Occupational risk of blood-borne viruses in healthcare workers: a 5-year surveillance program.

OBJECTIVE: This study presents the results of a 5-year surveillance program involving the prospective follow-up of healthcare workers (HCWs) in the Veneto region of Italy exposed to blood-borne viruses. DESIGN: All HCWs who reported an occupational exposure to blood-borne infection joined the surveillance program. Both HCWs and patients were tested for viral markers (hepatitis B surface antigen [HBsAg], antibody to hepatitis B surface antigen [anti-HBs], antibody to hepatitis B core antigen [anti-HBc], antibody to hepatitis C virus [anti-HCV], HCV RNA, and antibody to human immunodeficiency virus [HIV]) and had these markers plus transaminases assayed at 3, 6, and 12 months and then yearly thereafter. Moreover, a program of hepatitis B virus (HBV) prophylaxis was offered to those whose anti-HBs levels were less than 10 IU/mL. PARTICIPANTS: Two hundred forty-five HCWs (156 women and 89 men) with a mean age of 37 (+/- 10) years who reported occupational exposure during the 5-year period. RESULTS: At the time of exposure, 1 HCW was positive for HBsAg (0.4%) and 2 were positive for HCV RNA (0.8%). Among the patients involved, 28 (11.4%) were positive for HBsAg, 68 (27.8%) were positive for HCV RNA, 6 (2.4%) were positive for HIV, and 147 (60.0%) were negative for all viral markers (4 patients were positive for both HCV and HIV). During the follow-up period after exposure (mean, 2.7 [+/- 1.6] years), there was no increase in transaminases or seroconversions to any of the viral markers. CONCLUSION: Our accurate postexposure follow-up revealed a lack of transmission of HBV, HCV, and HIV.     

Seroepidemiology of hepatitis B virus infection among adults in Singapore: A 12-year review

We undertook a national hepatitis B seroprevalence study to assess the seroprevalence of hepatitis B virus (HBV) markers in the adult population in Singapore in 2010 and make comparisons with the seroprevalence in 1998 and 2004. The study involved residual sera from national health surveys conducted every six years since 1998. The tests for HBV markers were carried out using commercial chemiluminescent microparticle immunoassay. In 2010, the prevalence of hepatitis B surface antigen (HBsAg) among 3293 Singapore residents aged 18–79 years was 3.6% (95% confidence interval [CI] 2.9–4.2%). Hepatitis B e antigen (HBeAg) was detected in 4.2% of those who were HBsAg positive. About 22.5% (95% CI 21.1–23.9%) were positive for antibody to hepatitis B core antigen (anti-HBc). The overall population immunity to HBV, as determined by antibody to hepatitis B surface antigen (anti-HBs) ≥ 10 mIU/mL, was 43.9% (95% CI 42.2–45.6%). Among young adults below 30 years of age, HBsAg prevalence (1.1%) was half that in 1998 and 2004, and in those positive for HBsAg, none was positive for HBeAg in 2010, compared to 20.8% in 1998 and 15.8% in 2004. In this age group, anti-HBc prevalence also decreased significantly from 22.1% in 2004 to 4.4% in 2010, while anti-HBs (≥10 mIU/mL) prevalence increased significantly from 27.9% in 1998 to 43.3% in 2010 (p < 0.001). The national childhood HBV immunisation and catch-up programmes implemented in 1987 and 2001–2004, respectively, had a significant impact in reducing HBV infection and in raising the immunity of the adult population 18–29 years of age.     

The seroepidemiology of hepatitis A and B in a Japanese town.

Sera collected from 1,118 healthy children and adults aged between four years and 90 years during the period 1989 to 1990, were tested for serological markers of hepatitis A virus (HAV) [antibody to HAV (anti-HAV)] and hepatitis B virus (HBV) [hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBsAb)]. The overall prevalence rates of anti-HAV, HBsAg, and anti-HBV were 20.2%, 0.36%, and 5.1%, respectively. No body was found to be positive for anti-HAV below 30 years of age but more than 70% of the adults aged 50 years or over were positive for anti-HAV. The level of exposure of HAV infection is declining in Japan and paradoxically at the same time a vast majority of people are becoming susceptible to more severe illness. The fall in prevalence of HBsAg possibly represents the positive impact of ongoing vaccination programs and other preventive measures against HBV.     

深圳市居民乙型肝炎病毒感染危险因素分析

目的 了解广东省深圳市居民乙肝病毒(HBV)感染现状,分析HBV感染的相关危险因素.方法 于2010年在深圳市采用多阶段系统随机抽样方法抽取10个社区、1000户家庭,进行入户个案调查乙肝感染相关危险因素,并采集血样.用酶联免疫吸附试验(ELISA)检测乙肝血清标志物:乙肝表面抗原(HBsAg)、乙肝表面抗体(抗-HBs)和乙肝核心抗体(抗-HBc).结果 HBsAg、抗-HBs、抗-HBc阳性率和HBV感染率分别为6.68％ (252/3771)、71.92％(2 712/3771)、37.39％(1564/3771)和45.98％(1734/3771);≤15岁人群乙肝疫苗接种率为93.62％(1 752/1 872),＞15岁人群接种率为79.48％(1 509/1899),差异有统计学意义(x2=160.89,P ＜0.01);接种乙肝疫苗者与未接种者的HBV感染率分别为32.45％(1508/3261)和87.24％ (445/510),差异有统计学意义(x2 =552.72,P＜0.01);HBsAg阳性率与HBV感染率均随年龄上升有增加的趋势;多因素Logistic回归分析结果显示,家中有乙肝患者、内窥镜史、手术史及有偿献血史是深圳市居民乙肝感染的危险因素.结论 深圳市乙肝感染情况低于全国平均水平;乙肝感染具有家庭聚集性;医疗卫生因素对乙肝感染的影响较大.     

Hepatitis B markers in Gloucestershire firemen

Occupational exposure to blood and body fluids and the prevalenceof serological markers of hepatitis B virus (HBV) infectionwere studied in Gloucestershire firemen to assess the occupationalrisk of HBV infection. A high compliance was achieved (472/503,94 per cent). Cumulative occupational exposure to blood or bodyfluids rose progressively to 68 per cent after 24 years' service.No sera were positive for hepatitis B surface antigen (HBsAg).Six sera were positive for hepatitis B surface antibody (anti-HBs)and were tested for hepatitis B core antibody (anti-HBc). Thefour subjects who were positive for anti-HBs alone had all receivedHBV vaccine. Two sera contained both anti-HBs and anti-HBc.Therefore, 2/472 firemen (0.42 per cent) showed evidence ofprevious HBV infection, a similar proportion to that found ina recent study in UK blood donors (0.49 per cent). Despite considerableexposure to blood and body fluids, an occupational risk of hepatitisB infection was not found in Gloucestershire firemen.     

贵州少数民族人群乙肝流行率及流行模式分析

摘要:目的　了解贵州少数民族人群乙肝流行率及流行模式,为制定乙肝防治策略提供依据。方法　采用多阶段整群随机抽样方法,于2013年11-12月抽取贵州省3个少数民族自治州中的2个县8个村共1629名常住居民,进行问卷调查同时采集血样,用时间分辨免疫荧光法（TRFIA）检测血清中乙肝表面抗原（HBsAg）、乙肝表面抗体（HBsAb）、乙肝核心抗体（HBcAb）,分析乙肝流行模式。结果　1629名调查对象中,HBV 感染者825例,总感染率为 50.6%;共有 6种血清标志物模式组合,按照血清标志物模式分布特征将乙肝流行模式分为三类,其中以易感模式为主占45.9%、免疫模式占31.9%、感染模式占22.2%;不同民族、一起生活的人有无表面抗原阳性、不同婚姻状态、不同年龄、家庭HBV感染人数、是否接种乙肝疫苗、家庭人口数、是否饮酒、文化程度在3组流行模式间差异均有统计学意义（P＜0.05）;是否外出打工过、性别、是否共用牙刷、过去1年家庭总收入不同、是否吸烟在3组流行模式间差异均无统计学意义（P＞0.05）。结论　贵州少数民族人群乙肝流行模式以易感模式（3项全阴）为主,不同特征人群流行模式存在差异;易感模式流行的人群应加强免疫接种,提高该人群的乙肝特异性免疫力;对感染模式流行人群加强健康宣教,减少其乙肝的传播。     

乙型肝炎母婴传播阻断成功儿童乙型肝炎病毒突破性感染的特征

目的了解乙型肝炎(乙肝)母婴传播阻断成功儿童乙肝病毒(HBV)突破性感染及其影响因素。方法选取江苏省淮安市淮安区2009年9月-2011年1月乙肝表面抗原(HBsAg)阳性母亲所生儿童,且乙肝母婴传播阻断成功。阻断成功定义为儿童按国家免疫程序在完成出生时乙肝疫苗(HepB)和乙肝免疫球蛋白以及1、6月龄HepB接种后7-12月龄HBsAg阴性,HBV突破性感染定义为阻断成功儿童在12月龄后HBsAg阳性或24月龄后乙肝核心抗体(HBcAb)阳性。至2019年9月进行5次随访并检测HBV血清标志物,分析HBV突破性感染及其影响因素。结果本研究共纳入儿童390名,其中12名29-117月龄儿童发生HBV突破性感染,发生率为3.08%(12/390),均为乙肝核心抗体(HBcAb)阳性和HBsAg阴性。乙肝疫苗(HepB)初次免疫无、低、正常、高应答儿童HBV突破性感染率分别为25.00%、6.67%、2.61%、0.95%;母亲HBeAg阳性、阴性的儿童分别为9.76%、0.00%;母亲高、低HBV病毒载量的儿童分别为11.96%、0.34%。儿童HBV突破性感染发生密度为0.36/100人年;多因素Cox回归分析显示,HepB初次免疫低或无应答、母亲高病毒载量是儿童HBV突破性感染的危险因素(HR=5.91,95%CI:1.87-18.71;HR=45.81,95%CI:5.88-356.96)。结论乙肝母婴传播阻断成功儿童的HBV突破性感染发生率较低;母亲HBeAg阳性、母亲高HBV病毒载量、HepB初次免疫低或无应答的儿童更易发生突破性感染。     

Household clustering and intra-household transmission patterns of hepatitis B virus infection in South Africa

The objective of this study was to investigate household clustering of hepatitis B virus (HBV) infection in South Africa in order to understand intra-household patterns of virus transmission that would provide information on potential risk factors of HBV infection. Subjects were the household contacts of 28 hepatitis B surface antigen (HBsAg) positive children (index-carrier), 22 hepatitis B surface antibody positive children (index-past-infection) and 35 children with no serological evidence of HBV infection (index-negative). Evidence of HBV infection (at least one positive HBV marker) was present in 73.7%, 48.7% and 38.2% and HBsAg was present in 19.9%, 8.7% and 2.9% of household contacts of index-carrier (N = 186), index-past-infection (N = 150) and index-negative (N = 207) children respectively. The clustering of HBV infection and HBsAg was present in all subgroups of household contacts regardless of the degree of relatedness to the index child. As age increased, the cumulative prevalence of HBV infection increased while the likelihood of being HBsAg positive decreased. Regardless of age, males were more likely (p less than 0.01) than females to be HBsAg positive. We conclude that HBV infection clusters in households; that there is an increased susceptibility, which is probably not genetically mediated, of becoming an HBV carrier in certain households and that males are at greater risk of being HBV carriers. Intra-household horizontal person-to-person transmission, the precise mechanisms of which are not known, is important in South African blacks.     

Hepatitis B virus infection in Chinese families in Hong Kong

Between January 1983 and July 1984, 731 family members of 240 hepatitis B surface antigen (HBsAg) carriers were screened for hepatitis B virus markers. The percentage of those who were positive for HBsAg was 28.3 and that for antibody to hepatitis B surface antigen/antibody to hepatitis B core antigen was 43.1. The carrier rate was higher among siblings (53%) and offspring (50.5%) of female carriers, but similar to that of the age-matched general population for spouses (10.8%). Maternal transmission was the most important mode of spread of hepatitis B virus infection within the family. The HBsAg-positive offspring and siblings were clustered within certain families. Intrafamilial spread is important in perpetuating hepatitis B virus infection in Chinese persons. Susceptible family members, especially newborns and other young children of female carriers, should be vaccinated.     

云南省2019年8月龄-14岁儿童乙型肝炎血清流行率调查

目的了解2019年云南省<15岁儿童乙型肝炎(乙肝)血清流行率。方法采用分层随机抽样在云南省所有县(市、区)抽取387个乡镇1149个村(居委会、社区)的8月龄-14岁儿童,采用酶联免疫吸附试验检测血清乙肝表面抗原(HBsAg)、乙肝表面抗体(HBsAb)和乙肝核心抗体(HBcAb),分析三项标志物组合模式和阳性率。结果在21177名调查儿童中共检出8种HBsAg、HBsAb和HBcAb组合模式,其中三项指标均阴性、仅HBsAb阳性、HBsAb和HBcAb阳性、仅HBcAb阳性分别占31.26%、59.40%、6.46%、2.51%。儿童HBsAg、HBsAb、HBcAb总阳性率分别为0.37%、66.00%、9.17%;乙肝疫苗(HepB)全程接种、未全程接种、免疫史不详儿童HBsAg阳性率分别为0.35%、0.59%、0.82%(χ²=5.27,P=0.07);首剂及时、不及时接种儿童分别为0.34%、0.58%(χ²=4.48,P=0.03)。8月龄-4岁、5-9岁、10-14岁儿童HBsAg阳性率分别为0.32%、0.43%、0.61%(趋势χ²=5.05,P=0.03)。结论2019年云南省8月龄-14岁儿童HBsAg阳性率降至较低水平,但随年龄增长呈增加趋势;HepB接种对阻断儿童乙肝传播的效果显著。需进一步提高适龄儿童HepB全程和首剂及时接种率。     

深圳市2011-2014年孕妇乙型肝炎病毒感染状况分析

目的 了解2011-2014年深圳市孕妇乙型肝炎病毒（hepatitis B virus,HBV）感染状况,为预防和控制乙型肝炎（简称乙肝）母婴传播提供科学依据。方法 对到助产机构初次进行产前检查的孕妇免费检测乙肝两对半,并由助产机构责任医生将孕妇的基本信息及检测结果录入自主研发的信息管理系统,通过SPSS 19.0进行统计分析。结果 深圳市孕妇乙肝表面抗原（hepatitis B surface antigen,HBsAg）阳性率、乙肝表面抗体（antibody to hepatitis B surface antigen,抗-HBs）阳性率、乙肝病毒e抗原（hepatitis B e antigen,HBeAg）阳性率、乙肝病毒e抗体（antibody to hepatitis B e antigen,抗-HBe）阳性率及乙肝病毒c抗体（antibody to hepatitis B core antigen,抗-HBc）阳性率分别为8.40%、47.84%、3.11%、12.28%、21.24%。不同年份、户籍类型、年龄、文化程度和职业的孕妇HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc这五项指标阳性率之间的差异均有统计学意义（均有P<0.001）。结论 深圳市孕妇HBsAg阳性率仍高于全国水平,半数以上孕妇没有检测到抗-HBs,流动人口孕妇HBV感染状况较常住人口严重。加强深圳市孕妇的免疫接种和查漏补种,有助于控制乙肝母婴传播。     

HBsAg阳性母亲与婴幼儿HBV血清标志物关系

目的了解HBsAg阳性母亲及其经乙肝高效价免疫球蛋白联合乙肝疫苗免疫的婴幼儿乙型肝炎病毒（HBV）血清标志物变化及转归情况。方法对125例HBsAg阳性母亲及其128例婴幼儿（双胎3例）进行随访调查,并分别于婴幼儿7月龄、24~36月龄应用酶联免疫吸附试验检测母亲和婴幼儿血清HBV主要标志物。结果7月龄随访83例婴幼儿,24~36月龄随访75对母子。128例婴幼儿出生时HBsAg阳性4例,随访时仅1例持续阳性,其余出生时HBsAg阴性的94例婴幼儿随访中未发现HBsAg阳转;HBsAg、HBeAg双阳性的26例母亲所产婴幼儿出生时20例HBeAg阳性,随访时除1例HBsAg为阳性的婴幼儿HBeAg仍持续阳性外,余均转阴,未见婴幼儿出现HBeAg阳转;婴幼儿抗-HBe和抗-HBc在7月龄和远期随访中逐渐阴转。结论乙肝病毒经胎盘所致的宫内感染率约为3.13%（4/128）,出生后转为慢性感染者约为25.00%（1/4）;HBeAg可通过人类胎盘从母亲传递给胎儿,但在7月龄前消失;出生于HBsAg阳性母亲的婴幼儿在婴幼儿期单独抗-HBe和（或）抗-HBc阳性,不能说明处于HBV感染状态。     

阜阳市人群HBV感染的血清流行病学调查

目的了解某地自然人群乙型肝炎病毒(HBV)感染情况。方法调查2005年3-12月在某疾病预防控制中心进行健康体检人群的HBV血清标志物检测结果。HBV血清标志物检测采用酶联免疫吸附试验。结果单纯检测乙型肝炎表面抗原(HBsAg)的2 802人中,阳性255人,阳性率9.10%;各年龄组人群以31~40岁组HBsAg阳性率最高,占12.16%(71/584)。1 907例检测HBV5项血清标志物者中,HBsAg阳性者238例(12.48%),以HBsAg阳性合并抗HBe、抗HBc阳性为主(44.96%),HBsAg阳性合并HBeAg、抗HBc阳性次之(38.24%);5项全阴性者占总人群的46.88%。结论该地区自然人群HBV感染水平较高,近一半人没有保护性抗体,应加强健康宣教,推广普及乙肝疫苗的接种,改善环境卫生。     

Nigerian medical students are at risk for hepatitis B infection

Medical students are exposed to blood and body fluids. This study was conducted to estimate the prevalence of hepatitis B virus (HBV) infection amongst medical students of the Lagos State University College of Medicine, Ikeja, Nigeria. Data were collected through a self-administered questionnaire and through blood analysis for hepatitis B surface antigen (HBsAg), hepatitis B 'e' antigen (HBeAg) as well as antibodies to the core (anti-HBc), surface (anti-HBs) and 'e' (anti-HBe) antigens. Three hundred and thirteen of 325 students (96%) participated. The mean age was 24.3+/-3.98 years; 231 (74%) were pre-clinical students and 82 (26%) were in the clinical years of study. Only 8 (2.6%) had received three doses of vaccination against HBV. Eighty-one (26%) tested positive for anti-HBc, 10 (3.2%) were positive for HBsAg and 56 (17.9%) had anti-HBs antibodies. A significant relationship was found between students who had a positive history of hepatitis B in the family and anti-HBc (P=0.03). Age was also significantly associated with HBsAg (P=0.012). Two hundred and twenty-five (72%) students were susceptible to the infection and required vaccination. Most students at this medical school are susceptible to HBV infection and should be vaccinated.     

Prevalence and risk factors of hepatitis B in Spanish prostitutes

Eighty prostitutes were tested by solid-phase radioimmunoassay for serum markers of hepatitis B virus (HBV). Of 8 (10%) with hepatitis B surface antigen (HBsAg), 6 (75%) also had hepatitis Be antigen (HBeAg). Antibodies to HBsAg (anti-HBs) and to hepatitis B core antigen (anti-HBc) were found in 52 (65%). Antibodies to HBeAg (anti-HBe) were positive in 32 (40%). Anti-HBc alone was found in 5 (6%) and anti-HBs alone in 2 (2%). Sixty-seven (84%) were positive for at least one HBV marker and 13 (16%) were still susceptible to infection. Hepatitis B markers were more prevalent in prostitutes than in the normal Spanish population. Age, a history of sexually transmitted diseases (STD), drug abuse and promiscuity are factors which were highly related to hepatitis B markers. We concluded that screening prostitutes for the presence of markers and vaccinating those who are negative would be worth while.     

乙型肝炎病毒表面抗原在慢性乙型肝炎病毒感染后不同临床阶段的定量检测及临床意义

目的 测定慢性乙型肝炎病毒（HBV）感染后不同临床阶段患者血清乙型肝炎病毒表面抗原（HBsAg）定量,同时探究其与患者血清HBV DNA水平和年龄的相关性.方法 将未经抗病毒治疗的774例慢性HBV感染患者按照临床特征分为六组：慢性HBV携带组（102例）、非活动性HBsAg携带组（211例）、乙型肝炎病毒e抗原（HBeAg）阳性慢性乙型肝炎组（236例）、HBeAg阴性慢性乙型肝炎组（114例）、HBeAg阳性乙型肝炎肝硬化组（52例）、HBeAg阴性乙型肝炎肝硬化组（59例）,采用化学发光微粒子免疫分析法测定患者血清HBsAg定量,实时荧光定量聚合酶链反应法测定患者血清中HBV DNA定量,血清HBsAg和HBV DNA需要经常用对数转换后进行组间比较.结果 HBsAg定量由高到低分别为慢性HBV携带组、HBeAg阳性慢性乙型肝炎组、HBeAg阴性慢性乙型肝炎组、非活动性HBsAg携带组、HBeAg阴性乙型肝炎肝硬化组和HBeAg阳性乙型肝炎肝硬化组[7.80（6.69 ～ 8.32）、7.11（5.42～8.27）、6.57（5.66 ～ 7.53）、6.38（4.39～ 7.40）、6.22（4.84～ 6.91）、6.13 （5.48～7.01）].HBeAg阳性慢性乙型肝炎组和HBeAg阴性慢性乙型肝炎组HBsAg定量与HBV DNA呈正相关（r=0.714和0.390,P＜0.01）.慢性HBV感染患者血清HBsAg的定量与年龄呈负相关（r=-0.416,P＜0.01）;监测年龄≥40岁非活动性HBsAg携带者的血清HBsAg定量有重要的临床价值.结论 慢性HBV感染后不同临床阶段患者血清HBsAg定量不同,血清HBsAg定量与患者HBV DNA水平和年龄相关,临床上应重点监测年龄≥40岁非活动性HBsAg携带患者血清HBsAg定量.     

热灭活对输血相关感染标志物的影响

 目的 探讨热灭活对血清和全血两种不同类型标本中输血相关感染标志物结果的影响。方法 收集乙型肝炎病毒表面抗原(HBsAg)、丙型肝炎病毒抗体(抗-HCV)、人类免疫缺陷病毒抗体(抗-HIV)、梅毒螺旋体抗体(抗-TP)、乙型肝炎病毒(HBV) DNA和丙型肝炎病毒(HCV) RNA阳性血清标本共57份,HBsAg、抗-HCV、抗-TP和HBV DNA阳性全血标本共38份。将标本56℃水浴加热30 min灭活(可有效灭活冠状病毒)处理后,采用化学发光和荧光定量聚合酶链式反应(PCR)分别检测相应的项目,比较热灭活前后各指标的差异。结果 血清灭活后HBsAg、抗-HCV、抗-HIV、抗-TP、HBV DNA和HCV RNA检测结果与灭活前相比,差异均无统计学意义(均P>0.05);全血灭活后HBsAg、抗-HCV、抗-TP和HBV DNA检测值与灭活前相比,差异亦均无统计学意义(均P>0.05);Bland-Altman散点图显示 所有的差值数据均位于95%一致性界限(95%LoA)内,各指标灭活后与灭活前存在较好的一致性。结论 56℃水浴加热 30 min的处理方法对输血相关感染标志物的检测无明显影响,在新型冠状病毒疫情期间可考虑推广使用。     

Differences in Sexual Identity,Risk Practices,and Sex Partners between Bisexual Men and Other Men among a Low-Income Drug-Using Sample

Hepatitis B vaccination and targeted testing for hepatitis C virus (HCV) are recommended for jails with medical services available. This study estimates hepatitis B virus (HBV) and HCV infection prevalence among jail inmates, since most previous studies have been conducted among prison inmates. Prison and jail populations differ: jails hold a wide spectrum of persons for an average of 10–20 days, including persons awaiting arraignment, trial, conviction, or sentencing, while prisons typically hold convicted criminals for at least 1 year. A stratified random sample of sera obtained during routine syphilis testing of inmates entering jails in Chicago (March–April 2000), Detroit (March–August 1999), and San Francisco (June 1999–December 2000) was tested for serologic markers of HBV and HCV infection. All sera had been previously tested for antibody to HIV (anti-HIV). A total of 1,292 serum samples (12% of new inmates) was tested. Antibody to HCV (anti-HCV) prevalence was 13%. Antibody to hepatitis B core antigen (anti-HBc) prevalence was 19%, and hepatitis B surface antigen (HBsAg) prevalence was 0.9%; 12% had serologic evidence of hepatitis B vaccination. Hispanics had high rates of chronic HBV infection (3.6% HBsAg positive) along with Asians (4.7% HBsAg positive). Among HIV-infected persons, 38% were anti-HCV positive and 8.2% were HBsAg positive. Anti-HBc positivity was associated with anti-HCV positivity (aOR = 4.58), anti-HIV positivity (aOR = 2.94), syphilis infection (aOR = 2.10), and previous incarceration (aOR = 1.78). Anti-HCV-positivity was associated with anti-HBc positivity (aOR = 4.44), anti-HIV-positivity (aOR = 2.51), and previous incarceration (aOR = 2.90). Jail entrants had high levels of HCV and HBV infection and HIV co-infection; HBV prevalence was comparable to previous prison studies, and HCV prevalence was lower than prison studies. Hispanics had an unexpectedly high rate of chronic hepatitis B infection and had the lowest rate of hepatitis B vaccination. The finding that hepatitis B vaccination coverage among jail entrants is lower than the general population, despite this population’s increased risk for infection, highlights the need to support vaccination in jail settings.     

Anti-hepatitis B core antibody is not required for prevaccination screening in healthcare workers

Vaccination against hepatitis B virus (HBV) is recommended for health care workers (HCWs), but it is not clear whether HBV vaccination is required for HCWs who have isolated antibody to hepatitis B core antigen (anti-HBc), or whether prevaccination screening for anti-HBc is needed in HCWs. Among 1812 HCWs, subjects with isolated anti-HBc and those with no HBV markers (control) were screened. The anamnestic response (antibody to hepatitis B surface antigen over 50 mIU/mL after the first vaccine injection) was compared prospectively between the two groups. The prevalence of isolated anti-HBc was 2.3%. Their anamnestic response was lower than that of controls (27.5% vs. 46.9%, P = 0.020). The subjects who had isolated anti-HBc were older and predominantly male, compared with the controls. Multivariate analysis revealed that age (odds ratio [OR], 0.67; confidence interval [CI], 0.51-0.90) and prior vaccination (OR, 3.36; CI, 2.04-5.54) were independent predictors of the anamnestic response, regardless of the anti-HBc status. Serum HBV DNA was not detected in any subject. Anti-HBs seroconversion was achieved in most of the anti-HBc-positive subjects after full vaccination, and the rate was comparable with controls (89.5% vs. 96.6%, P = 0.067). Isolated anti-HBc-positive HCWs are rare and most of them respond to vaccination. Anti-HBc testing is not a prerequisite for vaccination. This serology suggests a loss of acquired anti-HBs rather than occult HBV infection. Their reduced immunity to vaccination may be related to old age.     

A ten year serological survey of hepatitis A, B and C viruses infections in Nepal

BACKGROUND: In 1987, we reported that the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in Nepal was low, as compared to hepatitis A virus (HAV) infection, and that no human T-lymphotropic type-1 (HTLV-1) infection was found in Nepal. OBJECTIVES: To determine changes in the prevalence of HAV, HBV, and HCV infections between 1987 and 1996 in inhabitants of Bhadrakali (suburban) and Kotyang (rural) villages in Nepal. STUDY DESIGN: We did a cross-sectional survey of 458 inhabitants of two Nepalese villages, to assess the prevalence of antibody to HAV (anti-HAV), antibody to hepatitis B core antigen (anti-HBc), hepatitis B surface antigen (HBsAg), antibody to HCV (anti-HCV), and antibody to HTLV-I (anti-HTLV-I). RESULTS: Anti-HAV was detected in 454 (99.1%), HBsAg in 5 (1.1%), anti-HBc in 33 (7.2%) and anti-HCV in 8 (1.7%) of serum samples tested in 1996. Statistically significant differences by gender or age group were nil. The prevalence of HCV infection was significantly higher in 1996 than in 1987 after adjusting for age of subjects living in the two villages (p < 0.01). The prevalence of HBsAg was significantly higher in 1996 than 1987 in Bhadrakali after adjusting for the factor of age (p < 0.05). Between 1987 and 1996, evidence for HTLV-1 positive residents was nil. CONCLUSION: These results suggest that HAV has been endemic in Nepal for long time while not of HBV, and that HCV infection tends to be increased recently.