Assessing the prevalence of hepatitis B virus infection among health care workers in a referral hospital in Kisantu, Congo DR: a pilot study
Masaka Blandine LUNGOSIBasilua André MuzemboN MbendiNatuhoyila Aliocha NkodilaNlandu Roger NgatuTomoko SuzukiKoji WadaNsukini Sebastien MbendiShunya Ikeda
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We aimed to determine hepatitis B virus (HBV) prevalence and risk factors for health care workers (HCWs) to contract HBV infection in a referral hospital in the Democratic Republic of Congo. From October 2015 to August 2016, we recruited 97 HCWs (55 males and 42 females, aged 41.2 ± 10 yr) from Kisantu St. Luke's Hospital, a Congolese referral hospital located in the province of Kongo Central. Serum samples were assayed for HBV markers using ELISA. A questionnaire was used to record the HCWs' demographics, medical histories, and risk factors. The overall prevalence of exposure to HBV infection [HBsAg+, and/or hepatitis B core antibody (anti-HBc)+] was 56.7% (55/97). HBsAg positivity was found in 18.6% (18/97) of the HCWs whereas 29.9% (29/97) were anti-HBc positive. Approximately 8.2% (8/97) of the HCWs tested positive for both HBsAg and anti-HBc. Being a physician [odds ratio (OR)=2.8 (95% CI: 1.34-12.23)], a laboratory technician [OR=3.35 (95% CI: 1.35-5.21)], and having multiple sex partners [OR=3.05 (95% CI: 1.13-9.09)] were found to be factors associated with HBV infection. Exposure to HBV is common among HCWs at Kisantu St. Luke's Hospital. Isolated HBsAg was also prevalent among them. There is a high risk that HBV could be spread to others. Therefore, there is an urgent need for HBV screening, treatment, and vaccination policies.Keywords:
Hepatitis B
The aim of this study was to determine the prevalence of hepatitis B surface antigen (HBsAg) among febrile individuals tested at Mercy Hospital Research Laboratory (MHRL) in Bo, Sierra Leone.A total of 860 febrile individuals ages 5 years and older were tested by MHRL between July 2012 and June 2013 with a Standard Diagnostics Bioline HBsAg rapid diagnostic test. The overall HBsAg prevalence rate was 13.7%, including a rate of 15.5% among males and 12.6% among females. The HBsAg rate did not differ by child or adult age group (p > 0.5). The prevalence rate in Bo was similar to the 11-15% HBsAg prevalence rates reported in the past decade from other studies across West Africa. Scaling up the infant hepatitis B vaccination program in Sierra Leone will be important for reducing the future burden of disease and premature death attributable to chronic viral hepatitis B disease.
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Effects of hepatitis B vaccination on hepatitis B surface antigen in neonates and its change in vivo
Vaccination is effective to prevent hepatitis B virus (HBV) infection. However, there is still a risk of infection after vaccination. In clinical work, we found that newborns were positive for HBV surface antigen (HBsAg) after vaccination.To determine the effect of hepatitis B vaccination on the detection of HBsAg trend in newborns.We collected data at birth, history of vaccination for hepatitis B, quantitative HBsAg results, and other information about newborns born in our hospital from July 2017 to July 2020. Serum samples from healthy neonates were randomly selected to be supplemented with recombinant hepatitis B vaccine on a concentration gradient, and HBsAg was measured quantitatively.Data from 1417 neonates were included in the study; 306 (21.6%) were HBsAg positive within 8 d after vaccination, with levels ranging from 0.104 IU/mL to 0.339 IU/mL. The proportion of neonates with HBsAg-positive serum was significantly correlated with the level of hepatitis B surface antibodies (anti-HBs) in the serum of their mothers (P < 0.01). Experiments in vitro showed that the proportion of neonates with HBsAg-positive serum was correlated with the dose of the hepatitis B vaccine, and when the concentration of the hepatitis B vaccine reached 5 ng/mL and 10 ng/mL, the serum HBsAg levels showed a significant negative correlation with the original concentration of serum anti-HBs.Hepatitis B vaccination can affect the level of HBsAg detected in neonatal serum, and the effect could be mitigated by delaying the measurement. Moreover, maternal anti-HBs offset the effects of neonatal vaccination on HBsAg serum levels.
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Hepatitis B is the most common viral hepatitis, potentially life threatening, with long term complications. Currently, vaccine is the most effective tool against hepatitis B infection. It is worthwhile mentioning that due to rampant use of hepatitis B vaccine (HBV), there have been concerns about hepatitis B surface antigen (HBsAg) reactivity. This article aims to report the false positive results of HBsAg due to recent HBV among healthy male adults.The subjects were selected from a Community Health Center, under the umbrella of a tertiary care hospital, Saudi Arabia. The data was retrieved from electronic medical records maintained at the clinic.A total of 130 employees were recruited, only 117 records could be retrieved from the system. The mean age of participants was 31.34 ± 12.73 years. The administration of HBV and HBsAg test was performed simultaneously. The lab reported three cases of HBsAg positivity, a false positive result of 2.56%. Repeat testing after one week for HBsAg was negative for the three cases.This study confirmed that HBsAg reactivity might be seen in regular screening programs for healthy adults.
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This study was conducted by the International Consortium for Blood Safety (ICBS) to identify high-quality test kits for detection of hepatitis B virus (HBV) surface antigen (HBsAg) for the benefit of developing countries.The 70 HBsAg test kits from around the world were evaluated comparatively for their clinical sensitivity, analytical sensitivity, sensitivity to HBV genotypes and HBsAg subtypes, and specificity using 394 (146 clinical, 48 analytical and 200 negative) ICBS Master Panel members of diverse geographical origin comprising the major HBV genotypes A-F and the HBsAg subtypes adw2,4, adr and ayw1-4.Seventeen HBsAg enzyme immunoassay (EIA) kits had high analytical sensitivity <0.13 IU/ml, showed 100% diagnostic sensitivity, and were even sensitive for the various HBV variants tested. An additional six test kits had high sensitivity (<0.13 IU/ml) but missed HBsAg mutants and/or showed reduced sensitivity to certain HBV genotypes. Twenty HBsAg EIA kits were in the sensitivity range of 0.13-1 IU/ml. The other eight EIAs and the 19 rapid assays had analytical sensitivities of 1 to >4 IU/ml. These assays were falsely negative for 1-4 clinical samples and 17 of these test kits showed genotype dependent sensitivity reduction. Analytical sensitivities for HBsAg of >1 IU/ml significantly reduce the length of the HBsAg positive period which renders them less reliable for detecting HBsAg in asymptomatic HBV infections. Reduced sensitivity for HBsAg with genetic diversity of HBV occurred with genotypes/subtypes D/ayw3, E/ayw4, F/adw4 and by S gene mutants. Specificity of the HBsAg assays was >or=99.5% in 57 test kits and 96.4-99.0% in the remaining test kits.Diagnostic efficacy of the evaluated HBsAg test kits differed substantially. Laboratories should therefore be aware of the analytical sensitivity for HBsAg and check for the relevant HBV variants circulating in the relevant population.
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Rationale & ObjectiveHepatitis B virus (HBV) transmission in hemodialysis units has become a rare event since implementation of hemodialysis-specific infection control guidelines: performing hemodialysis for hepatitis B surface antigen (HBsAg)-positive patients in an HBV isolation room, vaccinating HBV-susceptible (HBV surface antibody and HBsAg negative) patients, and monthly HBsAg testing in HBV-susceptible patients. Mutations in HBsAg can result in false-negative HBsAg results, leading to failure to identify HBsAg seroconversion from negative to positive. We describe 4 unique cases of HBsAg seroconversion caused by mutant HBV infection or reactivation in hemodialysis patients.Study DesignFollowing identification of a possible HBsAg seroconversion and mutant HBV infection, public health investigations were launched to conduct further HBV testing of case patients and potentially exposed patients. A case patient was defined as a hemodialysis patient with suspected mutant HBV infection because of false-negative HBsAg testing results. Confirmed case patients had HBV DNA sequences demonstrating S-gene mutations.Setting & ParticipantsCase patients and patients potentially exposed to the case patient in the respective hemodialysis units in multiple US states.Results4 cases of mutant HBV infection in hemodialysis patients were identified; 3 cases were confirmed using molecular sequencing. Failure of some HBsAg testing platforms to detect HBV mutations led to delays in applying HBV isolation procedures. Testing of potentially exposed patients did not identify secondary transmissions.LimitationsLack of access to information on past HBsAg testing platforms and results led to challenges in ascertaining when HBsAg seroconversion occurred and identifying and testing all potentially exposed patients.ConclusionsMutant HBV infections should be suspected in patients who test HBsAg negative and concurrently test positive for HBV DNA at high levels. Dialysis providers should consider using HBsAg assays that can also detect mutant HBV strains for routine HBV testing. Hepatitis B virus (HBV) transmission in hemodialysis units has become a rare event since implementation of hemodialysis-specific infection control guidelines: performing hemodialysis for hepatitis B surface antigen (HBsAg)-positive patients in an HBV isolation room, vaccinating HBV-susceptible (HBV surface antibody and HBsAg negative) patients, and monthly HBsAg testing in HBV-susceptible patients. Mutations in HBsAg can result in false-negative HBsAg results, leading to failure to identify HBsAg seroconversion from negative to positive. We describe 4 unique cases of HBsAg seroconversion caused by mutant HBV infection or reactivation in hemodialysis patients. Following identification of a possible HBsAg seroconversion and mutant HBV infection, public health investigations were launched to conduct further HBV testing of case patients and potentially exposed patients. A case patient was defined as a hemodialysis patient with suspected mutant HBV infection because of false-negative HBsAg testing results. Confirmed case patients had HBV DNA sequences demonstrating S-gene mutations. Case patients and patients potentially exposed to the case patient in the respective hemodialysis units in multiple US states. 4 cases of mutant HBV infection in hemodialysis patients were identified; 3 cases were confirmed using molecular sequencing. Failure of some HBsAg testing platforms to detect HBV mutations led to delays in applying HBV isolation procedures. Testing of potentially exposed patients did not identify secondary transmissions. Lack of access to information on past HBsAg testing platforms and results led to challenges in ascertaining when HBsAg seroconversion occurred and identifying and testing all potentially exposed patients. Mutant HBV infections should be suspected in patients who test HBsAg negative and concurrently test positive for HBV DNA at high levels. Dialysis providers should consider using HBsAg assays that can also detect mutant HBV strains for routine HBV testing.
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SUMMARY Objectives To calculate the hepatitis B surface antigen ( HBsAg ) reactive rate for 2011 blood donors (BD) across Morocco. In addition, to monitor the profile of donors bearing the HBsAg during 2000 and 2011, we calculated the percentage of the prevalence in both sexes, in different age groups and in first‐time replacement and regular BD from the Rabat Regional Blood Transfusion Centre. Background Hepatitis B is a viral infection that spreads through blood and other biological fluids. The hepatitis B virus remains one of the most common serious complications of transfusion. No information exists on the real prevalence of hepatitis B in Moroccan BD. Methods For the 2011 national HBsAg reactive rate, the percentage was calculated based on enzyme‐linked immunosorbent assay ( ELISA ) results of the 232 190 blood donations collected around the country. For the Rabat blood Centre, we calculated the hepatitis B sero‐prevalence from donations made at the donors' suite during 2000 and 2011. Results The national prevalence of HBsAg was 1·34%. The HBsAg variations among different regions was between 0·43 and 2·86%. The Rabat donors' suite hepatitis B prevalence decreased from 2·47% in 2000 to 0·91% in 2011 ( P < 0·001). In both years, family/replacement donors were found as safe as first‐time BD and female donors were the safest. Conclusions These results, presented for the first time in the country, mapped the hepatitis B distribution across Morocco in a healthy population. The findings of this study could be of great importance in setting up strategies for the recruitment of the BD and keeping blood safety at the highest level.
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To investigate the effect of hepatitis B virus (HBV) and hepatitis B virus surface antigen (HBsAg) on microRNA-31 (miR-31) expression in HBV-related hepatocellular carcinoma using HepG2 hepatoma cells.Stable HBsAg-overexpressing cell lines were established by transfecting HepG2 cells with an HBsAg-bearing mammalian expression vector, and the clones (designated as HepG2-H2 cells) were validated by enzyme-linked immunosorbent assay and immunohistochemistry. Effects on expression of miR-31 were determined by measuring the mRNA level by real-time PCR and performing statistical comparisons with levels detected in HepG2-H0 cells (stably transfected with empty vector) and HepG2.2.15 cells (stably transfected with the HBV genome).The HepG2-H2 HBsAg-overexpressing transfectant cell line was successfully established. The expression level of miR-31 was significantly higher in the HepG2-H0 cells than in the HepG2.2.15 cells (t = 583.8, P less than 0.001). In contrast, the expression level of miR-31 was significantly higher in the HBsAg-overexpressing HepG2-H2 cells than in the HepG2-H0 cells (F = 24.9, P less than 0.05).Intact HBV leads to down-regulation of miR-31 expression and HBsAg overexpression leads to up-regulation of miR-31 expression in hepatocarcinoma cells.
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Objective To observe the HBsAg and HBcAg expression in the renal tissue in hepatitis B virus associated glomerulonephritis(HBV-GN) . Methods We selected 50 cases of HBV-GN as research group and the other randomly selected 20 cases of non-HBV-GN(NHBV-GN) as control group and used indirect immunofluorescence assay to detect the HBsAg and HBcAg expression in the renal puncture biopsies. Results The HBsAg and HBcAg-positive particles in the HBV-GN renal tissue could be detected,with the positive rates of 70%(35/50) and 24%(12/50) ,while HBsAg and HBcAg failed to be detected in the kidney tissue of 20 cases of NHBV-GN,with a significant difference between the two groups(P0.05) . Conclusion The immune fluorescence detection of HBsAg and HBcAg is an important indicator in the diagnosis of HBV-GN. HBV plays an important role in the kidney tissue infection and replication and the pathogenesis of HBV-GN.
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