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Cheng TW, Yang JF, Chen YY, Wu KT, Lee MS, Kuo HJ, Lin TC, Wang CL, Hsieh MH, Lin CY, Batsaikhan B, Ho CK, Dai CY. Epidemiology of Chronic Hepatitis B Infection in the Cohort of College Students with Vaccination in Taiwan. Vaccines (Basel) 2023; 11:vaccines11020348. [PMID: 36851225 PMCID: PMC9964940 DOI: 10.3390/vaccines11020348] [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: 12/31/2022] [Revised: 01/28/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
After the mass vaccination project in Taiwan, the prevalence of the hepatitis B virus (HBV) infection for the college-aged population of 18 to 21 years is uncertain. We aimed to investigate the prevalence of hepatitis B markers in different birth cohorts. A total of 38,075 students in universities in Kaohsiung area undergoing entrance examinations between July 2006 to September 2020 were included. Seroprevalence of the hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs) status and laboratory data were collected. The seropositive rate of HBsAg was less than 1% for students born after 1991. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST), were significantly higher, and body mass index (BMI) was significantly lower in HBV carriers compared to those who were not carriers (all p < 0.001). Multivariate logistic regression showed that age, male, higher BMI, and positive HBsAg were risk factors of abnormal ALT value. A decrease in the positive rate of anti-HBs which was significantly higher in the cohort of plasma-derived vaccines than recombinant vaccines was found. We concluded that there were decreasing trends in seropositive rates of HBsAg and anti-HBs for students of the college-aged population in the Kaohsiung area. The status of HBsAg was a predictive factor of abnormal ALT levels. The period effect on anti-HBs seropositivity for DNA recombinant vaccine somehow existed.
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Affiliation(s)
- Te-Wei Cheng
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Jeng-Fu Yang
- Health Management Center, Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Yi-Yu Chen
- Health Management Center, Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Kuan-Ta Wu
- Health Management Center, Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Meng-Szu Lee
- Health Management Center, Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Hsiang-Ju Kuo
- Health Management Center, Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Tzu-Chun Lin
- Executive Master of Healthcare Administration, Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Chao-Ling Wang
- Health Management Center, Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Meng-Hsuan Hsieh
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Health Management Center, Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Chia-Yi Lin
- Health Management Center, Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Batbold Batsaikhan
- Department of Internal Medicine, Institute of Medical Sciences, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia
| | - Chi-Kung Ho
- Health Management Center, Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Chia-Yen Dai
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Health Management Center, Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Correspondence:
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Sheena BS, Hiebert L, Han H, Ippolito H, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abbastabar H, Abdoli A, Abubaker Ali H, Adane MM, Adegboye OA, Adnani QES, Advani SM, Afzal MS, Afzal S, Aghaie Meybodi M, Ahadinezhad B, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi S, Ahmed H, Ahmed MB, Ahmed Rashid T, Akalu GT, Aklilu A, Akram T, Al Hamad H, Alahdab F, Alem AZ, Alem DT, Alhalaiqa FAN, Alhassan RK, Ali L, Ali MA, Alimohamadi Y, Alipour V, Alkhayyat M, Almustanyir S, Al-Raddadi RM, Altawalah H, Amini S, Amu H, Ancuceanu R, Andrei CL, Andrei T, Anoushiravani A, Ansar A, Anyasodor AE, Arabloo J, Arab-Zozani M, Argaw AM, Argaw ZG, Arshad M, Artamonov AA, Ashraf T, Atlaw D, Ausloos F, Ausloos M, Azadnajafabad S, Azangou-Khyavy M, Azari Jafari A, Azarian G, Bagheri S, Bahadory S, Baig AA, Banach M, Barati N, Barrow A, Batiha AMM, Bejarano Ramirez DF, Belgaumi UI, Berhie AY, Bhagat DS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhojaraja VS, Bijani A, Biondi A, Bodicha BBA, Bojia HA, Boloor A, Bosetti C, Braithwaite D, Briko NI, Butt ZA, Cámera LA, Chakinala RC, Chakraborty PA, Charan J, Chen S, Choi JYJ, Choudhari SG, Chowdhury FR, Chu DT, Chung SC, Cortesi PA, Cowie BC, Culbreth GT, Dadras O, Dai X, Dandona L, Dandona R, De la Hoz FP, Debela SA, Dedefo MG, Demeke FM, Demie TGG, Demissie GD, Derbew Molla M, Desta AA, Dhamnetiya D, Dhimal ML, Dhimal M, Didehdar M, Doan LP, Dorostkar F, Drake TM, Eghbalian F, Ekholuenetale M, El Sayed I, El Sayed Zaki M, Elhadi M, Elmonem MA, Elsharkawy A, Enany S, Enyew DB, Erkhembayar R, Eskandarieh S, Esmaeilzadeh F, Ezzikouri S, Farrokhpour H, Fetensa G, Fischer F, Foroutan M, Gad MM, Gaidhane AM, Gaidhane S, Galles NC, Gallus S, Gebremeskel TG, Gebreyohannes EAA, Ghadiri K, Ghaffari K, Ghafourifard M, Ghamari SH, Ghashghaee A, Gholami A, Gholizadeh A, Gilani A, Goel A, Golechha M, Goleij P, Golinelli D, Gorini G, Goshu YA, Griswold MG, Gubari MIM, Gupta B, Gupta S, Gupta VB, Gupta VK, Haddadi R, Halwani R, Hamid SS, Hamidi S, Hanif A, Haque S, Harapan H, Hargono A, Hariri S, Hasaballah AI, Hasan SMM, Hassanipour S, Hassankhani H, Hay SI, Hayat K, Heidari G, Herteliu C, Heyi DZ, Hezam K, Holla R, Hosseini MS, Hosseini M, Hosseinzadeh M, Hostiuc M, Househ M, Huang J, Hussein NR, Iavicoli I, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Irham LM, Islam JY, Ismail NE, Jacobsen KH, Jadidi-Niaragh F, Javadi Mamaghani A, Jayaram S, Jayawardena R, Jebai R, Jha RP, Joseph N, Joukar F, Kaambwa B, Kabir A, Kabir Z, Kalhor R, Kandel H, Kanko TKT, Kantar RS, Karaye IM, Kassa BG, Kemp Bohan PM, Keykhaei M, Khader YS, Khajuria H, Khan G, Khan IA, Khan J, Khan MAB, Khanali J, Khater AM, Khatib MN, Khodadost M, Khoja AT, Khosravizadeh O, Khubchandani J, Kim GR, Kim H, Kim MS, Kim YJ, Kocarnik JM, Kolahi AA, Koteeswaran R, Kumar GA, La Vecchia C, Lal DK, Landires I, Lasrado S, Lazarus JV, Ledda C, Lee DW, Lee SW, Lee YY, Levi M, Li J, Lim SS, Lobo SW, Lopukhov PD, Loureiro JA, MacLachlan JH, Magdy Abd El Razek H, Magdy Abd El Razek M, Majeed A, Makki A, Malekpour MR, Malekzadeh R, Malik AA, Mansour-Ghanaei F, Mansournia MA, Martins-Melo FR, Matthews PC, Mendoza W, Menezes RG, Meretoja TJ, Mersha AG, Mestrovic T, Miller TR, Minh LHN, Mirica A, Mirmoeeni S, Mirrakhimov EM, Misra S, Mithra P, Moazen B, Mohamadkhani A, Mohammadi M, Mohammed S, Moka N, Mokdad AH, Moludi J, Momtazmanesh S, Monasta L, Moradi G, Moradzadeh M, Moradzadeh R, Moraga P, Mostafavi E, Mubarik S, Muniyandi M, Murray CJL, Naghavi M, Naimzada MD, Narasimha Swamy S, Natto ZS, Nayak BP, Nazari J, Negoi I, Negru SM, Nejadghaderi SA, Neupane Kandel S, Nguyen HLT, Ngwa CH, Niazi RK, Nnaji CA, Noubiap JJ, Nowroozi A, Nuñez-Samudio V, Oancea B, Ochir C, Odukoya OO, Oh IH, Olagunju AT, Olakunde BO, Omar Bali A, Omer E, Otstavnov SS, Oumer B, Padubidri JR, Pana A, Pandey A, Park EC, Pashazadeh Kan F, Patel UK, Paudel U, Petcu IR, Piracha ZZ, Pollok RCG, Postma MJ, Pourshams A, Poustchi H, Rabiee M, Rabiee N, Rafiei A, Rafiei S, Raghuram PM, Rahman M, Rahmani AM, Rahmawaty S, Rajesh A, Ranasinghe P, Rao CR, Rao SJ, Rashidi M, Rashidi MM, Rawaf DL, Rawaf S, Rawassizadeh R, Rezaei N, Rezapour A, Rezazadeh-Khadem S, Rodriguez JAB, Rwegerera GM, Sabour S, Saddik B, Saeb MR, Saeed U, Sahebkar A, Saif-Ur-Rahman KM, Salahi S, Salimzadeh H, Sampath C, Samy AM, Sanabria J, Sanmarchi F, Santric-Milicevic MM, Sarveazad A, Sathian B, Sawhney M, Seidu AA, Sepanlou SG, Seylani A, Shahabi S, Shaikh MA, Shaker E, Shakhmardanov MZ, Shannawaz M, Shenoy SM, Shetty JK, Shetty PH, Shibuya K, Shin JI, Shobeiri P, Sibhat MM, Singh AD, Singh JA, Singh S, Skryabin VY, Skryabina AA, Sohrabpour AA, Song S, Tabaeian SP, Tadesse EG, Taheri M, Tampa M, Tan KK, Tavakoli A, Tbakhi A, Tefera BN, Tehrani-Banihashemi A, Tesfaw HM, Thapar R, Thavamani A, Tohidast SA, Tollosa DN, Tosti ME, Tovani-Palone MR, Traini E, Tran MTN, Trihandini I, Tusa BS, Ullah I, Vacante M, Valadan Tahbaz S, Valdez PR, Varthya SB, Vo B, Waheed Y, Weldesenbet AB, Woldemariam M, Xu S, Yahyazadeh Jabbari SH, Yaseri M, Yeshaw Y, Yiğit V, Yirdaw BW, Yonemoto N, Yu C, Yunusa I, Zahir M, Zaki L, Zamani M, Zamanian M, Zastrozhin MS, Vos T, Ward JW, Dirac MA. Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol 2022; 7:796-829. [PMID: 35738290 PMCID: PMC9349325 DOI: 10.1016/s2468-1253(22)00124-8] [Citation(s) in RCA: 197] [Impact Index Per Article: 98.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 12/23/2022]
Abstract
Background Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, and national prevalence of hepatitis B virus (HBV), as well as mortality and disability-adjusted life-years (DALYs) due to HBV, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This included estimates for 194 WHO member states, for which we compared our estimates to WHO elimination targets. Methods The primary data sources were population-based serosurveys, claims and hospital discharges, cancer registries, vital registration systems, and published case series. We estimated chronic HBV infection and the burden of HBV-related diseases, defined as an aggregate of cirrhosis due to hepatitis B, liver cancer due to hepatitis B, and acute hepatitis B. We used DisMod-MR 2.1, a Bayesian mixed-effects meta-regression tool, to estimate the prevalence of chronic HBV infection, cirrhosis, and aetiological proportions of cirrhosis. We used mortality-to-incidence ratios modelled with spatiotemporal Gaussian process regression to estimate the incidence of liver cancer. We used the Cause of Death Ensemble modelling (CODEm) model, a tool that selects models and covariates on the basis of out-of-sample performance, to estimate mortality due to cirrhosis, liver cancer, and acute hepatitis B. Findings In 2019, the estimated global, all-age prevalence of chronic HBV infection was 4·1% (95% uncertainty interval [UI] 3·7 to 4·5), corresponding to 316 million (284 to 351) infected people. There was a 31·3% (29·0 to 33·9) decline in all-age prevalence between 1990 and 2019, with a more marked decline of 76·8% (76·2 to 77·5) in prevalence in children younger than 5 years. HBV-related diseases resulted in 555 000 global deaths (487 000 to 630 000) in 2019. The number of HBV-related deaths increased between 1990 and 2019 (by 5·9% [–5·6 to 19·2]) and between 2015 and 2019 (by 2·9% [–5·9 to 11·3]). By contrast, all-age and age-standardised death rates due to HBV-related diseases decreased during these periods. We compared estimates for 2019 in 194 WHO locations to WHO-GHSS 2020 targets, and found that four countries achieved a 10% reduction in deaths, 15 countries achieved a 30% reduction in new cases, and 147 countries achieved a 1% prevalence in children younger than 5 years. As of 2019, 68 of 194 countries had already achieved the 2030 target proposed in WHO Interim Guidance of an all-age HBV-related death rate of four per 100 000. Interpretation The prevalence of chronic HBV infection declined over time, particularly in children younger than 5 years, since the introduction of hepatitis B vaccination. HBV-related death rates also decreased, but HBV-related death counts increased as a result of population growth, ageing, and cohort effects. By 2019, many countries had met the interim seroprevalence target for children younger than 5 years, but few countries had met the WHO-GHSS interim targets for deaths and new cases. Progress according to all indicators must be accelerated to meet 2030 targets, and there are marked disparities in burden and progress across the world. HBV interventions, such as vaccination, testing, and treatment, must be strategically supported and scaled up to achieve elimination. Funding Bill & Melinda Gates Foundation.
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Wang WC, Lin YS, Chang YF, Yeh CC, Su CT, Wu JS, Su FH. Association of HLA-DPA1, HLA-DPB1, and HLA-DQB1 Alleles With the Long-Term and Booster Immune Responses of Young Adults Vaccinated Against the Hepatitis B Virus as Neonates. Front Immunol 2021; 12:710414. [PMID: 34484213 PMCID: PMC8416438 DOI: 10.3389/fimmu.2021.710414] [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] [Received: 05/16/2021] [Accepted: 07/19/2021] [Indexed: 01/02/2023] Open
Abstract
The neonatal hepatitis B vaccination (HBVac) was implemented 35 years ago in Taiwan, but many vaccinees exhibit inadequate long-term vaccine-induced seroprotective hepatitis B surface antibody (anti-HBs) levels. We investigated the association of the human leukocyte antigen (HLA) alleles (DPA1, DPB1, DQA1, and DQB1) with the long-term immunological response to the neonatal HBVac and adolescent booster HBVac in a Taiwanese cohort. We divided 281 Han students (median age 22, age range 17–29 years) into the following groups: (1) Group A (n = 61): anti-HBs titer ≥ 10 mIU/mL at the beginning of the study; (2) Group B (n = 75): anti-HBs level > 1000 mIU/mL after the first booster; (3) Group C (n = 37): anti-HBs level < 10 mIU/mL after the first booster; and (4) Group D (n = 5): anti-HBs level < 10 mIU/mL after three boosters. DQA1, DQB1, DPA1, and DPB1 typing of the participants was performed using sequence-specific oligonucleotides. Associations of HLA alleles and haplotypes with effects on neonatal HBVac and booster HBVac were examined through logistic regression analysis and Fisher’s exact test. A false discovery rate-based measure of significance, the q-value, was used for multiple comparisons, and an association was considered significant if the corresponding q-value was < 0.1. DPA1 alleles were associated with the long-term immunological response to the neonatal HBVac. The estimated odds ratio (OR) of the lack of HBV protective immunity when carrying an additional DPA1*01 and DPA1*02 was 0.36 [95% confidence interval (CI) = 0.17–0.76, p = 0.0076] and 2.39 (95% CI = 1.17–4.87, p = 0.016), respectively. DPB1 and DQB1 alleles were associated with a response to the adolescent booster vaccination. The estimated ORs of being nonresponsive to the first booster when carrying an additional DPB1*05 and DQB1*02 were 2.11 (95% CI = 1.13–3.93, p = 0.019) and 3.73 (95% CI = 1.43–9.71, p = 0.0070), respectively. All DPB1*03 carriers responded to the first booster (p of Fisher’s exact test = 0.0045). In our study, we discovered that HLA-DPA1 was primarily associated with the long-term response of primary infantile HBVac, and HLA-DPB1 and HLA-DQB1 exhibited associations with the HBV booster vaccination.
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Affiliation(s)
- Wen-Chang Wang
- The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Cancer Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yu-Shiang Lin
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.,Department of Clinical Laboratory, the First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Yin-Fan Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Ching Yeh
- Cancer Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.,Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.,Master Program in Applied Epidemiology, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Chien-Tien Su
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.,Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Family Medicine, National Cheng Kung University Hospital, Douliou Branch, College of Medicine, National Cheng Kung University, Yunlin, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Fu-Hsiung Su
- Department of Family Medicine, Cardinal Tien Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.,School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
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