HIV is uncommon in this area.

Updated Seroprevalence of Hepatitis B Surface Antigen and Anti-Hepatitis Core Antibody Among Blood Donors in Yemen

Purpose

Hepatitis B virus (HBV) is one of the most common infectious pathogens worldwide. Various studies found a prevalence of HBV infection among blood donors ranging from 2% to 18%. Hence, this study aimed to provide an updated prevalence of HBsAg and anti-HBcAb among blood donors.

Patients and Methods

This was a cross-sectional study to investigate the donation records of blood donors in Sana’a, Yemen, over one year (January to December 2019). Eligible blood donors were included in the study. The serum samples of blood donors were tested for HBsAg and anti-HBcAb (IgG & IgM) using the electrochemiluminescence (ECL) and enzyme immunoassay (EIA) techniques.

Results

A total of 16,367 blood donors were recruited in this study, of whom 14,300 (87.4%) donated only once during this study (single, non-duplicated blood donors), while 2067 (12.6%) were repeated or duplicated. The overall prevalence of HBsAg and anti-HBcAb was 2.4% and 10.8%, respectively. Among single non-duplicated blood donors, HBsAg and Anti-HBcAb were 2.3% and 10.6% and 3.0% and 12.5% for repeated blood donors, respectively. There were statistically significant differences between HBsAg and Anti-HBcAb in terms of donor type and testing techniques.

Conclusion

The seroprevalence of HBsAg and anti-HBcAb among the blood donors was 2.0% and 10.3%, respectively. The ECL technique is more sensitive, has a lower error rate, and shows an advantage over the manual EIA technique. Duplicated blood donors influence the accuracy of the seroprevalence of HBsAg and anti-HBcAb.

Seroprevalence of Hepatitis B Virus Infection and Its Associated Factors Among Blood Donors in Yemen

Background

In limited-resource countries, the prevalence of hepatitis B virus (HBV) infection can be measured using data taken from blood donors. This study aimed to determine the HBV infection seroprevalence and its associated factors among blood donors in Sana’a Governorate, Yemen.

Methods

A cross-sectional study was conducted on 500 people who donated blood at hospitals located in Sana’a between August and October 2016. The volunteers were aged 18–65 years old and were recruited using convenience sampling. A set of questionnaires was administered through face-to-face interviews. Blood samples from each donor were tested for hepatitis B surface antigens using enzyme-linked immunosorbent assay.

Results

The overall seroprevalence of HBV infection in the blood donors was 2.6%. Participants with a history of dental treatment had 7.80 higher odds (95% confidence interval [CI]: 2.26, 26.71; P = 0.002) for HBV infection. Respectively, blood donors who had history of malaria infection or cupping therapy had 7.48 (95% CI: 1.75, 31.82; P = 0.010) and 7.32 (95% CI: 1.72, 30.83; P = 0.010) greater odds of HBV infection.

Conclusion

The seroprevalence of HBV infection in Sana’a is lower than in other governorates in Yemen. Stakeholders could focus on a history of dental procedure, malaria infection and cupping treatment when strategising about HBV infection prevention and control among blood donors.

Occult Hepatitis B virus (HBV) infection and challenges for hepatitis elimination: A literature review

Occult hepatitis B infection (OBI) is characterized by the detection of hepatitis B virus (HBV) DNA in serum or liver but negativity for hepatitis B surface antigen. OBI, which is thought to be maintained by host, immunological, viral and/or epigenetic factors, is one of the most challenging clinical features in the study of viral hepatitis. Currently, there is no validated detection test for OBI. It is believed that OBI is widely distributed throughout the world, with a higher prevalence in populations at high-risk HBV, but the detailed worldwide prevalence patterns are unknown. We conducted a survey of recently published studies on OBI rates across all continents. High prevalence rates of OBI are observed in some specific groups, including patients with hepatitis C virus, human immunodeficiency virus co-infection or hepatocellular carcinoma. In 2016, the World Health Organization adopted strategies to eliminate viral hepatitis by 2030, but the difficulties in detecting and treating OBI currently challenge this goal. Subjects with OBI can transmit HBV, and episodes of reactivation can occur. Further studies to understanding the mechanisms that drive the development of OBI are needed and can contribute to efforts at eliminating viral hepatitis.

SASLT practice guidelines for the management of Hepatitis B virus - An update

Infection with hepatitis B virus (HBV) remains an important public health problem with a high burden worldwide. The Saudi Association for the Study of Liver diseases and Transplantation formed a working group to develop HBV practice guidelines in Saudi Arabia. The methodology used to develop these guidelines was based on reviewing the available evidence, local data, and major international practice guidelines on the management of HBV. The aim of these guidelines is to assist healthcare providers in the management of HBV in Saudi Arabia. These updated guidelines summarize the latest local studies performed on HBV epidemiology, major changes in the prevalence of this virus, and advances in disease management.

A label-free immunosensor based on PtPd NCs@MoS2 nanoenzymes for hepatitis B surface antigen detection

Nowadays, nanomaterials with enzymatic properties have aroused wide interest because of their special advantages, such as catalytic activity, simple preparation method and high stability. We introduced new nanoenzymes to a label-free electrochemical immunosensor for Hepatitis B surface antigen (HBs Ag) detection. In this study, PtPd nanocubes@MoS₂ nanoenzymes (PtPd NCs@MoS₂) were prepared by loading PtPd nanocubes (PtPd NCs) on molybdenum disulfide nano-sheet (MoS₂) through in situ redox polymerization. The prepared nanoenzymes exhibited enhanced peroxidase-like activity than separate MoS₂ and PtPd NCs. The catalytic process of PtPd NCs@MoS₂ is in agreement with the Michaelis-Menten kinetic equation. PtPd NCs@MoS₂ were used for sensitive detection of HBs Ag, which is ascribed to their superior peroxidase activity, good conductivity and high specific surface area and synergistic amplification for current signals. Compared with the detection limit of colorimetric method (3.3 pg/mL), the electrochemical method (10.2 fg/mL) shows a lower detection limit and a wider linear range from 32 fg/mL to 100 ng/mL, so it is more suitable for quantitative analysis of Hepatitis B. In summary, the prepared immunosensor provides a better opportunity for early diagnosis of Hepatitis B and also has further applications in biosensing and medical diagnostics.

Usefulness of nucleic acid testing among negative HBs Ag blood donors in Egypt

INTRODUCTION

Hepatitis B viral infection has been transmitted from donors with HBV infections who have negative HBs Ag. Many countries have implemented nucleic acid testing (NAT) to screen donors with non- reactive HBs Ag for detection of HBV DNA and enhance safety of blood transfusion, while it is restricted to limited blood banks in Egypt.

OBJECTIVE

To evaluate the significance of NAT technology in detection of HBV DNA in the Egyptian blood donors with HBs Ag non- reactivity.

METHODS

The study included 36,584 collected blood samples from volunteer blood donors at the blood bank of Zagazig University Hospitals. Each specimen was tested for HBs Ag; non- reactive sera were further tested for qualitative detection of HBV-DNA by NAT testing. All positive HBV-DNA donors were tested for anti- HBc and anti- HBs by electro-chemiluminescence immunoassay and confirmed by quantitative RT-PCR.

RESULTS

Among 34,671 donors non-reactive to HBs Ag, 34,657 (99.96%) were tested negative for HBV- DNA and 14 specimens (0.04%) were positive for HBV via NAT testing. Among HBV NAT positive donors, HBs Ab reactive only in (2); HBc Ab reactive only in (3); HBs and HBc Abs reactive in (3) while HBs and HBc Ab non-reactive in (6). All tested sera 14 (100%) showed low viral load for HBV (<50 IU/ml) confirmed by RT- qPCR.

CONCLUSION

Our results highlighted the significance of the HBV NAT technique to reduce the potential risk of HBV transfusion-transmission and the critical need to enforce the usage of NAT technology in all blood banks in Egypt.