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Hedayati-Moghaddam MR, Tehranian F, Mosavat A, Miri R, Ahmadi Ghezeldasht S. Low Prevalence of Anti-HBc Antibody and Lack of HBV DNA Among HBsAg-Negative Blood Donors in Iran: A Cross-sectional Study and Review of Literature. ARCHIVES OF IRANIAN MEDICINE 2024; 27:305-312. [PMID: 38855800 PMCID: PMC11264625 DOI: 10.34172/aim.28579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/11/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Occult hepatitis B infection (OBI) refers to the presence of hepatitis B virus (HBV) DNA in the serum or liver of individuals who tested negative for HBV surface antigen (HBsAg). This study aimed to determine seropositivity for antibodies against HBV core antigen (anti-HBc) and the frequency of OBI among the HBsAg non-reactive blood donors in Mashhad, northeastern Iran. METHODS In this cross-sectional study, serum samples of HBsAg-negative blood donors were examined for anti-HBc during June and August 2018. Anti-HBc-positive samples were tested for antibodies against HBsAg (anti-HBs), and those with negative results were classified as isolated anti-HBc cases. The presence of HBV DNA in the C, S, and X gene regions was assessed by a qualitative real-time polymerase chain reaction method in all HBsAg-negative samples. OBI subjects were detected by the presence of at least one HBV genomic region. RESULTS Of 540 HBsAg-negative donors, 29 (5.4%; 95% confidence interval: 3.6-7.6%) showed seroreactivity for anti-HBc, of whom 18 individuals were also seropositive for anti-HBs. All donors showed negative results for all three HBV genes regardless of their serum anti-HBc status. CONCLUSION Based on our findings, we suggest routine screening of Iranian blood donation volunteers for serum anti-HBc and anti-HBs but not HBV DNA.
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Affiliation(s)
- Mohammad Reza Hedayati-Moghaddam
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan, Mashhad, Iran
| | - Farahnaz Tehranian
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
- Razavi Khorasan Blood Transfusion Center, Mashhad, Iran
| | - Arman Mosavat
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan, Mashhad, Iran
| | - Rahele Miri
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan, Mashhad, Iran
| | - Sanaz Ahmadi Ghezeldasht
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan, Mashhad, Iran
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Price O, Swanton R, Grebely J, Hajarizadeh B, Webb P, Peacock A, Dore GJ, Cowie BC, Vickerman P, Degenhardt L. Vaccination coverage among people who inject drugs: A systematic review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 127:104382. [PMID: 38503233 DOI: 10.1016/j.drugpo.2024.104382] [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: 11/27/2023] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND People who inject drugs may be at excess risk of acquiring vaccine-preventable diseases and negative associated health outcomes, but experience barriers to vaccination. We aimed to determine vaccination coverage among people who inject drugs globally. METHODOLOGY We conducted systematic searches of the peer-reviewed and grey literature, date limited from January 2008 to August 2023, focusing on diseases for which people who inject drugs are at elevated risk for and for which an adult vaccination dose is recommended (COVID-19, hepatitis A, hepatitis B, human papillomavirus, influenza, pneumococcal disease, tetanus). To summarise available data, we conducted a narrative synthesis. RESULTS We included 78 studies/reports comprising 117 estimates of vaccination coverage across 36 countries. Most estimates were obtained from high income countries (80%, n=94). We located estimates for hepatitis B vaccination in 33 countries, which included 18 countries with data on serological evidence of vaccine-derived hepatitis B immunity (range: 6-53%) and 22 countries with self-report data for vaccine uptake (<1-96%). Data for other vaccines were scarcer: reported hepatitis A vaccination coverage ranged 3-89% (five countries), COVID-19 ranged 4-84% (five countries), while we located estimates from fewer than five countries for influenza, tetanus, pneumococcal disease, and human papillomavirus. CONCLUSION Estimates were sparse but where available indicative of suboptimal vaccination coverage among people who inject drugs. Improving the consistency, timeliness, and geographic coverage of vaccine uptake data among this population is essential to inform efforts to increase uptake.
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Affiliation(s)
- Olivia Price
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia.
| | - Rosie Swanton
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | | | | | - Paige Webb
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia; School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | | | - Benjamin C Cowie
- Department of Infectious Diseases, University of Melbourne, Melbourne, Australia; WHO Collaborating Centre for Viral Hepatitis, Victorian Infectious Diseases Reference Laboratory, Doherty Institute, Melbourne, Australia; Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Australia
| | - Peter Vickerman
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
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Xie WY, Sun C, He H, Deng C, Sheng Y. Estimates of the prevalence of occult HBV infection in Asia: a systematic review and meta-analysis. Infect Dis (Lond) 2022; 54:881-896. [PMID: 36047593 DOI: 10.1080/23744235.2022.2115126] [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] [Indexed: 11/05/2022] Open
Abstract
PURPOSE Occult Hepatitis B virus infection (OBI) is of great significance to the transmission of Hepatitis B virus (HBV) and the evolution of the patient's clinical outcome. We conducted a systematic review and meta-analysis to estimate the prevalence of OBI in Asia. METHODS Literature search was conducted in PubMed, Cochrane Library database, Web of Science and Embase with the keywords of 'Hepatitis B virus', 'occult infection', 'prevalence'. 70 studies were included in the meta-analysis. Meta-analysis was performed using random-effects models to calculate the pooled prevalence of OBI and 95% confidence interval (CI). The data were analyzed in R 4.1.2. RESULTS The overall prevalence of OBI was 4% (95%CI: 0.03-0.06) in Asia. Subgroup analysis based on geographic region showed a prevalence of 3% (95%CI 0.02-0.06) in East Asia, 9% (95%CI 0.05-0.15) in West Asia, 3% (95%CI 0.01-0.11) in Southern Asia and 9% (95%CI 0.05-0.15) in Southeast Asia. Subgroup analysis demonstrated a prevalence of 1% (95%CI 0.00-0.02) in general population, 5% (95%CI: 0.03-0.08) in high-risk population, 9% (95%CI: 0.03-0.22) in the human immunodeficiency virus (HIV)-infected patient, 18% (95%CI: 0.09-0.32) in the hepatopathy patients. CONCLUSION Based on the meta-analysis of the prevalence of OBI in different populations, we concluded that the prevalence of OBI in the high-risk population, hepatopathy patients, and HIV-infected patients was higher than that in the general population. A systematic review showed that OBI was associated with disease progression and prognosis. Therefore, these populations should be routinely screened for OBI and promptly intervened to avoid promoting disease progression.
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Affiliation(s)
- Wen Yangyang Xie
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Changfeng Sun
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Infection & Immunity Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hongyan He
- Experimental Teaching Center, School of Public Health of Southwest Medical University, Luzhou, China
| | - Cunliang Deng
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yunjian Sheng
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Infection & Immunity Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Shirmast P, Shahri MA, Pashangzadeh S, Mirshahabi H, Samadi E, Motamed N. Detection of occult hepatitis B virus in patients undergoing chemotherapy in Iran. Future Virol 2022. [DOI: 10.2217/fvl-2020-0386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: Occult hepatitis B infection (OBI) is life threatening and has a high mortality rate despite applying antiviral treatments in cancer patients. This study aimed to investigate the prevalence of OBI in patients undergoing chemotherapy in Iran. Materials & methods: A total of 342 patients undergoing chemotherapy were enrolled. OBI detection in anti-HBc positive individuals was conducted using nested PCR. Results: Among 342 subjects, 103 (30.1%) were positive for anti-HBc. Fifteen (14.6%) cases of 103 anti-HBc positive samples were also positive for HBsAg. Overall, HBV DNA was positive in three (3.4%) of 88 anti-HBc subjects. Conclusion: Our results indicated that OBI might occur in almost one in 25 anti-HBc-positive patients undergoing chemotherapy.
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Affiliation(s)
- Paniz Shirmast
- Department of Microbiology & Virology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahdi Abedinzade Shahri
- Department of Biology, Faculty of Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Salar Pashangzadeh
- Iranian Research Center of HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hessam Mirshahabi
- Department of Microbiology & Virology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Elham Samadi
- Department of Microbiology & Virology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Nima Motamed
- Department of Community Medicine, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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Sarbandi H, Hosseini SM, Vakili K, Fathi M, Deravi NV, Vaezjalali M. [Hepatitis B Virus (Hepadnaviridae: Orthohepadnavirus: Hepatitis B virus) among Hospitalized Mentally Disabled Patients is not transmitted by their nurses or family members]. Vopr Virusol 2021; 65:350-356. [PMID: 33533231 DOI: 10.36233/0507-4088-2020-65-6-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Prevalence of hepatitis B virus (HBV) infection has been reported to be higher in the institutionalized mentally disabled patients than that of the general population previously reported in Iran. This study aims to investigate HBV infection among nurses and families of the hospitalized mentally disabled patients. MATERIAL AND METHODS This study was conducted on 110 nurses and family members of the mentally disabled patients who were hospitalized in five residential care centers of Tehran. The presence of hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (HBcAb) was examined using the enzyme-linked immunosorbent assay (ELISA). Afterwards, HBV DNA was extracted, and then propagated via a nested polymerase chain reaction (PCR) and specific primers. Finally, a phylogenetic tree was constructed using the neighbor-joining method to compare virus genomes in the nurses' serum with other isolated HBVs worldwide. RESULTS Out of 102 studied nurses, three (3%) were positive for HBsAg (100% female). Also, no patient was positive for the HBV genome, while eight (7.3%) nurses were positive for HBcAb including two (25%) males and six (75%) females. Genome sequencing of one DNA positive sample showed that the isolated virus from this patient contained sub genotype D1 and subtype ayw2. The results of none of the family members were positive for HBsAg, HBcAb, or HBV DNA. CONCLUSION This study showed a higher prevalence of HBsAg among nurses (3%) compared to the Iranian general population (1.7-2.1%). The virus isolated from the nurses belonged to subgenotype D1 and subtype ayw2 in accordance with previous Iranian reports. Also, there was no drug-resistant or vaccine-escape mutations in the obtained viral genome. Moreover, low immune pressure on the virus in the asymptomatic chronic HBV patients might be responsible for low nucleotide divergence among the derived HBV genome.
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Affiliation(s)
- H Sarbandi
- Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University of Medical Sciences
| | - S M Hosseini
- Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University of Medical Sciences
| | - K Vakili
- Student Research committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences
| | - M Fathi
- Student Research committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences
| | - N V Deravi
- Student Research committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences
| | - M Vaezjalali
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences
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Frequency of injecting among people who inject drugs: A systematic review and meta-analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 76:102619. [PMID: 31864107 DOI: 10.1016/j.drugpo.2019.102619] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 10/29/2019] [Accepted: 12/03/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND People who inject drugs (PWID) do so at varying frequencies. More frequent injecting is associated with skin and soft tissue infection, blood borne viruses, and overdose. The aims of this review are to estimate the prevalence of injecting frequency among PWID and compare these estimates to current needle-syringe distribution coverage estimates, and identify socio-demographic and risk characteristics, and harms associated with daily or more injecting. METHODS We conducted a systematic review of the peer-reviewed and grey literature from 2008 to 2018 and extracted needle-syringe distribution coverage data from a recent systematic review. We generated country-, region-, and global-level estimates of daily or more injecting. We also ran meta-regression analyses to determine associations between daily or more injecting and socio-demographic characteristics, injecting risk behaviour, non-fatal overdose, injection site skin infection, and blood borne virus prevalence. RESULTS Our search resulted in 61,077 sources, from which 198 studies were eligible for inclusion in this review. There were 74 countries with estimates for injecting frequency. Globally, we estimated that 68.1% (95%CI 64.5-71.6%) of PWID, equating to approximately 10.5 (95% UI 6.8-15.0) million people, inject daily or more frequently. There was a higher percentage of participants reporting daily or more injecting among samples with shorter injecting careers, more male participants and higher reporting of opioids as their main drug injected. Daily or more injecting was also associated with samples reporting a higher prevalence of HIV and hepatitis C antibody (anti-HCV), non-fatal overdose, and receptive needle sharing in the previous month. IMPLICATIONS WHO recently recommended a needle-syringe distribution target of 300 needles per PWID per year which is unlikely to be sufficient for the majority of PWID injecting daily or more who are out of drug treatment. FUNDING The Australian National Drug and Alcohol Research Centre, Australian National Health and Medical Research Council, University of New South Wales.
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Persons with Intellectual Disability: A Potential Reservoir of Invasive Strains of Hepatitis B Virus. HEPATITIS MONTHLY 2019. [DOI: 10.5812/hepatmon.85661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Sali S, Azarmmanesh S, Ghalikhani H, Vaezjalali M. Phylogenetic Analysis of Hepatitis B Virus among Household Members with HBV Chronic Infection. Avicenna J Med Biotechnol 2019; 11:221-228. [PMID: 31379994 PMCID: PMC6626507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Intrafamilial spread of Hepatitis B virus (HBV) infection in Iran has only been investigated with serological testing without using molecular studies as the most informative and definitive type of analysis. METHODS In the present study, intrafamilial transmission of HBV among family members of Iranian index HBsAg carriers was investigated using phylogenetic analysis of the S region of the viral genome. Nested polymerase chain reaction was used for detection of HBV DNA in serum samples from 22 index and 43 contact patients with chronic HBV infection. HBV DNA was detected in 37 samples (14 indexes, 23 contacts). The S gene region of the DNA isolates was subjected to direct sequencing and phylogenetic analysis by Bioedit, Mega and Phylip programs. RESULTS All isolates (from 26 patients) were clustered with genotype D, of which 24 strains were of subgenotype D1, subtype ayw2, while 2 additional strains were of subgenotype D2, subtype ayw3. Evidence of intrafamilial transmission of the virus was found in 8 families studied phylogenetically. Overall, 60 changes were detected in the amino acid sequences of the surface antigen protein in 23 patients. Four premature stop codons occurred in 3 isolates at residues 69 and 182. Seven out of 8 families displayed 25-100% common amino acid substitutions among their members. CONCLUSION Our data corroborated intrafamilial transmission of HBV, as evidenced by concordant HBV genotype among household members, viral sequence homology and close genetic relatedness of the strains on the phylogenetic tree, and horizontal transmission of S gene mutations among family members.
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Affiliation(s)
- Shahnaz Sali
- Department of Infectious Diseases and Tropical Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shirin Azarmmanesh
- Department of Infectious Diseases and Tropical Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hediyeh Ghalikhani
- Department of Immunology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Vaezjalali
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding author: Maryam Vaezjalali, Ph.D., Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Tel: +98 21 23872556, +98 9126194134, Fax: +98 21 22439964, E-mail:
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Prevalence and Risk Factors for Occult Hepatitis B and HIV Infections Among HCV Infected Intravenous Drug Users, Tehran, Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2018. [DOI: 10.5812/archcid.3075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jonaidi-Jafari N, Rezaee-Zavareh MS, Tavallaei-Nosratabadi J, Ajudani R, Ramezani-Binabaj M, Karimi-Sari H, Izadi M, Ranjbar R, Miri SM, Alavian SM. Occult Hepatitis B Infection in Hepatitis C Patients with Hematological Disorders. Jundishapur J Microbiol 2016; 10. [DOI: 10.5812/jjm.40816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
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