Prevalence of hepatitis virus infections in Albanian refugees

A sample of 393 Albanian refugees, including both children and adults, was tested for serological HAV, HBV, HDV and HCV markers. A high prevalence of infection with both the hepatitis A and B viruses was found, while HDV and HCV infections were uncommon. The overall prevalence of anti-HAV was 96%; it was very high in children 0-10 years, suggesting that HAV infection is largely acquired during childhood and that poor ambiental conditions influence the spreading of this viral infection.One or more serological markers of HBV infection were found in 295 Albanians (75%), confirming the endemic nature of this virus in the Albanian community. The overall prevalence of HBsAg was 19%, and the carrier rate was higher in males than in females. The high HBsAg prevalence among children suggests that HBV infection is usually acquired in early childhood.The serological data obtained in the Albanian sample examined clearly indicate the urgent need for measures to reduce the incidence of HAV and HBV infections and to avoid the further spread of HDV and HCV infections.Finally, the high prevalence of type B hepatitis indicates the necessity of vaccination against HBV for all risk groups and for all children at birth.     

Viral hepatitis in a Canadian street-involved population

BACKGROUND: Data on the prevalence and compliance with management of viral hepatitis in the street-involved population are limited. METHOD: Hepatitis A (HAV), B (HBV) and C (HCV) serology and compliance with HBV vaccination were documented in 533 street-involved individuals. RESULTS: The mean age of the study population was 25.7 years (range: 11-65) and 53% were female. Serologic evidence of HAV infection was present in 53%; HBV, 12% (3% ongoing infection); and HCV, 17%. HAV infections were associated with Aboriginal/Metis ethnicity and age over 25 years; HBV with injection drug use (IDU); and HCV with IDU, sex trade work and age over 25 years. Compliance with three-step HBV vaccination was 98%, 77% and 63%. CONCLUSIONS: HAV, HBV and HCV are common infections in urban street-involved persons. Successful HBV (and presumably HAV) vaccination can be achieved in the majority of this population, but concerns exist regarding compliance with more long-term, parenterally-based antiviral therapies.     

湖州市社区人群病毒性肝炎感染特征研究

目的了解湖州市社区人群病毒性肝炎的感染特征。方法对社区人群采用多阶段分层整群随机抽样方法抽取研究对象,进行个案调查和血清学检测。结果湖州市社区人群HAV、HBV、HCV、HDV、HEV标化感染率分别为55.74%、65.22%、0.12%、0%和38.88%。甲型肝炎总感染率城镇高于山区和平原水乡,感染率与年龄呈正相关。乙型肝炎总感染率男性高于女性,小年龄组即达较高水平;HBsAg携带率为4.14%,年龄分布呈中间高两头低,10岁以下携带率为0%;人群乙肝病毒标志物存在15种不同组合模式。戊型肝炎流行率地区间差异非常显著,城镇和平原水乡明显高于山区;流行率随年龄增长而逐渐上升。各型肝炎病毒混合感染比例较高,双重感染占37.52%。结论湖州市社区人群五型病毒性肝炎感染型别主要为HBV、HAV、HEV三种,流行特征各不相同,HEV感染率较高,HAV、HBV的感染率属中等水平,HCV、HDV的流行水平较低。     

福建省五型病毒性肝炎流行特征

为了解福建省人群病毒性肝炎流行特征 ,福建省于 1992年进行五型病毒性肝炎感染的血清流行病学调查。采用多阶段分层整群随机抽样法 ,采集福建省疾病监测点自然人群的 12 37户家庭中 1～ 59岁居民血样本 380 9份。采用 RIA法检测 HBs Ag、抗 - HBs、抗 - HBc,采用 EIA法检测抗 - HAV、抗 - HCV、抗 - HDV、抗 - HEV和 HBe Ag。结果显示各标化流行率为 HAV 76.60 %、HBV77.2 6%、HCV 3.99%、HDV 2 .10 %、HEV 18.80 %、HBs Ag 17.2 5%、抗 - HBs 34 .33%、抗 - HBc68.58%、HBe Ag 8.4 2 %。农村 HAV、HBV、HEV流行率均高于城市。 HBs Ag流行率出现儿童峰和成人峰而且男性高于女性。 HBV和 HEV感染有明显的家庭聚集性。青壮年 HEV流行率高 ,城市儿童 HAV流行率低。提示福建省是 HAV、HBV、HCV、HEV的高流行区。预防甲、乙型肝炎病毒感染最有效策略是免疫接种甲、乙型肝炎疫苗。     

肝炎病毒重叠感染

１８５例ＨＢＶ感染者，用ＥＬＩＳＡ法检测抗－ＨＡＶ－ＩｇＭ和抗－ＨＣＶ。ＨＢＶ感染者的ＨＡＶ、ＨＢＶ二重感染率为１７．３０％，ＨＢＶ、ＨＣＶ二重感染率为３．２４％，ＨＡＶ、ＨＢＶ、ＨＣＶ三重感染率为０．５４％。３２例ＨＡＶ和ＨＢＶ二重感染者，ＨＢｅＡｇ２８例转阴；与１５３例单纯ＨＢＶ感染者５７例转阴比较，有显著性差异（Ｆ＜０．０５），３２例甲、乙型肝炎二重感染者，肝功复常天数（３０．３±１２．１）与２３０例单纯甲型肝炎复常天数（２５．５±１３．５）比较，也有显著性差异。ＨＢＶ和ＨＣＶ二重感染以及ＨＡＶ、ＨＢＶ、ＨＣＶ三重感染者，也使ＨＢｅＡｇ转阴，病情重、病程长。这些结果提示，甲、乙、丙型肝炎重叠感染比单一感染者的预后差，不少甲型肝炎慢性化可能是重叠感染乙型肝炎或／及丙型肝炎的缘故。     

Prevalence of hepatitis B markers in patients with hepatitis C infection in north-eastern Poland: Risk factors and vaccine use

We evaluated the prevalence of hepatitis B virus (HBV) markers and established HBV vaccination status among 111 patients with hepatitis C virus (HCV) infection. A history of HBV immunisation was recorded in 30 patients (27.0%) and only 17/30 (66.7%) had anti-HBs level 10 mIU/ml. All patients were HBsAg-negative and 22.2% of nonvaccinated subjects had evidence of HBV infection as determined by anti-HBc presence. Among patients with anti-HBc in 7/18 cases (38.9%) anti-HBc was the only marker of HBV infection (without anti-HBs). The prevalence of anti-HBc was significantly higher among patients who reported a history of acute hepatitis. In conclusion the prevalence of HBV markers in patients with HCV infection in north-eastern Poland is similar to the prevalence in general population, which suggests no increased risk for nosocomial HBV infection among those individuals. HCV infection seems to favour unusual serological pattern of HBV infection with anti-HBc as the only marker. HBV vaccine use is low among patients with HCV infection in north-eastern Poland.     

Hepatitis infection among adolescents resident in Melbourne Juvenile Justice Centre: risk factors and challenges.

OBJECTIVE: To describe patterns of infection with, and risks for, hepatitis A, B and C viruses (HAV, HBV, and HCV) in male adolescents detained in the Melbourne Juvenile Justice Centre (MJJC). METHODS: A cross-sectional serosurvey for HAV, HBV, and HCV among 90 male adolescents aged 15-18 years who were resident in MJJC for more than 1 week in 1996. RESULTS: Nine percent had been exposed to HAV, 8% were positive or equivocal for exposure to HBV, and 21% were antibody positive for HCV. All those with hepatitis markers except one positive for HAV had been injection heroin users for more than 1 year. Of those who were not HBcAb positive, only 28% were immune to HBV. For most respondents, sexual and drug-using risks began in the early teens and were associated with leaving school prematurely. CONCLUSIONS: Respondents were vulnerable to exposure to blood-borne viruses from an early age, posing a challenge for health education programs. An opportunity exists for harm minimization and prevention of spread of blood-borne viruses within the first year of injection drug use in this population.     

Hepatitis virus and HIV infections in inmates of a state correctional facility in Mexico

We sought to determine the prevalence and associated characteristics of hepatitis A, B, C and D viruses and HIV infections in a prison in Durango, Mexico. Sera from 181 inmates were analysed for HAV antibody, hepatitis B core antibody (HBcAb), hepatitis B surface antigen (HBsAg), HCV antibody, HDV antibody, HIV antibody and HCV genotypes. Prevalence of HAV antibody, HBcAb, HBsAg, HCV antibody, HDV antibody and HIV antibody were 99.4, 4.4, 0.0, 10.0, 0.0 and 0.6% respectively. HCV genotype 1a predominated in HCV-infected inmates (62.5%), followed by HCV genotype 1b (25%) and HCV genotype 3 (12.5%). An association between HBV infection and age > 30 years was found. HCV infection was associated with being born in Durango City, history of hepatitis, ear piercing, tattooing, drug abuse history, intravenous drug use and lack of condom use. We concluded that the prevalence of HAV, HBV, HDV and HIV infections in inmates in Durango, Mexico were comparable to those of the Mexican general population and blood donors, but lower than those reported in other prisons around the world. However, HCV infection in inmates was higher than that reported in Mexican blood donors but lower than those reported in other prisons of the world. These results have implications for the optimal planning of preventive and therapeutic measures.     

Long-term efficacy of immunization against hepatitis B virus in infants at high-risk analyzed by polymerase chain reaction.

Perinatal transmission of hepatitis B virus (HBV) is a common cause of chronic infection. In the present study, we evaluated the long-term efficacy of immunization against HBV in infants at high-risk, by using polymerase chain reaction (PCR). Two hundred and fifty-one infants received hepatitis B immunoglobulin at birth and a course of hepatitis B vaccine within 6 months of age between 1981 and 1993. Of 251 infants, 203 (81%) and 97 (39%) were followed until 1 and 4-6 years of age, respectively. HBV-DNA was detected by PCR in 74 (36%) of 203 children at 1 year of age, while the prevalence rate of children positive for HBV-DNA decreased to 14 (14%) of 97 children at 4-6 years of age, including 2 children who had the breakthrough variants of HBV. Our results indicate that most of HBV infections occur early, during the first year, and that immunization against HBV effectively protects infants at high-risk against viral transmission, at least up to 4-6 years of age.     

Seroepidemiology of hepatitis B and C in Kaingang Indians in the south of Brazil]

OBJECTIVE: To investigate the prevalence of infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) among Kaingang Indians living on the Mangueirinha reservation in the state of Paraná, Brazil. METHODS: The presence of viral markers was investigated in blood samples from 214 volunteers (81 males, 133 females), using immunoenzymatic techniques. The viral markers studied were: antibody to hepatitis B core antigen (anti-HB(c)), antibody to hepatitis B surface antigen (anti-HB(s)), hepatitis B surface antigen (HB(s)Ag), and antibody to hepatitis C virus (anti-HCV). The participants answered a questionnaire on their sociodemographic characteristics, living conditions, personal habits (such as smoking and consuming alcohol or illicit drugs), and history of disease and of vaccination. RESULTS: The respondents ranged in age from 1 to 90 years; their mean age was 29.85 years. Positivity for anti-HB(s) was 71.02%, and for anti-HB(c) it was 15.42%. None of the individuals was positive for HB(s)Ag. Anti-HCV was detected in only one participant, a 30-year-old woman. CONCLUSIONS: There were low prevalences of HBV and HCV infection in the Kaingang population studied. The high prevalence of anti-HB(s) in younger individuals indicates good immunization coverage. In the adult population, immunity against HBV was probably acquired mainly by contact with the virus.     

Viral hepatitis in South African healthcare workers at increased risk of occupational exposure to blood-borne viruses

The prevalence of hepatitis A, B and C antibodies was measured in a group of healthcare workers (HCWs) at increased risk of occupational acquisition of blood-borne viruses (N=402) from a large, urban referral hospital in South Africa. The aims of this study were to determine the immunity of HCWs to these agents and to recommend policy for the protection of HCWs against occupational exposure to viral hepatitis in this country. Race, sex and age were shown to be important factors influencing the presence of hepatitis A (HAV) antibodies. Most black HCWs (96.2%) are protected from HAV infection. Females have significantly higher HAV antibodies compared with males and antibodies increase with increasing age. Hepatitis B antibodies (anti-HBs) were found in 30.6% of HCWs. Anti-HBs levels were significantly associated with a past history of HBV vaccination. However, only a small proportion of HCWs (21.2%) could remember ever being immunized against HBV. For those individuals that did receive HBV vaccination (N=83), the mean number of years since their last vaccine was 6.2 years (SD +/- 3.5). HCV antibodies were found in 1.8% of HCWs at increased risk of occupational exposure. It was not possible to define whether these infections were occupationally acquired but genotyping of the HCV (in two of seven cases) showed genotype 5, the predominant South African genotype. New recommendations for the prevention of viral hepatitis in HCWs in South Africa are made, including pre-employment screening for HAV based on self-selection criteria, universal anti-HBs screening with HBV booster vaccination. HCV recommendations are based on appropriate education of HCWs about this infection and its prevention and a standardized post-exposure testing protocol.     

Non-A, non-B viral hepatitis in Egypt.

A study was carried out on 200 patients of ages 20-40 years suffering from acute viral hepatitis. Sera were tested for markers of hepatitis B (HBsAg, and IgM anti-HBc) and hepatitis A (IgM-anti-HAV) by the ELISA technique. Sera negative for the markers of both viruses: Hepatitis A (HAV) and Hepatitis B (HBV) were subsequently tested for IGM Heterophil antibodies against Epstein-Barr virus (EBV) by the Monospot slide test to diagnose acute infectious mononucleosis and tested for anti-CMV (IgM) by ELISA technique for the diagnosis of acute Cytomegalovirus (CMV) infection. Non-A, non-B hepatitis (NANB) was diagnosed by exclusion. The results of the study showed that 133 (66.5%) patients had evidence of HBV infection, while only 9(4.5%) were diagnosed as HAV infection. EBV and CMV were the possible etiological agents of acute viral hepatitis in (3.5%) and 1%) respectively. Accordingly the Non-A, non-B hepatitis in this study amounts to (24.5%) of the acute viral hepatitis.     

Pre-vaccine plasma levels of soluble inflammatory indices negatively predict responses to HAV,HBV, and tetanus vaccines in HCV and HIV infection

BackgroundChronic hepatitis C virus (HCV) and HIV infections are associated with impaired responses to neo-antigens contained in hepatitis A virus (HAV)/hepatitis B virus (HBV) vaccines, yet responsible mechanisms are unclear.MethodsACTG 5232 and CFAR0910 were clinical trials where pre-vaccine levels of plasma IP10, IL-6, sCD163 and sCD14 were measured in viremic HCV- (n = 15) or HIV-infected participants (n = 24) and uninfected controls (n = 10). Accelerated dosing HAV/HBV vaccine and tetanus booster were administered and antibody response was measured at 0, 1, 3, 8, and 24 weeks.ResultsPre-vaccine plasma IP10, IL-6, and sCD14 levels were elevated in both HCV and HIV-infected participants, while sCD163 was also elevated in HCV-infected participants. Pre-immunization tetanus antibody levels were lower in HIV-infected than in uninfected participants, while vaccine induced antibody responses were intact in HCV and HIV-infected participants. After HAV/HBV vaccination, HCV and HIV-infected participants had lower and less durable HAV and HBV antibody responses than uninfected controls.Among HCV-infected participants, pre-vaccine plasma IP10, IL-6, sCD14, and sCD163 levels inversely correlated with HAV, HBV and tetanus antibody responses after vaccine. Low HAV/HBV vaccine responses in HIV-infected participants prohibited assessment of immune correlates.ConclusionsDuring HCV and HIV infection markers of systemic inflammation reflect immune dysfunction as demonstrated by poor response to HAV/HBV neo-antigen vaccine.     

甲乙丙型肝炎病毒重叠感染情况分析

目的 了解甲型肝炎病毒(HAV)、乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)重叠感染情况。方法 应用ELISA法分别对283重叠感染者检测血清抗-HAV、抗-HCV和HBV-M,并比较各型临床类型各型病毒的感染情况。结果 肝炎病毒感染者中HBV的感染率最高86.9％,HAV和HBV的重叠感染最多42.8％,HBV和HCV重叠感染次之32.9％。结论甲型肝炎、乙型肝炎和丙型肝炎可以重叠感染。以HBV的感染为主,重叠感染加重病情。     

杭州地区妊娠晚期孕妇病毒性肝炎感染的调查研究

目的:调查杭州市2958例妊娠晚期孕妇乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、丁型肝炎病毒(HDV)、戊型肝炎病毒(HEV)的感染状况。方法:对杭州市2958例妊娠晚期孕妇的血清乙型肝炎标志物、HCV抗体、HDV抗体、HEV抗体的检测结果进行统计分析。结果:2958例妊娠晚期孕妇中乙型肝炎总感染率40.16%,HCV抗体阳性率0.40%,HDV抗体阳性率0.20%,HEV抗体阳性率2.60%。结论:杭州地区妊娠晚期孕妇病毒性肝炎的感染以乙型肝炎位居第一、戊型肝炎次之,丙型肝炎及丁型肝炎感染率较低。应加强育龄女性易感人群乙肝疫苗的预防接种,开展和实施有效的预防措施来防止病毒性肝炎的感染,提高新生人口的素质。     

厦门市区居民五型病毒性肝炎流行特征

按照全国五型病毒性肝炎血清流行病学调查方案，我市于１９９２年在居民中进行调查，以家庭为单位整群抽样，将１－５９岁居民作为调查对象，共采血样４０３份，共１８０户。各型肝炎总感染率为：ＨＡＶ６８．４９％ＨＶＢ７５．４３％、ＨＣＶ４．２２％、ＨＤＶ５０％、ＨＥＶ２０．６０％，ＨＢｓＡｇ阳性率１１．１７％、抗－ＨＢｃ５７．５７％、抗－ＨＢｓ４１．９４％、ＨＢｅＡｇ１．９９％。调查提示市区居民病毒性肝炎血清     

734例急性病毒性肝炎的病原学分析研究

目的研究急性病毒性肝炎病原学的特征,制定科学的预防措施。方法对2004年1月～2008年12月收治的734例急性病毒性肝炎患者,进行血清病原学分型及流行病学研究。结果 734例中,甲、乙、丙、戊型病毒性肝炎分别占15.7%、17.0%、2.4%和35.2%,未分型者占29.7%;发病年龄主要集中在30～69岁,占67.4%,甲型肝炎15～49岁为发病高峰期占62.7%,乙型肝炎发病年龄集中在15～69岁占96.0%,丙型肝炎发病年龄在15～69岁占94.5%,戊型肝炎30～69岁为疾病高发年龄段占61.3%,未分型年龄集中在50～69岁,占74.3%;男性患者519例,女性患者215例,男女性患者之比为2.4∶1,每年1～2季度为发病的高峰季节,分别占27.6%和36.4%;临床分型中急性黄疸型肝炎453例(61.7%),急性无黄疸型肝炎264例(36.0%),重型肝炎17例(2.3%)。结论急性病毒性肝炎以戊型和未分型肝炎类型为常见,急性黄疸型肝炎是主要的临床类型;注意个人卫生及改善卫生条件有助于预防甲型肝炎和戊型肝炎传播,接种甲型肝炎和乙型肝炎疫苗是有效的预防措施。     

福建省正常人群病毒性肝炎血清流行病学调查

按照全国肝炎流行病学调查统一方案，我省于1992年在国家疾病监测点正常人群中开展病毒性肝炎血清流行病学调查。以家庭为单位整群抽样，采血2210人，采血率91.6%，进行五型病毒性肝炎8项指标测定。HBsAg、抗-HBs、抗-HBc用RIA法检测，HBeAg、抗-HBV、抗-HCV、抗-HDV、抗-HEV用EIA法检测。检测结果5个疾病监测点各型肝炎病毒标化感染率为HAV76.9%、HBV73.6%、HCV3.4%、HDV1.3%、HEV16.6%、HBsAg阳性率17.2%、抗-HBs30.6%、抗-HBc67.0%、HBeAg6.7%。调查揭示了我省病毒性肝炎流行病学的一些规律和特征。如HBsAg阳性率男性高于女性；它的年龄分布曲线显示出儿童峰和成年峰；HBsAg家庭聚集率为37.2%；接种乙肝疫苗者抗-HBs阳转率升高，而HBsAg、抗-HBc阳性率降低；青壮年HEV感染率高，调查结果表明我省是HAV、HBV、HEV的高感染区。     

Prevalence of hepatitis and HIV infections and vaccination rates in patients entering the heroin-assisted treatment in Switzerland between 1994 and 2002

Background:  Hepatitis C virus (HCV) remains very prevalent in injection drug users (IDUs). In spite of recommended vaccinations against hepatitis A virus (HAV) and hepatitis B virus (HBV), many IDUs remain susceptible to HAV and HBV. Study population and methods:  Patients entering heroin-assisted treatment between 2000 and 2002 (N = 210) were compared for infectious disease status with patients entering this treatment in 1998 (N = 243) and between 1994 and 1996 (N = 1035). Infection status was determined with the aid of questionnaires and blood tests for antibodies against HAV, HBV core antigen, HCV and HIV. Results:  In the cohort 2000–2002 78.3% of the patients were HCV positive, 53.3% were HBV positive, 41.2% were HAV positive and 12.6% were HIV positive. In comparison to the cohorts entering the heroin- assisted treatment at an earlier time, there was a significant reduction of HBV and HAV infections, but not of HCV and HIV infections. 15.6% of the patients entering between 2000 and 2002 were vaccinated against HBV and 10.3% against HAV. 31.1% of patients at entrance were susceptible for HBV and 48.5% for HAV. In comparison to patients entering treatment in 1998 there was no significant increase in patients who were vaccinated against HBV. Conclusions: This data illustrates the need for improving HCV prevention and more consequent vaccination against HBV and HAV in IDUs.     

Examining Hepatitis,A and B Vaccination,and HBV Reactivation Monitoring During Direct-Acting Antiviral Therapy for Hepatitis C

The objective of this study was to examine Hepatitis A (HAV) and Hepatitis B (HBV) screening, and the risk of HBV reactivation during Hepatitis C (HCV) therapy with direct-acting antivirals (DAAs). A retrospective chart review was performed of patients treated with second generation DAA therapy from January 2014 to September 2016 at the Iowa City VA Healthcare System. In total 409 patients initiated HCV treatment, 308 (75%) and 241 (59%) were HAV and HBV vaccine eligible, respectively. Among those, 24 (8%) received a HAV vaccine, while only 20 (8%) received a HBV vaccine. Of these, 7 patients initiating an immunization in the clinic had record of completing the series. Further, 101 patients had a reactive Hepatitis B core Antibody indicating previous HBV infection, and 3 of these were tested for HBV reactivation during HCV therapy. Overall, the assessment found low rates of HAV and HBV vaccine administration, indicating missed opportunities for preventative care during HCV therapy. With the known risk of HBV reactivation with DAAs, the need for HAV and HBV screening is essential.