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Wirahmadi A, Gunardi H, Medise BE, Oswari H, Sari TT, Kaswandani N, Karyanti MR. Seroconversion among children with HBsAg-positive mothers in Indonesia and factors affecting the anti-HBs titers. GLOBAL EPIDEMIOLOGY 2024; 7:100135. [PMID: 38283938 PMCID: PMC10821614 DOI: 10.1016/j.gloepi.2024.100135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/30/2024] Open
Abstract
Background and aim Around 2% of newborns are at risk of hepatitis B virus (HBV) infection from their mothers. To prevent this, infants born to HBsAg-positive mothers are given hepatitis B immune globulin (HBIG) and hepatitis B (HB) vaccine as immunoprophylaxis. This study aims to investigate the efficacy of immunoprophylaxis in infants born to HBsAg-positive mothers and the contributing factors. Methods The study was conducted on a group of 87 children, ranging from nine months to under 36 months, born to HBsAg-positive mothers and received immunoprophylaxis within 24 h after birth followed by a national immunization schedule at the Community Health Center (CHC) in three administrative cities of DKI Jakarta. We measured the levels of HBsAg and anti-HBs, and utilized ordinal logistic regression models to identify factors that influence the anti-HBs titers after vaccination. Results Out of 87 children, only one child had positive HBsAg results. The data showed that 88.5% of the children had seroprotection with anti-HBs levels ≥10 mIU/mL. Additionally, 48.3% of the children had a high protective response with anti-HBs levels ≥100 mIU/mL, while 11.5% had a non-protective response. Children under one year of age, with a family history of HBV carriers, and who received five doses of the HB vaccine exhibited higher levels of anti-HBs titer category with adjusted OR 3.9 (95%CI: 1.3-11.6), 5.3 (95%CI: 1.1-27.4), and 8.3 (95%CI: 2-34.8), respectively. Conclusion The administration of HBIG and HB vaccine successfully prevented vertical transmission, resulting in a high seroprotection rate.
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Affiliation(s)
- Angga Wirahmadi
- Faculty of Medicine, Universitas Indonesia, Department of Pediatrics, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Hartono Gunardi
- Faculty of Medicine, Universitas Indonesia, Department of Pediatrics, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Bernie Endyarni Medise
- Faculty of Medicine, Universitas Indonesia, Department of Pediatrics, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Hanifah Oswari
- Faculty of Medicine, Universitas Indonesia, Department of Pediatrics, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Teny Tjitra Sari
- Faculty of Medicine, Universitas Indonesia, Department of Pediatrics, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Nastiti Kaswandani
- Faculty of Medicine, Universitas Indonesia, Department of Pediatrics, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Mulya Rahma Karyanti
- Faculty of Medicine, Universitas Indonesia, Department of Pediatrics, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Anwar AD, Nugrahani AD, Santoso DPJ, Aziz MA, Ulfah L, Surachman A. Assessing the Impact of Hepatitis B Elimination Program on Maternal-Infant Health in West Java, Indonesia: A Cross-Sectional Study. Med Sci Monit 2023; 29:e941639. [PMID: 37614017 PMCID: PMC10464507 DOI: 10.12659/msm.941639] [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: 07/01/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection during pregnancy is a significant concern due to the risk of vertical transmission to the newborn, posing serious health complications. Understanding the effectiveness of intervention programs is paramount, especially in regions where comprehensive research is sparse. This study delves into the efficacy of the HBV elimination program in Garut Regency, West Java, Indonesia, targeting pregnant women and their newborns. MATERIAL AND METHODS This cross-sectional research encompassed 100 HBsAg-positive pregnant women who delivered at a singular facility in Garut Regency and their 62 offspring. Clinical data collection was rigorous, and HBsAg status was determined using rapid test kits, employing the precision of the 2-sided sandwich assay immunochromatography method. Data interpretation was multifaceted, involving univariate, bivariate, and multiple regression logistic analyses. RESULTS Notably, 16.95% of women, previously diagnosed as HBsAg-negative by initial health assessments, were subsequently diagnosed as positive at the specialized referral hospital. A noteworthy finding was that children administered with the HBV vaccine manifested a significantly diminished Positive-HBsAg status (P=0.029). Intriguingly, a majority of the maternal variables displayed a direct correlation with the HBsAg status of their offspring. The protective role of the HBV vaccine against HBV infection stood out distinctly (OR=0.326; CI 0.019-5.554; P=0.029). CONCLUSIONS While our center successfully met the desired HBsAg testing coverage in pregnant women, the administration of the hepatitis B vaccine to infants born to HBsAg-positive mothers lags behind the intended target. Emphasizing the vaccination's vital role, our study underscores its significance as a frontline defense for such infants.
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Affiliation(s)
- Anita Deborah Anwar
- Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Faculty of Medicine Padjadjaran University, Dr. Hasan-Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Annisa Dewi Nugrahani
- Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Faculty of Medicine Padjadjaran University, Dr. Hasan-Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Dhanny Primantara Johari Santoso
- Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Faculty of Medicine Padjadjaran University, Dr. Hasan-Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Muhammad Alamsyah Aziz
- Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Faculty of Medicine Padjadjaran University, Dr. Hasan-Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Lia Ulfah
- Head of Triple Elimination Program, Maternal-Child Health Division, Karangpawitan Primary Health Care, Garut, West Java, Indonesia
| | - Asep Surachman
- Head of Disease Prevention and Control, Department of Health, Garut, West Java, Indonesia
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Lestari CSW, Dewi RM, Sunarno S, Hasugian AR, Handayani S, Maha MS, Panjaitan NSD, Ningrum N, Sari M, Fairuza F. The effectiveness of hepatitis B vaccine in toddlers based on the five-year period national basic health research (Riskesdas 2007, 2013 and 2018) in Indonesia. PeerJ 2023; 11:e15199. [PMID: 37214093 PMCID: PMC10194077 DOI: 10.7717/peerj.15199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/16/2023] [Indexed: 05/24/2023] Open
Abstract
Background Hepatitis B is a viral infection that has a high prevalence in Indonesia. The Ministry of Health of Indonesia has conducted a national vaccination program for hepatitis B. In order to evaluate the success of the hepatitis B vaccination in Indonesia, a community study based on basic health research (Riskesdas) was performed nationwide since 2007 for five year period in 2007, 2013, and 2018. Methods Further statistical analysis was performed specifically for the children under 59 months old (toddlers) immunized in both urban and rural areas in 2007, 2013, and 2018 based on certain characteristics by examining antibodies against HBsAg (anti-HBs), IgG antibodies against the core antigen (HBcAb), surface antigen (HBsAg) of hepatitis B virus (HBV). The data obtained from the data management laboratory of Ministry of Health, Indonesia, was analyzed with Bivariate analysis with continuity correction chi-square or Pearson chi-square using Stata software version 16. Results This study showed an increase in hepatitis B coverage of complete immunization (30% in 2007, 60.3% in 2013, and 57% in 2018), which was also influenced by mothers' level of education (Pearson chi-square , p ¡ 0.05) and access to health service points within 30 minutes (OR = 1.3-2.8, p ¡ 0.05). The trend of the percentage of immune status (anti-HBs) was increased (41.8% in 2007; 56.1% in 2013; and 79.1% in 2018). The higher anti-HBs was found in complete hepatitis B immunization status (OR = 1.5-2, p ¡ 0.05) and in good nutritional status (p ¡ 0.05). However, the anti-HBs was found decreased with increasing age (p ¡ 0.05). The trend of positive HBcAb (exposure to HBV infection) showed a decrease gradually of almost ten times from 2007 (8.6%-13.5%) compared to 2013 (2.6%-11.1%) and 2018 (1.1%-2%). Urban areas were at higher risk of hepatitis B exposure (OR = 1.4-2.2) than rural areas (OR = 0.37-0.80). The HBsAg data were only available in 2013 and 2018. Riskesdas data analysis showed the prevalence of hepatitis B (HBsAg) was lower in complete immunization status than that in incomplete one (p ¡ 0.05), but with an increase from 3.9% (2013) to 9.3% (2018), possibly due to inappropriate implementation of birth dose immunization or a vaccine-escape mutant from the HBV variants. Conclusions The effectiveness of hepatitis B vaccine obtained from the three Riskesdas periods in Indonesia showed an improvement, with an increase in immune status, reduced exposure to HBV and a lower prevalence of hepatitis B in children with complete vaccination. However, there is still an increase in hepatitis B infection, especially in urban areas. Therefore, a long-term evaluation of immunization coverage especially ensuring that the initial dose of immunization was given within the first 24 h of birth, HBsAg and HBcAb, nutritional status, genomic surveillance of HBV, and other aspects of program quality evaluation are needed to ensure that elimination efforts have been implemented properly.
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Affiliation(s)
- Christina Safira Whinie Lestari
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Rita Marleta Dewi
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Sunarno Sunarno
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Armedy Ronny Hasugian
- Research Center for Preclinical and Clinical Medicine, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Sarwo Handayani
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Masri Sembiring Maha
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Novaria Sari Dewi Panjaitan
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Nathalia Ningrum
- Department of Paediatrics, Faculty of Medicine, Universitas Trisakti, West Jakarta, Jakarta, Indonesia
| | - Meiriani Sari
- Department of Paediatrics, Faculty of Medicine, Universitas Trisakti, West Jakarta, Jakarta, Indonesia
| | - Firda Fairuza
- Department of Paediatrics, Faculty of Medicine, Universitas Trisakti, West Jakarta, Jakarta, Indonesia
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Bello KE, Mat Jusoh TNA, Irekeola AA, Abu N, Mohd Amin NAZ, Mustaffa N, Shueb RH. A Recent Prevalence of Hepatitis B Virus (HBV) Genotypes and Subtypes in Asia: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:healthcare11071011. [PMID: 37046937 PMCID: PMC10094200 DOI: 10.3390/healthcare11071011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
Background and Aim: Despite introducing the hepatitis B virus (HBV) vaccine, the incidence of the Hepatitis B virus globally is still a major health concern. This systematic review and meta-analysis were conducted to provide detailed information on the prevalence of HBV genotypes and subtypes in circulation in Asia. Methods: A systematic search for articles describing the prevalence of HBV genotypes and subtypes in Asia was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Results: Our search returned 207 eligible articles involving 49,279 genotypes and 7457 subtypes representing 28 Asian countries. A meta-analysis was performed on our eligible studies using the Random effect Model. The pooled prevalence of HBV genotypes showed that genotype C (30.9%) (95% CI, 27.5–34.5%; I2 = 97.57%; p < 0.001) was the most common HBV genotype in Asia, followed by genotype B (17.8%) (95% CI, 15.5–20.4%; I2 = 97.26%; p < 0.001) and genotype D (15.4%) (95% CI, 11.8–19.8%). Vietnam had the highest prevalence of genotype B, Lebanon had the highest prevalence of genotypes C, and Jordan had the highest prevalence of genotype D. There was variation in genotypic prevalence with respect to the target genes for HBV genotyping. Reverse dot blot hybridization had the highest estimate of genotypes B and C. HBV subtype C2 (40.0%) (95% CI, 33.3–47.0) is the most prevalent HBV subtype. Conclusion: Evidence from this study reveals that HBV genotypes C and B are the most dominant HBV genotypes in Asia, and HBV subtype C2 is more endemic in Asia.
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Affiliation(s)
- Kizito Eneye Bello
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Microbiology, Faculty of Natural Science, Kogi State University (Prince Abubakar Audu University), Anyigba 1008, Kogi State, Nigeria
| | - Tuan Nur Akmalina Mat Jusoh
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Ahmad Adebayo Irekeola
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Microbiology Unit, Department of Biological Sciences, College of Natural and Applied Sciences, Summit University Offa, Offa 4412, Kwara State, Nigeria
| | - Norhidayah Abu
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Advanced Materials Research Centre (A.M.R.E.C.), Lot 34 Jalan Hi-Tech 2/3, Kulim Hi-Tech Park, Kulim 09000, Kedah, Malaysia
| | - Nur Amalin Zahirah Mohd Amin
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Nazri Mustaffa
- Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Rafidah Hanim Shueb
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Institute for Research in Molecular Medicine (I.N.F.O.R.M.M.), Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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5
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Machmud PB, Führer A, Gottschick C, Mikolajczyk R. Barriers to and Facilitators of Hepatitis B Vaccination among the Adult Population in Indonesia: A Mixed Methods Study. Vaccines (Basel) 2023; 11:398. [PMID: 36851280 PMCID: PMC9967628 DOI: 10.3390/vaccines11020398] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/07/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
To reach the goals of the Global Hepatitis Elimination 2030 program, Indonesia is now preparing a new regulation for hepatitis B vaccinations for adult population. This study aimed to determine the factors influencing vaccine uptake for hepatitis B in the adult population, and identify barriers to, and facilitators of, hepatitis B vaccination programmes. An explanatory sequential mixed methods design was implemented in this study. We conducted a survey involving 893 participants in the general population followed by 14 in-depth interviews with health providers. The survey found that only 15% (95% confidence interval 13-18%) of participants received at least one dose of the hepatitis B vaccine. Factors associated with vaccine uptake were, living in Yogyakarta compared to living in Aceh, having secondary and higher education compared to primary education, working as a health worker compared to working in other sectors, and having health insurance that covered hepatitis B vaccination compared to not having such health insurance. Our qualitative study also identified several barriers to the adult hepatitis B vaccination programme in Indonesia such as the high cost of vaccination, lack of vaccine availability in certain areas, limited human resources to implement the hepatitis B vaccination programme, and the ineffective dissemination of hepatitis B vaccination. This study highlights that accessibility and affordability of vaccinations are important determinants of vaccination uptake that should be taken into account when planning vaccination campaigns.
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Affiliation(s)
- Putri Bungsu Machmud
- Institute of Medical Epidemiology, Biometrics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany
- Department of Epidemiology, Public Health Faculty, Universitas Indonesia, Jl. Prof Dr Bahder Djohan, Depok 16424, Jawa Barat, Indonesia
| | - Amand Führer
- Institute of Medical Epidemiology, Biometrics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany
| | - Cornelia Gottschick
- Institute of Medical Epidemiology, Biometrics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biometrics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany
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Machmud PB, Mikolajczyk R, Gottschick C. Understanding hepatitis B vaccination willingness in the adult population in Indonesia: a survey among outpatient and healthcare workers in community health centers. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01775-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Abstract
Aim
This study aimed to assess factors associated with the willingness to be vaccinated against hepatitis B among Indonesia’s adult population, considering cultural and geographic differences by analysing the two provinces of Aceh and Yogyakarta.
Subject and methods
An institution-based cross-sectional survey was conducted in 16 community health centres. A multivariable logistic regression model stratified by province was employed to assess variables associated with the willingness to receive hepatitis B vaccination.
Results
We found that participants from Yogyakarta more often had a higher knowledge and risk perception of hepatitis B and were more often willing to get vaccinated than participants from Aceh. We also found that a high-risk perception of hepatitis B infection was associated with the willingness to be vaccinated against hepatitis B in participants from both Aceh and Yogyakarta. Furthermore, in Yogyakarta, a fair and high knowledge of hepatitis B infection and vaccination, being female, and having health insurance covering hepatitis B vaccination costs were associated with the willingness to be vaccinated. In Aceh, health care workers in high-risk units for hepatitis B had a higher willingness to be vaccinated than those who were not high-risk health care workers.
Conclusion
Given the different factors associated with the willingness to be vaccinated against hepatitis B in Aceh and Yogyakarta, this study also highlights the need of a locally adjusted, culture-based approach to improve the hepatitis B vaccination programme.
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Marjenberg Z, Wright C, Pooley N, Cheung KW, Shimakawa Y, Vargas-Zambrano JC, Vidor E. Hepatitis B surface antigen prevalence and the rates of mother-to-child transmission of hepatitis B virus after the introduction of infant vaccination programs in South East Asia and Western Pacific regions: a systematic review. Int J Infect Dis 2022; 124:65-75. [PMID: 36089151 DOI: 10.1016/j.ijid.2022.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Infant vaccination against the hepatitis B virus began in the World Health Organization South East Asia Region and the Western Pacific Region between 1983 and 2016. This systematic review examined the seroprevalence of hepatitis B surface antigen (HBsAg) in children and the rate of mother-to-child transmission (MTCT) in these regions between 1990 and 2020. METHODS MEDLINE and EMBASE were searched for articles published between January 1990 and September 2020, which reported seroprevalence of HBsAg in children aged 0-15 years and/or the rate of MTCT in the South East Asia Region and Western Pacific Region. A pragmatic review identified supporting information. This review was registered in the International Prospective Register of Systematic Reviews (#CRD42020211707). RESULTS Of 115 included studies, 77 (24 countries) reported HBsAg prevalence, and 38 (nine countries) reported MTCT. The seroprevalence of HBsAg ranged between 0.0% and 27.4%, with a decreasing trend over time in each country. MTCT rates were 0.0-5.2% in infants of mothers who are hepatitis B e antigen-negative and 2.7-53.0% in infants of mothers who are hepatitis B e antigen-positive. CONCLUSION After the introduction of infant hepatitis B virus vaccination programs, the countries in South East Asia Region and Western Pacific Region observed a reduction in HBsAg seroprevalence in children. Nevertheless, the risk of MTCT persists, emphasizing the importance of antenatal screening to identify high-risk pregnancies.
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Affiliation(s)
| | - Ciara Wright
- Maverex Limited, Newcastle upon Tyne, United Kingdom.
| | - Nick Pooley
- Maverex Limited, Newcastle upon Tyne, United Kingdom.
| | - Ka Wang Cheung
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
| | - Yusuke Shimakawa
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France.
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Nency YM, Rahmadi FA, Mulyono, Anantyo DT, Farhanah N, Hapsari R, Farida H, Sadhana U, Djagat H, Kristina TN, Juniarto AZ, Puspita M, Sari RM, Bachtiar NS. Protectivity and safety following recombinant hepatitis B vaccine with different source of bulk compared to hepatitis B (Bio Farma) vaccine in Indonesia. Clin Exp Vaccine Res 2022; 11:43-52. [PMID: 35223664 PMCID: PMC8844670 DOI: 10.7774/cevr.2022.11.1.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/25/2021] [Accepted: 11/11/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Indonesia, a high populous and the second-highest country in epidemicity of hepatitis B in South-East Asia require maintaining its capacity of monovalent hepatitis B production to keep up with both the national immunization program and global needs. To keep the sustainability of the vaccine, a new bulk is needed to be made available. This study aims to evaluate the immunogenicity and safety of Bio Farma newly formulated recombinant hepatitis B vaccines, which came from different sources of bulk, compared to the already registered hepatitis B vaccine. Materials and Methods An experimental, randomized, double-blind, cohort intervention phase II clinical trial was conducted on three recombinant hepatitis B vaccines from different bulk sources, with Bio Farma registered hepatitis B vaccine as the control group. A total of 536 participants around age 10 to 40 years old were thricely vaccinated with twice serological assessments. The subject’s safety was monitored for 28 days after each vaccination. Results Of 536 enrolled participants, 521 finished the vaccination and serology assessments. The investigational products were proven not to be inferior to the control. All vaccines were well tolerated. No differences in rates of local and systemic reactions were seen between the investigational products and control. No serious adverse event was found to be related to the investigational vaccines. Conclusion Investigational vaccines are shown to be equally immunogenic and safe as the control vaccine.
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Affiliation(s)
- Yetty M. Nency
- Faculty of Medicine, University of Diponegoro, Semarang, Indonesia
| | | | - Mulyono
- Faculty of Medicine, University of Diponegoro, Semarang, Indonesia
| | | | - Nur Farhanah
- Faculty of Medicine, University of Diponegoro, Semarang, Indonesia
| | | | - Helmia Farida
- Faculty of Medicine, University of Diponegoro, Semarang, Indonesia
| | - Udadi Sadhana
- Faculty of Medicine, University of Diponegoro, Semarang, Indonesia
| | - Herry Djagat
- Faculty of Medicine, University of Diponegoro, Semarang, Indonesia
| | - Tri Nur Kristina
- Faculty of Medicine, University of Diponegoro, Semarang, Indonesia
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Heywood A, Dyda A, Hu W, Saha A, Mahimbo A, Gidding H, Kefalas B, Seale H, Macintyre CR, Zwar N, Rawlinson W. Seroprevalence of hepatitis B antibodies among international and domestic university students. J Viral Hepat 2021; 28:1400-1412. [PMID: 34309992 DOI: 10.1111/jvh.13580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/14/2021] [Accepted: 07/21/2021] [Indexed: 12/09/2022]
Abstract
Chronic hepatitis B prevalence is low in most Australian populations, with universal infant HBV vaccination introduced in 2000. Migrants from high prevalence countries are at risk of acquisition before arrival and non-immune adults are potentially at risk through skin penetrating procedures and sexual contact, particularly during international travel. The risk profile of young adult students, many from high prevalence countries, is inadequately understood. A cross-sectional online survey conducted among university students collected data on demographic, vaccination and travel characteristics and blood samples were tested for hepatitis B surface antibody (HBsAb) and hepatitis B core antibody (HBcAb). Analyses identified factors associated with HBsAb seroprevalence and self-reported vaccination. The serosurvey was completed by 804 students born between 1988 and 1993, with 613/804 (76.2%, 95% CI 73.2-79.1) self-reporting prior HBV vaccination. Overall, 526/804 (65.4%, 95% CI 62.0%-68.6%) students were seropositive to HBsAb, including 438/613 (71.5%, 95% CI 67.8-74.9) students self-reporting a prior HBV vaccine and 88/191 (46.1%, 95% CI 39.2-53.2) students self-reporting no prior HBV vaccine. Overall, 8/804 (1.0%, 95% CI 0.5%-2.0%) students were HBcAb positive, of whom 1/804 (0.1%, 95% CI 0.02%-0.7%) was currently infectious. The prevalence of chronic HBV infection was low. However, more than one in four students were susceptible to HBV and over-estimated their immunity. Future vaccination efforts should focus on domestic students born before the introduction of the infant program and all international students. Screening and vaccination of students, including through campus-based health services, are an opportunity to catch-up young adults prior to undertaking at-risk activities, including international travel.
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Affiliation(s)
- Anita Heywood
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Amalie Dyda
- University of Queensland, Brisbane, Queensland, Australia
| | - William Hu
- Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Amit Saha
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Abela Mahimbo
- University of Technology, Sydney, New South Wales, Australia
| | | | - Bill Kefalas
- UNSW Health Service, UNSW Sydney, Sydney, New South Wales, Australia
| | - Holly Seale
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - C Raina Macintyre
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Nicholas Zwar
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.,Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
| | - William Rawlinson
- Serology and Virology Division (SAViD), NSW Health Pathology SEALS-Randwick, Randwick, New South Wales, Australia.,Schools of Medical Sciences (SOMS), Biotechnology and Biomolecular Sciences (BABS), and Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia
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10
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van Zutphen KG, Kraemer K, Melse-Boonstra A. Knowledge Gaps in Understanding the Etiology of Anemia in Indonesian Adolescents. Food Nutr Bull 2021; 42:S39-S58. [PMID: 34282655 PMCID: PMC8293751 DOI: 10.1177/0379572120979241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Anemia is a public health problem among adolescents in Indonesia. Strategies to prevent or treat anemia should be tailored to local conditions, taking into account its specific etiology and prevalence in a given setting and population group. OBJECTIVE This review aims to (1) identify and synthesize the current knowledge on the etiology of anemia among adolescents in Indonesia, (2) reveal knowledge gaps in this area, and (3) suggest directions for future research and programmatic work. METHODS We systematically searched PubMed, Web of Science, Scopus, Medline, and WorldCat databases for peer-reviewed journal articles to identify which etiological factors were related to anemia among Indonesian adolescents. Research papers were reviewed and included in the review according to inclusion criteria. RESULTS Of 13 studies, 8 showed that anemia was associated with iron deficiency; 4 are suggestive of vitamin A deficiency; and 2 of folic acid deficiency. Five studies underscore different etiological determinants for anemia, such as malaria, protein and energy malnutrition, vitamin B2 deficiency, calcium, and vitamin C deficiency. Based on these findings, we developed a framework on knowledge gaps on the etiology of anemia among adolescents in Indonesia, divided in 3 levels of knowledge: (1) significant knowledge gaps, (2) knowledge gaps, and (3) established knowledge. CONCLUSIONS The knowledge gaps around the etiology of anemia among Indonesian adolescents are significant. Our framework emphasizes the need for further research across all etiological factors, namely inadequate nutritional intake and absorption, genetic hemoglobin disorders, infection and inflammation, and menstrual disorders.
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Affiliation(s)
- Kesso Gabrielle van Zutphen
- 4508Wageningen University & Research, Wageningen, the Netherlands.,Sight and Life Foundation, Basel, Switzerland
| | - Klaus Kraemer
- Sight and Life Foundation, Basel, Switzerland.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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11
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Ohta T, Ito K, Sugiura T, Koyama N, Saitoh S, Murakami S, Tanaka Y. Breakthrough HBV infection in a vaccinated child due to vaccine escape mutant. KANZO 2021; 62:403-412. [DOI: 10.2957/kanzo.62.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Affiliation(s)
- Takanori Ohta
- Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University
| | - Koichi Ito
- Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University
| | | | | | - Shinji Saitoh
- Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University
| | - Shuko Murakami
- Department of Virology and Liver Unit, Graduate School of Medical Sciences, Nagoya City University
| | - Yasuhito Tanaka
- Department of Gastroenterology and Hepatology, Kumamoto University
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12
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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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13
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Immunogenicity of Hepatitis B Vaccine in Preterm or Low Birth Weight Infants: A Meta-Analysis. Am J Prev Med 2020; 59:278-287. [PMID: 32564973 DOI: 10.1016/j.amepre.2020.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 03/09/2020] [Accepted: 03/23/2020] [Indexed: 12/23/2022]
Abstract
CONTEXT The study aims to quantitatively assess the immune response to hepatitis B vaccine in infants born preterm or with low birth weight. EVIDENCE ACQUISITION In December 2018, a literature search was conducted in 4 databases without date restrictions. The pooled ORs, mean differences, and their corresponding 95% CIs were calculated with random-effects models using the DerSimonian-Laird estimator. The potential risk of bias of each study was assessed using the Newcastle-Ottawa Scale. The stability and publication bias of the pooled estimates were also evaluated. Analyses were completed in 2019. EVIDENCE SYNTHESIS A total of 27 studies including 22,202 infants were eligible for analysis. The studies found that infants born preterm had significantly poorer immune responses to the hepatitis B vaccine. Preterm infants were 1.36 times more likely to exhibit nonresponse to the hepatitis B vaccine (95% CI=1.12, 1.65, p=0.002) compared with their full-term counterparts. The pooled estimates for preterm birth may be subject to a potential publication bias. However, these results were stable, as suggested by the leave-one-out analysis and fail-safe number. The association between low birth weight and impaired immune response to the hepatitis B vaccine was not statistically significant when birth weight was dichotomized at 2,500 g. CONCLUSIONS These findings suggest an association between preterm birth and lowered immune responses to hepatitis B vaccine.
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14
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Lin CC, Shih CT, Lee CH, Ku MK, Huang YL. Seroepidemiology of Hepatitis B Virus Infection in Native and Immigrant Pregnant Women: A 20-Year Retrospective Study in Taiwan. Am J Trop Med Hyg 2020; 101:899-904. [PMID: 31392948 DOI: 10.4269/ajtmh.19-0088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Universal immunoprophylaxis against hepatitis B virus (HBV) is regarded as a key element to prevent perinatal HBV infection. The aim of the present study was to investigate the changes in the hepatitis B surface antigen (HBsAg)- and hepatitis B envelope antigen (HBeAg)-positive rates in native and immigrant pregnant women, to realize the impact of immigrants, and to identify any weaknesses 30 years after the implementation of hepatitis B vaccination in Taiwan. A total of 20,020 test results of HBsAg and HBeAg in pregnant women-2,915 (14.6%) immigrant women and 17,105 native Taiwanese-from 1996 to 2015 were analyzed for changes during this 20-year retrospective cohort study. Native Taiwanese have a higher HBsAg-positive rate than immigrant women (P < 0.001). However, the HBsAg-positive rates decreased by 0.6% per year among native women, but did not decrease significantly (only by 0.18% per year) among immigrant women. The overall HBsAg-positive rate remained at high levels, 4.8% in the year 2015. The HBeAg-positive rate decreased significantly, by 0.22% per year, in the total women as well as by 0.23% per year in the native women (all P < 0.001); by contrast, the HBeAg-positive rate in immigrants decreased at a slower rate (0.10% per year), without a significant decreasing trend (P = 0.300). Higher HBeAg (+)/HBsAg (+) rate was found for the immigrants than for the native women (P < 0.001). To quickly and effectively lower the risk of vertical transmission, new approaches combined with vaccination may be needed in the post-immunization era.
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Affiliation(s)
- Ching-Chiang Lin
- Department of Education and Research, Fooyin University Hospital, Pingtung, Taiwan.,Department of Medical Laboratory Science and Biotechnology, Fooyin University, Kaohsiung, Taiwan
| | - Ching-Tang Shih
- Department of Family Medicine, Fooyin University Hospital, Pingtung, Taiwan
| | - Chien-Hung Lee
- Department of Public Health and Environmental Medicine Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Kun Ku
- Department of Internal Medicine, Fooyin University Hospital, Pingtung, Taiwan
| | - Yeou-Lih Huang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Chemistry, National Sun Yat-sen University, Kaohsiung, Taiwan.,Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
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15
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Sarin SK, Kumar M, Eslam M, George J, Al Mahtab M, Akbar SMF, Jia J, Tian Q, Aggarwal R, Muljono DH, Omata M, Ooka Y, Han KH, Lee HW, Jafri W, Butt AS, Chong CH, Lim SG, Pwu RF, Chen DS. Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol 2020; 5:167-228. [PMID: 31852635 PMCID: PMC7164809 DOI: 10.1016/s2468-1253(19)30342-5] [Citation(s) in RCA: 287] [Impact Index Per Article: 71.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 07/20/2019] [Accepted: 08/02/2019] [Indexed: 02/06/2023]
Abstract
The Asia-Pacific region is home to more than half of the global population and accounted for 62·6% of global deaths due to liver diseases in 2015. 54·3% of global deaths due to cirrhosis, 72·7% of global deaths due to hepatocellular carcinoma, and more than two-thirds of the global burden of acute viral hepatitis occurred in this region in 2015. Chronic hepatitis B virus (HBV) infection caused more than half of the deaths due to cirrhosis in the region, followed by alcohol consumption (20·8%), non-alcoholic fatty liver disease (NAFLD; 12·1%), and chronic infection with hepatitis C virus (HCV; 15·7%). In 2015, HBV accounted for about half the cases of hepatocellular carcinoma in the region. Preventive strategies for viral hepatitis-related liver disease include increasing access to clean drinking water and sanitation. HBV vaccination programmes for neonates have been implemented by all countries, although birth-dose coverage is extremely suboptimal in some. Availability of screening tests for blood and tissue, donor recall policies, and harm reduction strategies are in their initial stages in most countries. Many governments have put HBV and HCV drugs on their essential medicines lists and the availability of generic versions of these drugs has reduced costs. Efforts to eliminate viral hepatitis as a public health threat, together with the rapid increase in per-capita alcohol consumption in countries and the epidemic of obesity, are expected to change the spectrum of liver diseases in the Asia-Pacific region in the near future. The increasing burden of alcohol-related liver diseases can be contained through government policies to limit consumption and promote less harmful patterns of alcohol use, which are in place in some countries but need to be enforced more strictly. Steps are needed to control obesity and NAFLD, including policies to promote healthy lifestyles and regulate the food industry. Inadequate infrastructure and insufficient health-care personnel trained in liver diseases are issues that also need to be addressed in the Asia-Pacific region. The policy response of most governments to liver diseases has thus far been inadequate and poorly funded. There must be a renewed focus on prevention, early detection, timely referral, and research into the best means to introduce and improve health interventions to reduce the burden of liver diseases in the Asia-Pacific region.
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Affiliation(s)
- Shiv K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India.
| | - Manoj Kumar
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India
| | - Mohammed Eslam
- Storr Liver Centre, The Westmead Institute for Medical Research, University of Sydney and Westmead Hospital, Westmead, Australia
| | - Jacob George
- Storr Liver Centre, The Westmead Institute for Medical Research, University of Sydney and Westmead Hospital, Westmead, Australia
| | - Mamun Al Mahtab
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sheikh M Fazle Akbar
- Department of Pathology, Ehime University Proteo-Science Center, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medial University, Beijing, China
| | - Qiuju Tian
- Liver Research Center, Beijing Friendship Hospital, Capital Medial University, Beijing, China
| | - Rakesh Aggarwal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Masao Omata
- Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan; University of Tokyo, Tokyo, Japan
| | - Yoshihiko Ooka
- Department of Gastroenterology, Chiba University Hospital, Chiba, Japan
| | - Kwang-Hyub Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Won Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Wasim Jafri
- Department of Medicine, Section of Gastroenterology, The Aga Khan University, Karachi, Pakistan
| | - Amna S Butt
- Department of Medicine, Section of Gastroenterology, The Aga Khan University, Karachi, Pakistan
| | - Chern H Chong
- Division of Gastroenterology & Hepatology, National University Health System, Singapore; Division of General Medicine, Woodlands Health Campus, Singapore
| | - Seng G Lim
- Division of Gastroenterology & Hepatology, National University Health System, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Raoh-Fang Pwu
- National Hepatitis C Program Office, Ministry of Health and Welfare, Taipei, Taiwan
| | - Ding-Shinn Chen
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan
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16
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Bierhoff M, Pinyopornpanish K, Pinyopornpanish K, Tongprasert F, Keereevijit A, Rijken M, Chu CS, Nosten F, Perfetto J, van Vugt M, Mcgready R, Angkurawaranon C. Retrospective Review of Documentation Practices of Hepatitis B Immunoglobulin, Birth Dose, and Vaccination at the Hospital of Birth, in Thai Nationals and Migrants in Northern Thailand. Open Forum Infect Dis 2019; 6:ofz518. [PMID: 31890723 PMCID: PMC6934156 DOI: 10.1093/ofid/ofz518] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 12/06/2019] [Indexed: 12/18/2022] Open
Abstract
Background Vaccination remains the mainstay of prevention of hepatitis B virus (HBV) including birth dose and hepatitis B immunoglobulins (HBIGs). National estimates of vaccination coverage exclude migrants. The objective of this study is to investigate documentation practices of HBV-related infant vaccinations in Northern Thailand including migrants. Methods This is a retrospective review of hospital records of women who birthed infants in 2015 at Maharaj Nakorn Hospital, Chiang Mai (CM) or on the Thailand-Myanmar border, Tak. Results Of 2522 women, 987 were from CM (861 Thai nationals, 126 migrants) and 1535 were from Tak (651 Thai residence and 884 Myanmar residence). In CM, documentation for the birth dose vaccine (999 of 999, 100%) and HBIG was complete. In Tak, documentation was 1441 of 1549 (93%) for birth dose and 26 of 34 (76.5%) for HBIG, with missed opportunities including home delivery, delay in obtaining hepatitis B e-antigen status, and limitations of the records. Expanded Program of Immunization (EPI) documentation of 3 follow-up vaccinations dwindled with subsequent doses and distance, and complete documentation of 3 HBV EPI vaccines at the hospital of birth was low, 41.5% (1056 of 2547), but equitable for Thai or migrant status. Conclusions This review provides strong support for excellent documentation of HBIG and birth dose vaccination in urban and rural settings, and in migrants, consistent with Thailand's vaccination policy and practice. Documentation of the 3 HBV EPI at the hospital of birth decreases with sequential doses, especially in families further away. Innovative data linkage is required to prove coverage and identify gaps.
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Affiliation(s)
- M Bierhoff
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.,Division of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Kanokwan Pinyopornpanish
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - F Tongprasert
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Arunrot Keereevijit
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand
| | - M Rijken
- Utrecht University Medical Centre and Julius Centre Global Health, Utrecht, The Netherlands
| | - C S Chu
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Oxford, United Kingdom
| | - F Nosten
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Oxford, United Kingdom
| | - J Perfetto
- New York University School of Medicine, New York, New York, USA
| | - M van Vugt
- Division of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - R Mcgready
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Oxford, United Kingdom
| | - C Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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17
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Wahyuni RM, Utsumi T, Juniastuti, Yano Y, Murti IS, Amin M, Yamani LN, Istimagfiroh A, Purwono PB, Soetjipto, Lusida MI, Hayashi Y. Analysis of hepatitis B virus genotype and gene mutation in patients with advanced liver disease in East Kalimantan, Indonesia. Biomed Rep 2019; 10:303-310. [PMID: 31086664 PMCID: PMC6489537 DOI: 10.3892/br.2019.1202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/12/2019] [Indexed: 12/18/2022] Open
Abstract
Liver cirrhosis (LC) and hepatocellular carcinoma (HCC) are life-threatening conditions frequently associated with chronic hepatitis B virus (HBV) infection in Asian countries, including Indonesia. HBV genotypes and several specific mutations are associated with disease progression. To clarify the geographical variation in viral characteristics, HBV genotypes and gene mutations were investigated in patients with advanced liver disease (ALD) in Samarinda, East Kalimantan, Indonesia. Sera were collected from 41 patients with ALD at Abdul Wahab Sjahranie Hospital and HBV carriers from Red Cross Center blood bank in Samarinda, and screened for hepatitis B surface antigen and hepatitis B e-antigen. Liver function data were obtained from the medical records from each patient. HBV genotype and gene mutations were determined by polymerase chain reaction sequencing. Analysis of HBV isolates indicated that genotype B was the most frequent genotype, at 85.4 and 97.8%, followed by C, at 14.6 and 2.2%, in patients with ALD and in HBV carriers, respectively. The C1505A mutation in X region, T1753V and A1762T/G1764A mutations in the basal core promoter region and C1858T in precore (PC) region were frequent and only detected in patients with ALD (28.9, 40, 73.5 and 17.6%, respectively), whereas the G1896A mutation in the PC region was frequently detected in HBV carriers. The presence of HBV genotype B and certain HBV gene mutations were characteristic of patients with ALD in East Kalimantan.
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Affiliation(s)
- Rury Mega Wahyuni
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
| | - Takako Utsumi
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Juniastuti
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
- Department of Microbiology, Faculty of Medicine, Airlangga University, Campus A, Surabaya 60131, Indonesia
| | - Yoshihiko Yano
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Ignatia Sinta Murti
- Department of Internal Medicine, Faculty of Medicine, Mulawarman University, Samarinda 75119, Indonesia
| | - Mochamad Amin
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
| | - Laura Navika Yamani
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
- Department of Epidemiology, Faculty of Public Health, Airlangga University, Campus C, Surabaya 60115, Indonesia
| | - Anittaqwa Istimagfiroh
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
| | - Priyo Budi Purwono
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
- Department of Microbiology, Faculty of Medicine, Airlangga University, Campus A, Surabaya 60131, Indonesia
| | - Soetjipto
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
- Department of Biochemistry, Faculty of Medicine, Airlangga University, Campus A, Surabaya 60131, Indonesia
| | - Maria Inge Lusida
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
- Department of Microbiology, Faculty of Medicine, Airlangga University, Campus A, Surabaya 60131, Indonesia
| | - Yoshitake Hayashi
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
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Abstract
This Review presents current epidemiological trends of the most common liver diseases in Asia-Pacific countries. Hepatitis B virus (HBV) remains the primary cause of cirrhosis; despite declining prevalence in most Asian nations, this virus still poses a severe threat in some territories and regions. Mortality resulting from HBV infection is declining as a result of preventive measures and antiviral treatments. The epidemiological transition of hepatitis C virus (HCV) infection has varied in the region in the past few decades, but the medical burden of infection and the prevalence of its related cancers are increasing. The lack of licensed HCV vaccines highlights the need for novel treatment strategies. The prevalence of nonalcoholic fatty liver disease (NAFLD) has risen in the past decade, mostly owing to increasingly urbanized lifestyles and dietary changes. Alternative herbal medicine and dietary supplements are major causes of drug-induced liver injury (DILI) in some countries. Complications arising from these chronic liver diseases, including cirrhosis and liver cancer, are therefore emerging threats in the Asia-Pacific region. Key strategies to control these liver diseases include monitoring of at-risk populations, implementation of national guidelines and increasing public and physician awareness, in concert with improving access to health care.
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19
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Dionne-Odom J, Njei B, Tita ATN. Elimination of Vertical Transmission of Hepatitis B in Africa: A Review of Available Tools and New Opportunities. Clin Ther 2018; 40:1255-1267. [PMID: 29983265 PMCID: PMC6123260 DOI: 10.1016/j.clinthera.2018.05.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 05/21/2018] [Accepted: 05/21/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE This review article focuses on preventing vertical transmission of hepatitis B virus (HBV) among pregnant women living in sub-Saharan Africa (SSA), where disease is endemic and the estimated maternal HBV seroprevalence is >8%. Available interventions that have been studied in low- and middle-income countries are compared in terms of efficacy and effectiveness in clinical practice. Global disease-elimination targets, barriers to HBV-prevention efforts, and critical research gaps are discussed. METHODS A PubMed literature search in February 2018 identified relevant studies of interventions to reduce or prevent the transmission of HBV during pregnancy or in the peripartum period. Studies that focused on interventions that are currently available or could be made available in SSA were included. Trials conducted in SSA and other low-income countries were prioritized, although studies of interventions in middle- and high-income countries were included. FINDINGS Among 127 studies and reports included in the review, 60 included data from SSA. The most cost-effective intervention to reduce HBV infection rates in SSA is timely birth-dose vaccination followed by completion of the 3-dose infant-vaccination series. The identification and treatment of pregnant women with elevated HBV viral load to further reduce the risk for vertical transmission in SSA show promise, but efficacy and tolerability trials in Africa are lacking. IMPLICATIONS Scale-up of currently available tools is required to reach HBV disease-elimination goals in SSA. Many countries in SSA are in the process of rolling out national birth-dose vaccination campaigns; this roll out provides an opportunity to evaluate and improve processes in order to expand coverage. Early antenatal care, promotion of facility deliveries, and increased awareness of HBV prevention are also key components of prevention success. Future studies in SSA should identity an HBV-prevention package that is effective, well tolerated, and feasible and can be administered in the antenatal clinic and tailored to vertical-transmission risk.
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Affiliation(s)
- Jodie Dionne-Odom
- Department of Medicine, Division of Infectious Diseases, University of Alabama, Birmingham, Alabama.
| | - Basile Njei
- Department of Medicine, Section of Digestive Disease, Yale University, New Haven, Connecticut
| | - Alan T N Tita
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Center for Women's Reproductive Health, University of Alabama, Birmingham, Alabama
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