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Liu CL, Zhou T, Cheng LB, Fisher D, Pronyuk K, Musabaev E, Dang YP, Zhao L. The History of Controlling and Treating Infectious Diseases in Ancient China. Curr Med Sci 2024; 44:64-70. [PMID: 38393523 DOI: 10.1007/s11596-024-2831-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/19/2023] [Indexed: 02/25/2024]
Abstract
Infectious diseases are the common enemies of mankind. In the course of historical development, they persistently threaten human health and safety. Even today, despite the developments in medical science, we cannot escape the fear and suffering caused by infectious diseases. Whether in ancient or modern times, the source of infection, route of transmission, and a susceptible population are the three key conditions for the prevalence and spread of infectious diseases. All factors closely related to these three conditions can affect the prevalence of infectious diseases. China is one of the cradles of world civilization. The ancient people accumulated a great deal of experience and lessons in the long struggle against infectious diseases. In the face of the current threat posed by widespread infectious disease, it is imperative to review and summarize ancient Chinese ideas and health policies on epidemic prevention and control to inspire contemporary efforts in the prevention and control of infectious disease. The combination of prevention-oriented epidemic prevention ideology and traditional medicine provides valuable insights, especially for impoverished and medically underserved regions.
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Affiliation(s)
- Cui-Ling Liu
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Tao Zhou
- Department of Gastroenterology and Hepatology, Huanggang Hospital of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Huanggang, 438000, China
| | - Liang-Bin Cheng
- Clinical College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, 430065, China
- Department of Liver Diseases, Hubei Hospital of Traditional Chinese Medicine, Wuhan, 430061, China
| | - David Fisher
- Department of Medical Biosciences, Faculty of Natural Sciences, University of the Western Cape, Bellville, Cape Town, 7535, South Africa
| | - Khrystyna Pronyuk
- Department of Infectious Diseases, Bogomolets National Medical University, Kyiv, 02132, Ukraine
| | - Erkin Musabaev
- The Research Institute of Virology, Ministry of Health, Tashkent, 100122, Uzbekistan
| | - Yi-Ping Dang
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Lei Zhao
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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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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Liu X, Min Q, Song H, Yue A, Li Q, Zhou Q, Han W. Potentiating humoral and cellular immunity using a novel hybrid polymer-lipid nanoparticle adjuvant for HBsAg-VLP vaccine. J Nanobiotechnology 2023; 21:441. [PMID: 37993870 PMCID: PMC10666313 DOI: 10.1186/s12951-023-02116-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/16/2023] [Indexed: 11/24/2023] Open
Abstract
Aluminium adjuvants are commonly used in vaccines to stimulate the immune system, but they have limited ability to promote cellular immunity which is necessary for clearing viral infections like hepatitis B. Current adjuvants that do promote cellular immunity often have undesired side effects due to the immunostimulants they contain. In this study, a hybrid polymer lipid nanoparticle (HPLNP) was developed as an efficient adjuvant for the hepatitis B surface antigen (HBsAg) virus-like particle (VLP) vaccine to potentiate both humoral and cellular immunity. The HPLNP is composed of FDA approved polyethylene glycol-b-poly (L-lactic acid) (PEG-PLLA) polymer and cationic lipid 1, 2-dioleoyl-3-trimethylammonium-propane (DOTAP), and can be easily prepared by a one-step method. The cationic optimised vaccine formulation HBsAg/HPLNP (w/w = 1/600) can maximise the cell uptake of the antigen due to the electrostatic adsorption between the vaccine nanoparticle and the cell membrane of antigen-presenting cells. The HPLNP prolonged the retention of the antigen at the injection site and enhanced the lymph node drainage of antigen, resulting in a higher concentration of serum anti-HBsAg IgG compared to the HBsAg group or the HBsAg/Al group after the boost immunisation in mice. The HPLNP also promoted a strong Th1-driven immune response, as demonstrated by the significantly improved IgG2a/IgG1 ratio, increased production of IFN-γ, and activation of CD4 + and CD8 + T cells in the spleen and lymph nodes. Importantly, the HPLNP demonstrated no systemic toxicity during immunisation. The advantages of the HPLNP, including good biocompatibility, easy preparation, low cost, and its ability to enhance both humoral and cellular immune responses, suggest its suitability as an efficient adjuvant for protein-based vaccines such as HBsAg-VLP. These findings highlight the promising potential of the HPLNP as an HBV vaccine adjuvant, offering an alternative to aluminium adjuvants currently used in vaccines.
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Affiliation(s)
- Xuhan Liu
- Department of Emergency Medicine, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen University, No. 1098 Xueyuan Avenue, Shenzhen, 518000, Guangdong, China
| | - Qiuxia Min
- Department of Pharmacy, First People's Hospital of Yunnan Province, Kunming University of Science and Technology, No. 157 Jinbi Road, Kunming, 650034, Yunnan, China
| | - Huiping Song
- Department of Emergency Medicine, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen University, No. 1098 Xueyuan Avenue, Shenzhen, 518000, Guangdong, China
- First School of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Aochun Yue
- Department of Emergency Medicine, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen University, No. 1098 Xueyuan Avenue, Shenzhen, 518000, Guangdong, China
- Centre of Integrated Chinese and Western Medicine, School of Clinical Medicine, Qingdao University, Qingdao, China
| | - Qin Li
- Department of Emergency Medicine, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen University, No. 1098 Xueyuan Avenue, Shenzhen, 518000, Guangdong, China
| | - Qing Zhou
- The Center for Biomedical Research, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Wei Han
- Department of Emergency Medicine, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen University, No. 1098 Xueyuan Avenue, Shenzhen, 518000, Guangdong, China.
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Wang S, Chen J, Li Y, Zhang B, Li X, Han Y, Zhang J. Trends in sexually transmitted and blood-borne infections in China from 2005 to 2021: a joinpoint regression model. BMC Infect Dis 2023; 23:741. [PMID: 37904156 PMCID: PMC10614345 DOI: 10.1186/s12879-023-08733-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 10/20/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Sexually transmitted and blood-borne infections (STBBIs) is a major public health concern in China. This study assessed the overall trends in STBBIs to improve the comprehensive understanding of the burden of STBBIs and provide evidence for their prevention and control. METHODS Data for the period from 2005 to 2021 were analyzed across China on infections with hepatitis B or C; syphilis; gonorrhea; and HIV infection. Trends, annual percent change (APC), and average annual percent change (AAPC) in diagnosis rate was analyzed using joinpoint regression models for the five STBBIs together or individually. RESULTS From 2005 to 2021, the overall diagnosis rate of all five STBBIs increased, with an AAPC of 1.3% [95% confidence interval (CI) -0.5% to 3.1%]. Diagnosis rates of HIV, syphilis and hepatitis C increased individually, but it decreased for infections of hepatitis B and gonorrhea. Joinpoint analysis identified four phases in diagnosis rate of hepatitis C; three phases in diagnosis rate of hepatitis B, HIV infection, and syphilis; two in diagnosis rate of gonorrhea infection. CONCLUSION Despite national efforts to prevent and control STBBIs, their overall diagnosis rate has continued to rise in China, and they remain an important public health challenge. Further efforts should be made to educate the general population about STBBIs, particularly HIV. Interventions targeting vulnerable groups should be adopted and their efficacy monitored through regular analysis of trends.
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Affiliation(s)
- Shuyuan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China
| | - Jialu Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China
| | - Yuansheng Li
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China
| | - Beibei Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China
| | - Xiang Li
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China
| | - Ying Han
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China
| | - Junhui Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China.
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Liu X, Liu Y, Yang X, Lu X, Xu XN, Zhang J, Chen R. Potentiating the Immune Responses of HBsAg-VLP Vaccine Using a Polyphosphoester-Based Cationic Polymer Adjuvant. ACS APPLIED MATERIALS & INTERFACES 2023; 15:48871-48881. [PMID: 37816068 PMCID: PMC10614196 DOI: 10.1021/acsami.3c07491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/26/2023] [Indexed: 10/12/2023]
Abstract
Virus-like particle (VLP)-based vaccines are required to be associated with a suitable adjuvant to potentiate their immune responses. Herein, we report a novel, biodegradable, and biocompatible polyphosphoester-based amphiphilic cationic polymer, poly(ethylene glycol)-b-poly(aminoethyl ethylene phosphate) (PEG-PAEEP), as a Hepatitis B surface antigen (HBsAg)-VLP vaccine adjuvant. The polymer adjuvant effectively bound with HBsAg-VLP through electrostatic interactions to form a stable vaccine nanoformulation with a net positive surface charge. The nanoformulations exhibited enhanced cellular uptake by macrophages. HBsAg-VLP/PEG-PAEEP induced a significantly higher HBsAg-specific IgG titer in mice than HBsAg-VLP alone after second immunization, indicative of the antigen-dose sparing advantage of PEG-PAEEP. Furthermore, the nanoformulations exhibited a favorable biocompatibility and in vivo tolerability. This work presents the PEG-PAEEP copolymer as a promising vaccine adjuvant and as a potentially effective alternative to aluminum adjuvants.
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Affiliation(s)
- Xuhan Liu
- Department
of Chemical Engineering, Imperial College
London, South Kensington Campus, London SW7 2AZ, U.K.
- Department
of Emergency Medicine, Shenzhen University
General Hospital, Shenzhen University, Shenzhen 518051, China
| | - Yifan Liu
- Department
of Chemical Engineering, Imperial College
London, South Kensington Campus, London SW7 2AZ, U.K.
| | - Xiaoyu Yang
- AIM
Honesty Biopharmaceutical Co., Ltd, Dalian 116620, China
| | - Xinyu Lu
- Department
of Chemical Engineering, Imperial College
London, South Kensington Campus, London SW7 2AZ, U.K.
| | - Xiao-Ning Xu
- Department
of Infectious Diseases, Imperial College
London, London W12 0NN, U.K.
| | - Jiancheng Zhang
- AIM
Honesty Biopharmaceutical Co., Ltd, Dalian 116620, China
| | - Rongjun Chen
- Department
of Chemical Engineering, Imperial College
London, South Kensington Campus, London SW7 2AZ, U.K.
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Wu JN, Huang LF, Lin ZQ, Zhou Y. Association between vaccine dose and risk of hepatitis B virus infection in Fujian Province, China. Hum Vaccin Immunother 2022; 18:2153533. [PMID: 36519244 PMCID: PMC9891677 DOI: 10.1080/21645515.2022.2153533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The increased dose of hepatitis B vaccine has been adopted for newborns since 2013 in Fujian, China. However, little is known about the impact of this measure on hepatitis B virus (HBV) prevention. We used the seroepidemiological surveys conducted in 2014 and 2020 to address the concern. Compared with subjects who received a 5 μg hepatitis B vaccine, participants who took a 10 μg hepatitis B vaccine were associated with a lower risk of HBV infection (adjusted odds ratio [OR] 0.26, 95% confidence interval [CI]: 0.10-0.68) and a marginal reduction risk of anti-HBc positive (OR, 0.37; 95% CI: 0.13-1.08; P = .07), but not for HBsAg carrier risk. The relation between vaccine dose and risk of anti-HBc positive (OR, 0.20; 95% CI: 0.05-0.81) became slightly stronger and significant among children investigated in 2020 who probably received universal vaccination. No significant association was found for subjects whose mothers were positive for HBsAg. The current 10 μg hepatitis B vaccines for universal vaccination for newborns are reasonable and effective in HBV prevention. More measures should be taken to reduce the risk of HBsAg carriers for infants whose mothers are positive for HBsAg.
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Affiliation(s)
- Jiang-Nan Wu
- Department of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China,Jiang-Nan Wu Department of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University, 566 Fangxie Road, Shanghai200011, China
| | - Li-Fang Huang
- Department of Expanded of National Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Zhi-Qiang Lin
- Department of Expanded of National Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Yong Zhou
- Department of Expanded of National Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China,CONTACT Yong Zhou Department of Expanded of National Immunization Program, Fujian Provincial Center for Disease Control and Prevention, 386 Chong’an Road, Jin’an, Fuzhou350012, China
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Huang LF, Lin ZQ, Yang XH, Zhang HR, Wang FZ, Wang F, Wu JN, Zhou Y. Association of vaccine policy with virus infection and awareness of hepatitis B in Fujian, China. Hum Vaccin Immunother 2022; 18:2153535. [PMID: 36503415 PMCID: PMC9766471 DOI: 10.1080/21645515.2022.2153535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
China has regulated its hepatitis B vaccination policy. However, data on the prevalence of hepatitis B virus (HBV) infection have not been updated since 2014. In addition, the impact of the policy on awareness of hepatitis B is limited, especially in Fujian Province where HBV infection is highly prevalent. We conducted a sero-epidemiological survey in five national monitoring counties to address these concerns. A total of 5,873 subjects were included and classified into four birth cohorts according to the policy time nodes (1981, 1992, and 2002). The HBsAg carrier rate for the general population was 8.6% (95% confidence interval [CI]: 7.9-9.3). Compared with those born before 1981, adjusted odds ratios (OR) for HBV infection were 0.51 (95% CI: 0.43-0.62), 0.10 (0.08-0.12), and 0.015 (0.01-0.023) among the 1981-1991, 1992-2001, and ≥2002 birth cohorts, respectively; while the OR was 1.26 (1.00-1.57), 0.39 (0.26-0.58), and 0.019 (0.006-0.06) for HBsAg carriage, respectively. Among the 4865 residents aged ≥15 years, hepatitis B awareness has been declining since the introduction of the hepatitis B vaccine into the immunization program (β = -0.25, SE = 0.08, P = .001, and β = -0.20, SE = 0.08, P = .017 for 1992-2001 and ≥2002 birth cohort, respectively). This decline was obvious for the initiation time of the first dose of the hepatitis B vaccine. Although the hepatitis B vaccination policies have helped reduce the infection, the awareness has declined. More measures on the target population are warranted to improve the public's awareness of hepatitis B vaccination in the context of great achievements.
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Affiliation(s)
- Li-Fang Huang
- Department of National Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China,National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhi-Qiang Lin
- Department of National Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Xiu-Hui Yang
- Department of National Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Hai-Rong Zhang
- Department of National Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Fu-Zhen Wang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Feng Wang
- National Institute of Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiang-Nan Wu
- Department of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China,CONTACT Yong Zhou Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Yong Zhou
- Department of National Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China,Jiang-Nan Wu Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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Zhang C, Liu Y, Zhao H, Wang G. Global Patterns and Trends in Total Burden of Hepatitis B from 1990 to 2019 and Predictions to 2030. Clin Epidemiol 2022; 14:1519-1533. [PMID: 36540899 PMCID: PMC9760077 DOI: 10.2147/clep.s389853] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/02/2022] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND AND AIMS Despite widespread vaccination against hepatitis B and availability of antiviral drugs, hepatitis B remained a major global public health problem. Therefore, an improved understanding of the burden of hepatitis B was required to help design strategies for global intervention. METHODS Data on hepatitis B was collected by the Global Burden of Disease (GBD) 2019 database from 1990 to 2019. Age-standardized incidence rates (ASIR), mortality rates (ASMR) and disability-adjusted life year rates (ASDR) for hepatitis B were extracted from GBD 2019 and stratified by age, level of regionals and country. Estimated annual percentage changes (EAPC) of ASIR, ASMR and ASDR were calculated to quantify the temporal trends in hepatitis B. RESULTS Globally, ASIR showed a continuous downward trend, from 1552.2 in 1990 to 1010.0 per 100,000 persons in 2019, with an annual decrease of 1.52% (95% CI -1.66--1.38). ASMR showed a persistent decline, declining by nearly half in 2019 compared to 1990 (6.7 vs 12.4 per 100,000 persons), with an annual decrease of 2.55% (95% CI -2.74--2.35). ASDR showed a continuing downward trend, and the EAPC was -2.55% (95% CI -2.74--2.35). This decreasing pattern was heterogeneous across regions and countries. Hepatitis B related deaths increased significantly in high socio-demographic index countries such as UK, USA, and Canada. The ARIMA model estimates a 36.14% and 6.00% decrease in ASIR and ASMR, respectively, by 2030 compared to 2015. CONCLUSION Global hepatitis B morbidity and mortality rates decreased significantly from 1990 to 2019, but with a high degree of heterogeneity among regions and countries. It was still far from achieving the WHO goal of elimination of viral hepatitis by 2030, especially mortality rate.
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Affiliation(s)
- Chi Zhang
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, 100034, People’s Republic of China
| | - Yiqi Liu
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, 100034, People’s Republic of China
| | - Hong Zhao
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, 100034, People’s Republic of China
- Department of Infectious Diseases, Peking University International Hospital, Beijing, 102206, People’s Republic of China
| | - Guiqiang Wang
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, 100034, People’s Republic of China
- Department of Infectious Diseases, Peking University International Hospital, Beijing, 102206, People’s Republic of China
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Maomao C, He L, Dianqin S, Siyi H, Xinxin Y, Fan Y, Shaoli Z, Changfa X, Lin L, Ji P, Wanqing C. Current cancer burden in China: epidemiology, etiology, and prevention. Cancer Biol Med 2022; 19:j.issn.2095-3941.2022.0231. [PMID: 36069534 PMCID: PMC9425189 DOI: 10.20892/j.issn.2095-3941.2022.0231] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Cancer has become the most common cause of death in China. Owing to rapid economic development, improved livelihood, and shifts in risk factors, cancer epidemiology has experienced substantial changes during the past several decades. In this review, we aim to describe the current cancer epidemiology of the main types of cancer in China, report major risk factors associated with cancer development, and summarize the contributions of the Chinese government to controlling the cancer burden. A total of 4,064,000 new cases were diagnosed in China in 2016. The most frequent types are lung cancer (828,100; 20.4%), colorectal cancer (408,000; 10.0%), and gastric cancer (396,500; 9.8%). Lung (657,000; 27.2%), liver (336,400, 13.9%), and stomach (288,500; 12.0%) cancers are the 3 most deadly cancers in the general population. The 5-year survival rate for cancer has dramatically increased in recent decades. However, liver and particularly pancreatic cancers still have the poorest prognosis. The main modifiable risk factors associated with cancer development include infectious agents, smoking, alcohol consumption, obesity, unhealthful dietary habits, and inadequate physical activity. The Chinese government has made unremitting efforts to decrease the cancer burden, including cancer education and investment in cancer screening programs.
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Affiliation(s)
- Cao Maomao
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - Li He
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - Sun Dianqin
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - He Siyi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - Yan Xinxin
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - Yang Fan
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - Zhang Shaoli
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - Xia Changfa
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - Lei Lin
- Department of Cancer Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China
| | - Peng Ji
- Department of Cancer Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China
| | - Chen Wanqing
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
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10
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Tu F, Yang R, Wang W, Li R, Du G, Liu Y, Li W, Wei P. Analysis of Knowledge, Attitude and Practice of Hepatitis B Among Freshmen in Jiangsu Based on Lasso-Logistic Regression and Structural Equation Model. Infect Drug Resist 2022; 15:3063-3073. [PMID: 35734538 PMCID: PMC9207125 DOI: 10.2147/idr.s365728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/08/2022] [Indexed: 11/24/2022] Open
Abstract
Objective We aimed to describe the knowledge, attitude and practice (KAP) status of hepatitis B virus (HBV) among freshmen who were in the class of 2020 and from Jiangsu Province. Methods A random multistage sampling had been used to screen freshmen to conduct online questionnaire. The chi-square test was applied for pairwise comparison between sub-groups. Lasso regression and logistic regression were used to analyze the influencing factors of KAP about HBV. A structural equation model was established to explore the relationships among KAP of HBV. Results The total awareness rate of HBV among freshmen was 63.1%. More than 50% of freshmen reported that they were not willing to live with hepatitis B carriers. Only 51.0% of students had been immunized against HBV. The knowledge of HBV among students whose fathers had college/bachelor degree or above was 1.464 times higher than those whose fathers’ education level was junior high school or below (95% CI = 1.277~1.677). Both of positive attitude and behavior among female students were 1.424 times (95% CI = 1.329~1.525) and 1.468 times (95% CI = 1.291~1.669) than that within male students, respectively. The positive behaviors of students whose mothers had college education or above were 1.347 times higher than those whose mothers had the degree of junior high or below (95% CI = 1.147~1.582). Students who living with their parents were 1.167 times likely to have positive behaviors than those who living in other methods (95% CI = 1.020~1.334). The structural equation model had shown that the direct effect of knowledge on preventive motivation, attitude and behavior was 0.28, 0.53 and 0.10, respectively. Conclusion The population of freshmen still was far from a comprehensive understanding of HBV prevention and treatment. It is suggested that administrators of colleges and universities should pay more attentions to education of HBV knowledge as well as take multi-channel measures for prevention and management.
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Affiliation(s)
- Fulai Tu
- Key Laboratory of Environmental Medicine Engineering, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Ruizhe Yang
- Department of Prevention and Health Care, Children's Hospital of Nanjing Medical University, Nanjing, 210008, People's Republic of China
| | - Weixiang Wang
- Department of Acute Infectious Disease Control, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, People's Republic of China
| | - Rui Li
- Key Laboratory of Environmental Medicine Engineering, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Guoping Du
- Department of General Practice, Southeast University Hospital, Nanjing, 210018, People's Republic of China
| | - Yangyang Liu
- Key Laboratory of Environmental Medicine Engineering, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Wei Li
- Department of Quality Management, Children's Hospital of Nanjing Medical University, Nanjing, 210009, People's Republic of China
| | - Pingmin Wei
- Key Laboratory of Environmental Medicine Engineering, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
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11
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Seroprevalence of Transfusion Transmissible Infections and Associated Risk Factors in Hospitalized Patients before Transfusion in Jinling Hospital Nanjing University: A Three-Year Retrospective Study. Pathogens 2022; 11:pathogens11060710. [PMID: 35745563 PMCID: PMC9227149 DOI: 10.3390/pathogens11060710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/09/2022] [Accepted: 06/19/2022] [Indexed: 11/24/2022] Open
Abstract
Transfusion-transmitted infections (TTIs), such as hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and treponema pallidum (TP), must be detected before blood transfusion. However, few studies have been conducted on the prevalence and accuracy of positive results in hospitalized patients. The purpose of this study was to investigate the real seroprevalence of TTIs among patients before blood transfusion and analyze the characteristics of false-positive results in Jinling Hospital, Nanjing University, China. TTI results were collected from medical records and analyzed retrospectively. Additionally, we also used confirmatory assays to verify the accuracy of positive results. The overall prevalence of TTI was 8.96%, which was related to gender and age. The real positive rates were 86.67% (HBV), 35.09% (HCV), 20.75% (HIV), and 100% (TP). Our results also showed that high-speed centrifugation can reduce the false-positive rate of HBsAg. In summary, the results demonstrated that the positive rates of TTIs in hospitalized patients are higher than those in the general population. We also confirmed the existence of false-positive results in serological screening for TTIs. The method of processing specimens through high-speed centrifugation could reduce the false-positive results of detecting antigens effectively.
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12
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Liu W, Zhuang T, Xia R, Zou Z, Zhang L, Shen M, Zhuang G. Modelling the prevalence of hepatitis B towards eliminating it as a major public health threat in China. BMC Public Health 2022; 22:1179. [PMID: 35698098 PMCID: PMC9195287 DOI: 10.1186/s12889-022-13594-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) requires reduction in the prevalence of hepatitis B virus (HBV) surface antigen (HBsAg) in children to 0.1% by 2030, a key indicator for eliminating viral hepatitis as a major public health threat. Whether and how China can achieve this target remains unknown, although great achievements have been made. We aimed to predict the decline of HBsAg prevalence in China and identify key developments needed to achieve the target. METHODS An age- and time-dependent dynamic compartmental model was constructed based on the natural history of HBV infection and the national history and current status of hepatitis B control. The model was run from 2006 to 2040 to predict the decline of HBsAg prevalence under three scenarios including maintaining current interventions (status quo), status quo + peripartum antiviral prophylaxis (PAP, recommended by WHO in 2020), and scaling up current interventions + PAP. RESULTS Under the status quo, HBsAg prevalence would decrease steadily in all age groups, but the WHO's target of 0.1% prevalence in children aged < 5 years would not be achieved until 2037. The results are robust according to sensitivity analyses. Under the status quo + PAP, the HBsAg prevalence of children aged < 5 years would significantly decrease with the introduction of PAP, and the higher the successful interruption coverage is achieved by PAP, the more significant the decline. However, even if the successful interruption coverage reaches 90% by 2030, the 0.1% prevalence target would not be met until 2031. Under the scaling up current interventions + PAP, combined with scale-up of current interventions, the WHO's 0.1% target would be achieved on time or one year in advance if PAP is introduced and the successful interruption coverage is scaled up to 80% or 90% by 2030, respectively. CONCLUSIONS It is difficult for China to achieve the WHO's target of 0.1% HBsAg prevalence in children by 2030 by maintaining current interventions. PAP may play an important role to shorten the time to achieve the target. A comprehensive scale-up of available interventions including PAP will ensure that China achieves the target on schedule.
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Affiliation(s)
- Wenjun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Tianyi Zhuang
- Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Ruyi Xia
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Zhuoru Zou
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Lei Zhang
- China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi, China.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
| | - Mingwang Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China. .,China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi, China. .,Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China.
| | - Guihua Zhuang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China. .,China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi, China. .,Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China.
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13
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Yang H, Ran Z, Jin M, Qian JM. Current Status of Opportunistic Infection in Inflammatory Bowel Disease Patients in Asia: A Questionnaire-Based Multicenter Study. Gut Liver 2022; 16:726-735. [PMID: 35611664 PMCID: PMC9474486 DOI: 10.5009/gnl210217] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/05/2021] [Accepted: 10/01/2021] [Indexed: 02/04/2023] Open
Abstract
Background/Aims Opportunistic infection in inflammatory bowel disease (IBD) has become a serious problem. However, its status of doctors' opinions and test equipment in hospitals are unclear. The aim of the study was to investigate these issues to improve the prognosis of IBD patients. Methods This retrospective, multicenter study was conducted by 83 investigators who were members of the Asian Organization for Crohn's and Colitis. Data on opportunistic infection were collected from hospital databases between January 2017 and December 2017. The survey consisted of 11 items. Results Most physicians appreciated the diagnostic value of tissue cytomegalovirus (CMV) DNA, accounting for 86.1% of members in China, 37.5% in Japan, 52.9% in South Korea, and 66.7% in Southeast Asia. Only 83.1% of hospitals had the ability to test for CMV immunohistochemistry in Asia. Hepatitis B surface antigen (HBsAg) screening was recommended by all members. However, only 66.7% in China, 70.6% in South Korea, and 66.7% in Southeast Asia agreed to routinely vaccinate IBD patients when HBsAg tested negative. Most members preferred metronidazole (74.7%) as the first choice for patients with Clostridium difficile infection. However, the proportion of stool C. difficile toxin test was lower in China than in other areas (75.0% in China vs 95.8% in Japan and 100% in South Korea and Southeast Asia, p<0.05). Conclusions Opportunistic infection from CMV, hepatitis B virus, and C. difficile should be of high concern for IBD patients. More efforts are needed, such as understanding consensus in clinical practice and improving testing facilities in hospitals.
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Affiliation(s)
- Hong Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhihua Ran
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Inflammatory Bowel Disease Research Center, Shanghai Institute of Digestive Disease, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Meng Jin
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jia-Ming Qian
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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14
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Su X, Zheng L, Zhang H, Shen T, Liu Y, Hu X. Secular Trends of Acute Viral Hepatitis Incidence and Mortality in China, 1990 to 2019 and Its Prediction to 2030: The Global Burden of Disease Study 2019. Front Med (Lausanne) 2022; 9:842088. [PMID: 35360747 PMCID: PMC8962367 DOI: 10.3389/fmed.2022.842088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Understanding the patterns and trends in the context of both incidence and mortality and anticipating future trends is important for viral hepatitis prevention, treatment, and guiding resource allocation in China. The objective of this study is to provide a comprehensive temporal analysis of acute viral hepatitis and its type using the most updated data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2019) to estimate the incidence and mortality of hepatitis from 1990 to 2019 and make predictions to 2030. Methods The age-standardized incidence (ASIR) and mortality rate (ASMR) of viral hepatitis in China were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2019). Trends of ASIR and ASMR for viral hepatitis were plotted using locally weighted regression (LOESS). We used joinpoint regression analysis to detect temporal changes and estimate the annual percent of change (APC) of each trend segment and the corresponding 95% confidence interval (CI). A Bayesian age-period-cohort analysis was employed to describe ASIR and ASMR trends between 1990 and 2019 and projections to 2030. Results In 1990, there were 67 million incident cases of acute viral hepatitis, which then decreased to 47 million incidence cases in 2019. Hepatitis A and hepatitis B account for the majority of acute viral hepatitis, and the most pronounced declines in hepatitis B (−48.7%) and hepatitis C (−39.0%) were observed between 1990 and 2019. The ASIR of overall acute viral hepatitis shows a persistent decline, with an average annual percent of change (AAPC) of −1.9% (95% CI: −1.9, −1.8) between 1990 and 2019. The trend of ASMR demonstrated a rapid decline between 1990 and 2005, followed by a slow decline until 2030. Conclusion Our study reveals favorable declining trends of incidence and mortality for acute viral hepatitis in China from 1990 and 2019, and these favorable trends are predicted to continue up to 2030. Despite the favorable trends observed, the absolute number of viral hepatitis, especially hepatitis A and B, is still substantial in China. A scaled-up vaccine campaign is still needed to tackle the large number of vaccine preventable hepatitis infections.
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15
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Jiang M, Zhu B, Yao Q, Lou H, Zhang X. Anti-HBs levels in children under the age of two years born to HBV carrier mothers after immunoprophylaxis: a multicenter cross-sectional study. BMC Pediatr 2021; 21:492. [PMID: 34736435 PMCID: PMC8567679 DOI: 10.1186/s12887-021-02967-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background Serological testing for the presence of Hepatitis B Virus (HBV) markers and anti-HBs titers in infants born to HBsAg positive women is critically important for estimation in immunisation programme. Methods This was a multi-center and cross-sectional study conducted in Zhejiang province, China. Children aged 7 to 24 months born to HBsAg positive women during December 2018 to February 2019, completed additional HBV serological markers screening. We indicated distribution of HBV serological markers and anti-HBs titers in children. Multiple logistic regression model with adjusted odds ratio and 95% confidence interval (ORadj and 95% CI) was used to explore the factors associated with inadequate immune response (anti-HBs titers< 100 mIU/ml) among children. Results A total of 1849 children were included. Overall 25 children tested HBsAg positive, giving HBsAg positive rate of 1.35%(95%CI: 0.83-1.88%). 92.00% (23/25) HBsAg positive children were delivered by HBeAg positive mothers. The proportion of protective seroconversion (anti-HBs titers≥10mIU/ml) was 99.29% in all children, and 86.48% children were reported with adequate anti-HBs titers (≥100mIU/ml).We found a significant higher proportions of early antenatal health care (< 13 gestational weeks), and term birth in children with adequate response compared with inadequate response (all P < 0.05). Logistic regression showed preterm birth was a negative factor for inadequate anti-HBs titers (ORadj = 1.868,95%CI 1.132-3.085,P = 0.015). Conclusions Children delivered by HBeAg positive mothers had higher risk of vertical transmission of HBV, despite completion of 3 doses of hepatitis B vaccine and HBIG injection. Inadequate anti-HBs level was significantly associated with preterm birth in HBsAg positive women.
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Affiliation(s)
- Min Jiang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17 Section 3, Renmin South Road, Chengdu, Sichuan, 610041, People's Republic of China
| | - Bo Zhu
- Department of Medical Laboratory Science, Women's Hospital, School of Medicine, Zhejiang University, Xueshi Road 1, Hangzhou, Zhejiang, 310006, People's Republic of China
| | - Qiang Yao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17 Section 3, Renmin South Road, Chengdu, Sichuan, 610041, People's Republic of China
| | - Haifeng Lou
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Xueshi Road 1, Hangzhou, Zhejiang, 310006, People's Republic of China
| | - Xiaohui Zhang
- Department of Women's Health, Women's Hospital, School of Medicine, Zhejiang University, Xueshi Road 1, Hangzhou, Zhejiang, 310006, People's Republic of China.
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16
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Sun X, Zhu Y, Tang F, Deng X, Wang Z, Liu Y. Analysis of epidemiological serosurvey of hepatitis B virus among people under 29 years of age in Jiangsu Province, China. Hum Vaccin Immunother 2021; 17:3729-3734. [PMID: 34096830 DOI: 10.1080/21645515.2021.1928461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background: The purpose of this paper was to analyze the prevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core anti-body (anti-HBc)in1-29 years old living in the most populous eastern province of China,22 years after introduction of hepatitis B vaccine (HepB) vaccination of infants and provide provincial baseline data for developping a better prevention and control plan for hepatitis B virus (HBV)in Jiangsu Province, ChinaMethods: The incidence rates of HBV in Jiangsu province from 2004 to 2014 were obtained from the National Notifiable Disease Reporting System (NNDRS). A stratified cluster random sampling method was used to select 3,002 participants aged 1-29 years across 13 HBV monitoring points throughout the province, which had been classified as either urban or rural. HBV serological markers were measured by Abbott microparticle enzyme immunoassay (MEIA) kits (Abbott Laboratories, Chicago, Illinois).Results: The incidence of hepatitis B decreased by approximately 71.44% in Jiangsu province between 2004 and 2014. Serological assessments showed that the prevalence of the HBsAg, anti-HBc, and anti-HBsin the 1-29 age group were 1.20%, 5.33%,and 66.89%, respectively. There was a significantly lower prevalence of HepB who were vaccinated than in unvaccinated subjects (0.46% vs 14.93%, p < .0001). Among these the ages of 1-29, the coverage rate drops from 97.7% to 56.6% with age,andthe timely rate among people aged 1-14 years was 90.93%.Conclusions: Since the HepB was integrated into the immunization programme in Jiangsu province,the rate of hepatitis B reported and the prevalence of HBsAg decreased significantly, and the coverage of HepB and the vaccination rate within 24 hours after birth have played an important role in reducing HBV infection.
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Affiliation(s)
- Xiang Sun
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Yuanyuan Zhu
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Fenyang Tang
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Xiuying Deng
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Zhiguo Wang
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Yuanbao Liu
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
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17
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Bhattacharya S, Gökdemir Ö, Bashar MA, Thiyagarajan A, Singh A. Is it the Right Time to Introduce the Hepatitis B Booster Vaccine in National Immunization Schedule? An Analysis from the Available Evidence. Indian J Community Med 2021; 46:4-6. [PMID: 34035566 PMCID: PMC8117886 DOI: 10.4103/ijcm.ijcm_439_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 01/27/2020] [Indexed: 12/18/2022] Open
Abstract
Hepatitis B virus (HBV) infection is a global health concern, and it is considered one of the deadliest infections in the world, having nearly 1.2 million deaths annually. Around 75% of all global HBV carriers live in the Asia-Pacific region. In this regard, India has a prevalence ranging between 2% and 7% with exposure rates of 10%–60%. Hepatitis B is a vaccine-preventable disease. In India, the World Health Organization protocol for hepatitis B vaccination has been followed, and it is given free of cost in public health facilities under the National Immunization Schedule. Despite the free hepatitis vaccination program in India, coverage and awareness are low. Low awareness, followed by low coverage of hepatitis vaccination, can prove dangerous for the Indian population in the long run. A majority of chronic hepatitis cases progress silently to end-stage liver disease without having many signs and symptoms. Once occurred, a complete cure is not possible with currently available drugs. The studies from neighboring countries such as China and Taiwan documented that the impact of single-dose booster for children of 10 years has made a significant difference from the cost-effectiveness perspective. They have also included the booster dose in their national vaccination program. Considering the low level of vaccination awareness, small coverage, high disease burden, and high treatment cost, now, it is high time for India to introduce hepatitis B booster vaccine.
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Affiliation(s)
- Sudip Bhattacharya
- Department of Community Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Özden Gökdemir
- Izmir University of Economics, Faculty of Medicine, Izmir, Turkey
| | - Md Abu Bashar
- Department of Community Medicine, MM Institute of Medical Sciences and Research, MM Deemed University, Mullana, Haryana, India
| | | | - Amarjeet Singh
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India
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18
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Cross-Protection of Hepatitis B Vaccination among Different Genotypes. Vaccines (Basel) 2020; 8:vaccines8030456. [PMID: 32824318 PMCID: PMC7563454 DOI: 10.3390/vaccines8030456] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/09/2020] [Accepted: 08/12/2020] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B (HB) vaccination is the most effective method for preventing HB virus (HBV) infection. Universal HB vaccination containing recombinant HB surface antigens (HBsAg) is recommended. Our data revealed that human monoclonal HB surface antibody (anti-HBs) from individuals inoculated with genotype C-based HB vaccine induced cross-protection against HBV genotype A infection. An in vitro infection model demonstrated anti-HBs-positive sera from individuals inoculated with genotype A- or C-based HB vaccine harbored polyclonal anti-HBs that could bind to non-vaccinated genotype HBV. However, because there were low titers of anti-HBs specific for HBsAg of non-vaccinated genotype, high anti-HBs titers would be required to prevent non-vaccinated genotype HBV infection. Clinically, the 2015 Centers for Disease Control and Prevention guidelines state that periodic monitoring of anti-HBs levels after routine HB vaccination is not needed and that booster doses of HB vaccine are not recommended. However, the American Red Cross suggests that HB-vaccine-induced immune memory might be limited; although HB vaccination can prevent clinical liver injury (hepatitis), subclinical HBV infections of non-vaccinated genotypes resulting in detectable HB core antibody could not be completely prevented. Therefore, monitoring anti-HBs levels after routine vaccination might be necessary for certain subjects in high-risk groups.
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19
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Liu X, Zhou M, Wang F, Mubarik S, Wang Y, Meng R, Shi F, Wen H, Yu C. Secular Trend of Cancer Death and Incidence in 29 Cancer Groups in China, 1990-2017: A Joinpoint and Age-Period-Cohort Analysis. Cancer Manag Res 2020; 12:6221-6238. [PMID: 32801868 PMCID: PMC7398884 DOI: 10.2147/cmar.s247648] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/02/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose China has a heavy cancer burden. We aimed to quantitatively estimate the secular trend of cancer mortality and incidence in China. Methods We extracted numbers, age-specific and age-standardized rates of 29 cancer groups (from 1990 to 2017) from the Global Burden of Disease (GBD) study in 2017. We estimated rates of major cancer types for annual percent change by Joinpoint regression, and for age, period, and cohort effect by an age–period–cohort model. Results In 2017, breast cancer had the highest incidence rate in females. Lung cancer had the highest mortality and incidence rates in males. Although the age-standardized incidence rate of prostate cancer ranked second highest in males, it increased by 112% from 1990 to 2017. Individuals aged over 50 years were at high risk of developing cancer, and the number of deaths at this age accounted for over 89% of all cancers in all age groups. When compared with the global average level, the age-standardized mortality and incidence rates of both liver and esophageal cancers were 2.1 times higher in China, and stomach, lung and nasopharyngeal cancers in China also had high levels (more than 1.5 times higher). During 1990–2017, most of the 29 cancers exhibited an increasing incidence trend, and Joinpoint regression demonstrated increasing mortality of some major cancers. The period effect indicated that the risk of mortality and incidence due to the main cancers generally increased during 1992–2017. Conclusion Trend analysis provided information on the effects of prevention strategies and targeted interventions on the occurrence of different cancers. Etiological studies need to be conducted on some major cancers in the Chinese population.
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Affiliation(s)
- Xiaoxue Liu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, People's Republic of China
| | - Maigeng Zhou
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, People's Republic of China
| | - Fang Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, People's Republic of China
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, People's Republic of China
| | - Yafeng Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, People's Republic of China
| | - Runtang Meng
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, People's Republic of China
| | - Fang Shi
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, People's Republic of China
| | - Haoyu Wen
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, People's Republic of China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, People's Republic of China.,Global Health Institute, Wuhan University, Wuhan 430072, People's Republic of China
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Ranjan A, Shannon K, Chettiar J, Braschel M, Ti L, Goldenberg S. Barriers and facilitators to hepatitis B vaccination among sex workers in Vancouver, Canada: Implications for integrated HIV, STI, and viral hepatitis services. Int J Infect Dis 2019; 87:170-176. [PMID: 31404673 DOI: 10.1016/j.ijid.2019.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/26/2019] [Accepted: 07/26/2019] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Sex workers (SWs) face an increased burden of sexually transmitted and blood-borne infections, yet little is known regarding hepatitis B virus (HBV) prevention and care. This study was performed to characterize cross-sectional and prospective correlates of HBV vaccination among SWs in Vancouver. METHODS Questionnaire data were drawn from a community-based cohort of SWs (2010-2017). Multivariable logistic regression was used to examine correlates of lifetime self-reported HBV vaccination. Multivariable generalized estimating equation (GEE) regression was used to assess correlates of recent vaccination. RESULTS Among 855 participants, 68.3% reported lifetime HBV vaccination. Multivariable logistic regression showed that im/migrants (adjusted odds ratio (AOR) 0.50, 95% confidence interval (CI) 0.32-0.78) had lower odds of vaccination and that those using injection drugs (AOR 1.88, 95% CI 1.27- 2.78) and those who had undergone HIV testing (AOR 1.94, 95% CI 1.14-3.29) had higher odds of vaccination. In the multivariable GEE analysis, HIV seropositivity (AOR 1.93, 95% CI 1.26-2.97) and recent STI testing (AOR 2.95, 95% CI 1.99-4.39) correlated with recent HBV vaccination. CONCLUSIONS Im/migrant SWs from HBV-endemic settings appear to face gaps in HBV prevention. Evidence-based interventions addressing gaps in voluntary HBV prevention and care are needed, including community-based and culturally safe services. Injection drug use and HIV testing were linked to enhanced vaccination, suggesting that harm reduction and HIV programmes may facilitate linkage to HBV prevention.
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Affiliation(s)
- Anuisa Ranjan
- Centre for Gender and Sexual Health Equity (CGSHE), Vancouver, British Columbia, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
| | - Kate Shannon
- Centre for Gender and Sexual Health Equity (CGSHE), Vancouver, British Columbia, Canada; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jill Chettiar
- Centre for Gender and Sexual Health Equity (CGSHE), Vancouver, British Columbia, Canada
| | - Melissa Braschel
- Centre for Gender and Sexual Health Equity (CGSHE), Vancouver, British Columbia, Canada
| | - Lianping Ti
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Centre on Substance Use (BCCSU), Vancouver, British Columbia, Canada
| | - Shira Goldenberg
- Centre for Gender and Sexual Health Equity (CGSHE), Vancouver, British Columbia, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Division of Global Public Health, University of California, La Jolla, CA, USA
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McCullough AK, Lloyd RS. Mechanisms underlying aflatoxin-associated mutagenesis - Implications in carcinogenesis. DNA Repair (Amst) 2019; 77:76-86. [PMID: 30897375 PMCID: PMC6959417 DOI: 10.1016/j.dnarep.2019.03.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/01/2019] [Accepted: 03/05/2019] [Indexed: 01/07/2023]
Abstract
Chronic dietary exposure to aflatoxin B1 (AFB1), concomitant with hepatitis B infection is associated with a significant increased risk for hepatocellular carcinomas (HCCs) in people living in Southeast Asia and sub-Saharan Africa. Human exposures to AFB1 occur through the consumption of foods that are contaminated with pervasive molds, including Aspergillus flavus. Even though dietary exposures to aflatoxins constitute the second largest global environmental risk factor for cancer development, there are still significant questions concerning the molecular mechanisms driving carcinogenesis and what factors may modulate an individual's risk for HCC. The objective of this review is to summarize key discoveries that established the association of chronic inflammation (most commonly associated with hepatitis B viral (HBV) infection) and environmental exposures to aflatoxin with increased HCC risk. Special emphasis will be given to recent investigations that have: 1) refined the aflatoxin-associated mutagenic signature, 2) expanded the DNA repair mechanisms that limit mutagenesis via adduct removal prior to replication-induced mutagenesis, 3) implicated a specific DNA polymerase in the error-prone bypass and resulting mutagenesis, and 4) identified human polymorphic variants that may modulate individual susceptibility to aflatoxin-induced cancers. Collectively, these investigations revealed that specific sequence contexts are differentially resistant against, or prone to, aflatoxin-induced mutagenesis and that these associations are remarkably similar between in vitro and in vivo analyses. These recent investigations also established DNA polymerase ζ as the major polymerase that confers the G to T transversion signature. Additionally, although the nucleotide excision repair (NER) pathway has been previously shown to repair aflatoxin-induced DNA adducts, recent murine data demonstrated that NEIL1-initiated base excision repair was significantly more important than NER relative to the removal of the highly mutagenic AFB1-Fapy-dG adducts. These data suggest that inactivating polymorphic variants of NEIL1 could be a potential driver of HCCs in aflatoxin-exposed populations.
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Affiliation(s)
- Amanda K McCullough
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR 97239, United States; Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR 97239, United States
| | - R Stephen Lloyd
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR 97239, United States; Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR 97239, United States; Department of Physiology and Pharmacology, Oregon Health & Science University, Portland, OR 97239, United States.
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22
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Si J, Yu C, Guo Y, Bian Z, Meng R, Yang L, Chen Y, Jin J, Liu J, Guo Z, Chen J, Chen Z, Lv J, Li L. Chronic hepatitis B virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people. BMJ Open 2019; 9:e027696. [PMID: 30967410 PMCID: PMC6500223 DOI: 10.1136/bmjopen-2018-027696] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Chronic hepatitis B virus (HBV) infection is associated with a higher risk of liver diseases. Substantial uncertainty remains, however, about the associations of HBV infection with mortality from extrahepatic causes, especially from subtypes of cardiovascular diseases. We prospectively examined the association of chronic HBV infection with total and cause-specific mortality. DESIGN Population-based prospective cohort study. SETTING China Kadoorie Biobank in which participants from 10 geographically diverse areas across China were enrolled between 2004 and 2008. PARTICIPANTS 475 801 participants 30-79 years of age without reporting major chronic diseases at baseline were enrolled. Hepatitis B surface antigen (HBsAg) was tested using an on-site rapid test strip at baseline. PRIMARY AND SECONDARY OUTCOME MEASURES Total and cause-specific mortality. RESULTS A total of 35 822 deaths were recorded during ~10 years of follow-up. In multivariable-adjusted analyses, compared with HBsAg-negative participants, HBsAg-positive participants had an increased risk of total mortality (HR=2.01, 95% CI: 1.91 to 2.12), which was higher in men (HR=2.16, 95% CI: 2.01 to 2.31) than in women (HR=1.74, 95% CI: 1.60 to 1.90). Presence of HBsAg was associated with increased mortality from liver cancer (1339 deaths, HR=13.95, 95% CI: 12.46 to 15.62), infections (410 deaths, HR=10.30, 95% CI: 8.21 to 12.94), digestive diseases (688 deaths, HR=6.83, 95% CI: 5.49 to 8.50), intracerebral haemorrhage (4077 deaths, HR=1.38, 95% CI: 1.14 to 1.68) and ischaemic heart diseases (4624 deaths, HR=1.31, 95% CI: 1.09 to 1.58). The positive association between HBsAg status and risk of death was stronger in participants younger than 50 years, smokers, physically active or non-hypertensive participants. CONCLUSIONS Among Chinese adults, chronic HBV infection was associated with increased mortality from a range of hepatic and extrahepatic diseases.
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Affiliation(s)
- Jiahui Si
- Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Canqing Yu
- Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Ruogu Meng
- Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Ling Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jianrong Jin
- Wuzhong Center for Disease Control & Prevention, Suzhou, China
| | - Jingchao Liu
- Wuzhong Center for Disease Control & Prevention, Suzhou, China
| | - Ziyan Guo
- Nangang Center for Disease Control & Prevention, Harbin, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jun Lv
- Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Institute of Environmental Medicine, Peking University, Beijing, China
| | - Liming Li
- Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Chinese Academy of Medical Sciences, Beijing, China
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23
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Mass screening for liver cancer: results from a demonstration screening project in Zhongshan City, China. Sci Rep 2018; 8:12787. [PMID: 30143694 PMCID: PMC6109066 DOI: 10.1038/s41598-018-31119-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 08/06/2018] [Indexed: 12/11/2022] Open
Abstract
Current Chinese national guidelines recommend routine screening for liver cancer in patients positive for HBsAg, irrespective of fibrosis status, age, or family history of liver cancer. We aim to evaluate whether the recommended screening strategy could reduce liver-cancer-specific mortality. We conducted a liver cancer mass screening trial in Xiaolan Town, Zhongshan City, China, among residents aged 35–64 years in 2012. All volunteers were offered serological testing for hepatitis B virus surface antigen (HBsAg). We proposed biannual screening using serum alpha-fetoprotein (AFP) and ultrasonography examination for subjects positive for HBsAg. Among 17,966 participants (26.2% of 68,510 eligible residents) who were free of liver cancer at baseline in 2012, we identified 57 incident cases of liver cancer within the first 4 years of follow-up (i.e., 43 among 2,848 HBsAg-positive participants and 14 among 15,118 HBsAg-negative participants), compared with 104 cases identified in non-participants (N = 50,544). A total of 207 participants had the recommended number of ultrasonography examinations (every 6 months) during the screening period. Compared with cases identified from non-participants, the cases arising among participants were more likely to be at early stage and had better survival than those among non-participants. However, we did not observe a reduction in liver cancer-specific mortality rate among participants (relative risk = 1.04, 95% confidence interval = 0.68, 1.58, P = 0.856). Our demonstration screening study does not show a reduction in liver cancer mortality within the first 4 years of follow-up according to current guidance in China, although long-term efficacy remains to be evaluated. Targeted surveillance among high-risk individuals as recommended by international guidelines, along with measures to improve compliance, should be evaluated in the Chinese population.
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Zu J, Li M, Zhuang G, Liang P, Cui F, Wang F, Zheng H, Liang X. Estimating the impact of test-and-treat strategies on hepatitis B virus infection in China by using an age-structured mathematical model. Medicine (Baltimore) 2018; 97:e0484. [PMID: 29668627 PMCID: PMC5916706 DOI: 10.1097/md.0000000000010484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The potential impact of increasing test-and-treat coverage on hepatitis B virus (HBV) infection remains unclear in China. The objective of this study was to develop a dynamic compartmental model at a population level to estimate the long-term effect of this strategy.Based on the natural history of HBV infection and 3 serosurvey data of hepatitis B in China, we proposed an age- and time-dependent discrete model to predict the number of new HBV infection, the number of chronic HBV infection, and the number of HBV-related deaths for the time from 2018 to 2050 under 5 different test-and-treat coverage and compared them with current intervention policy.Compared with current policy, if the test-and-treat coverage was increased to 100% since 2018, the numbers of chronic HBV infection, new HBV infection, and HBV-related deaths in 2035 would be reduced by 26.60%, 24.88%, 26.55%, respectively, and in 2050 it would be reduced by 44.93%, 43.29%, 43.67%, respectively. In contrast, if the test-and-treat coverage was increased by 10% every year since 2018, then the numbers of chronic HBV infection, new HBV infection, and HBV-related deaths in 2035 would be reduced by 21.81%, 20.10%, 21.40%, respectively, and in 2050 it would be reduced by 41.53%, 39.89%, 40.32%, respectively. In particular, if the test-and-treat coverage was increased to 75% since 2018, then the annual number of HBV-related deaths would begin to decrease from 2018. If the test-and-treat coverage was increased to above 25% since 2018, then the hepatitis B surface antigen (HBsAg) prevalence for population aged 1 to 59 years in China would be reduced to below 2% in 2035. Our model also showed that in 2035, the numbers of chronic HBV infection and HBV-related deaths in 65 to 69 age group would be reduced the most (about 1.6 million and 13 thousand, respectively).Increasing test-and-treat coverage would significantly reduce HBV infection in China, especially in the middle-aged people and older people. The earlier the treatment and the longer the time, the more significant the reduction. Implementation of test-and-treat strategy is highly effective in controlling hepatitis B in China.
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Affiliation(s)
- Jian Zu
- School of Mathematics and Statistics
| | | | - Guihua Zhuang
- School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi
| | - Peifeng Liang
- Department of Statistics, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia
| | - Fuqiang Cui
- Health Science Center, Peking University, Beijing
| | - Fuzhen Wang
- Chinese Center for Disease Control and Prevention, Beijing, P. R. China
| | - Hui Zheng
- Chinese Center for Disease Control and Prevention, Beijing, P. R. China
| | - Xiaofeng Liang
- Chinese Center for Disease Control and Prevention, Beijing, P. R. China
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25
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Zhang S, Wang F, Zhang Z. Current advances in the elimination of hepatitis B in China by 2030. Front Med 2017; 11:490-501. [PMID: 29170919 DOI: 10.1007/s11684-017-0598-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/11/2017] [Indexed: 12/11/2022]
Abstract
With its 78 million chronic carriers, hepatitis B virus (HBV) infection is still one of the leading public health challenges in China. Over the last two decades, China has made great progress on the prevention of HBV transmission through national vaccination programs. Zero transmission from mother to infant has been proposed as the current goal. Available anti-HBV therapy is efficacious in suppressing HBV replication; however, it fails to completely cure patients with chronic hepatitis B and even requires lifelong treatment. To reduce the costs and improve the efficacy, several trials have been recently conducted in China to optimize the current anti-HBV managements. Novel biomarkers were identified to predict treatment outcomes, and new promising treatment strategies were developed. Reports also indicate that coinfections of HBV with other hepatotropic viruses and human immunodeficiency virus are common in China and cause severe liver diseases, which should be recognized early and treated properly. Work is still needed to eliminate hepatitis B in China by 2030.
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Affiliation(s)
- Shuye Zhang
- Shanghai Public Health Clinical Center and Institute of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Fusheng Wang
- Department of Infectious Diseases, Beijing 302 Hospital, Beijing, 100039, China
| | - Zheng Zhang
- Research Center for Clinical & Translational Medicine, Beijiing 302 Hospital, Beijing, 100039, China.
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26
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Cheng T, Zhang XL, Hu JJ, Li B, Wang Q. The role of routine screening in blood-borne pathogens in Chinese patients undergoing joint arthroplasty. Bone Joint Res 2017; 6:566-571. [PMID: 28963103 PMCID: PMC5630999 DOI: 10.1302/2046-3758.69.bjr-2017-0066.r2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 07/17/2017] [Indexed: 11/18/2022] Open
Abstract
Objectives Surgeons face a substantial risk of infection because of the occupational exposure to blood-borne pathogens (BBPs) from patients undergoing high-risk orthopaedic procedures. This study aimed to determine the seroprevalence of four BBPs among patients undergoing joint arthroplasty in Shanghai, China. In addition, we evaluated the significance of pre-operative screening by calculating a cost-to-benefit ratio. Methods A retrospective observational study of pre-operative screening for BBPs, including hepatitis B and C viruses (HBV and HCV), human immunodeficiency virus (HIV) and Treponema pallidum (TP), was conducted for sequential patients in the orthopaedic department of a large urban teaching hospital between 01 January 2009 and 30 May 2016. Medical records were analysed to verify the seroprevalence of these BBPs among the patients stratified by age, gender, local origin, type of surgery, history of previous transfusion and marital status. Results Of the subjects who underwent arthroplasty surgery in our institution, pre-operative screening tests were available for 96.1% (11 609 patients). The seroprevalence of HBV, HCV, HIV and TP was 5.47%, 0.45%, 0.08% and 3.6%, respectively. A total of 761 seropositive cases (68.4%) were previously undiagnosed. Pre-operative screening for HIV resulted in a low cost to benefit ratio, followed by HCV and HBV. Conclusion Routine HCV and HIV screening prior to joint arthroplasty is not a cost-effective strategy. Considering the high rate of undiagnosed patients and the shortage of protective options, targeted pre-operative screening for HBV and syphilis should be considered for the protection of healthcare workers in China who have not been vaccinated. Cite this article: Bone Joint Res 2017;6:566–571.
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Affiliation(s)
- T Cheng
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - X-L Zhang
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - J-J Hu
- Department of Infectious Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - B Li
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Zhengzhou University, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Q Wang
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
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27
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Zu J, Zhuang G, Liang P, Cui F, Wang F, Zheng H, Liang X. Estimating age-related incidence of HBsAg seroclearance in chronic hepatitis B virus infections of China by using a dynamic compartmental model. Sci Rep 2017; 7:2912. [PMID: 28588249 PMCID: PMC5460177 DOI: 10.1038/s41598-017-03080-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 04/24/2017] [Indexed: 02/08/2023] Open
Abstract
The age-specific seroclearance pattern of hepatitis B surface antigen (HBsAg) in chronic hepatitis B virus (HBV) infections of China remains unclear. In this study, based on three national serosurvey data of hepatitis B in China, we propose an age- and time-dependent discrete model and use the method of non-linear least squares to estimate the age-specific annual rate of HBsAg seroclearance. We found that the HBsAg seroclearance in chronic HBV infections of China aged 1–59 years occurred at an average annual rate of 1.80% (95% CI, 1.54–2.06%) from 1993 to 2006. The HBsAg seroclearance occurred predominantly in the early childhood, 20–24 and 35–39 year age groups. Moreover, our model estimated that HBsAg seroclearance resulted in 23.38% of the decrease of total HBsAg prevalence for population aged 1–59 years in 2006. It also prevented 9.30% of new HBV infections (about 7.43 million people) and 9.95% of HBV-related deaths (about 0.25 million people) from 1993 to 2006. This study develops a new and efficient method to estimate the age-specific incidence of HBsAg seroclearance at a population-level and evaluate its effect.
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Affiliation(s)
- Jian Zu
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, P.R. China. .,Department of Ecology and Evolution, The University of Chicago, Chicago, IL, 60637, USA.
| | - Guihua Zhuang
- School of Public Health, Xi'an Jiaotong University, Health Science Center, Xi'an, Shaanxi, 710061, P.R. China.
| | - Peifeng Liang
- Department of Medical Statistics, Ningxia People' Hospital, Yinchuan, Ningxia, 750002, P.R. China
| | - Fuqiang Cui
- Chinese Center for Disease Control and Prevention, Beijing, 100050, P.R. China
| | - Fuzhen Wang
- Chinese Center for Disease Control and Prevention, Beijing, 100050, P.R. China
| | - Hui Zheng
- Chinese Center for Disease Control and Prevention, Beijing, 100050, P.R. China
| | - Xiaofeng Liang
- Chinese Center for Disease Control and Prevention, Beijing, 100050, P.R. China.
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