The prevalence of hepatitis B surface antigen and anti-hepatitis B core antibody in Iran: A population-based study

Background: Hepatitis B virus infection is a very common cause of chronic liver disease worldwide. It is estimated that 3 of Iranians are chronically infected with hepatitis B virus. Current population-based studies on both rural and urban prevalence of hepatitis B virus infection in Iran are sparse with results that do not always agree. We performed this study to find the prevalence of hepatitis B surface antigen, anti-hepatitis B core antibody, and associated factors in the general population of three provinces of Iran. Methods: We randomly selected 6,583 subjects from three provinces in Iran, namely Tehran, Golestan, and Hormozgan. The subjects were aged between 18 and 65 years. Serum samples were tested for hepatitis B surface antigen and anti-hepatitis B core antibody. Various risk factors were recorded and multivariate analysis was performed. Results: The prevalence of hepatitis B surface antigen and anti-hepatitis B core antibody in Iran was 2.6 and 16.4, respectively. Predictors of hepatitis B surface antigen or anti-hepatitis B core antibody in multivariate analysis included older age, not having high-school diploma, living in a rural area, and liver disease in a family member. We did not find any significant differences between males and females. Conclusion: In spite of nationwide vaccination of newborns against hepatitis B virus since 1992, hepatitis B virus infection remains a very common cause of chronic liver disease in Iran which should be dealt with for at least the next 30-50 years

Persistence of hepatic hepatitis B virus after serological clearance of HBsAG with autologous peripheral stem cell transplantation

Delayed clearance of hepatitis B surface antigen was previously reported in a 38 year old woman after high dose chemotherapy with autologous peripheral blood stem cell rescue. Sixteen months later, this patient remained hepatitis B surface antigen negative, hepatitis B surface anti-body positive, and serum hepatitis B DNA negative by polymerase chain reaction. Serial liver biopsies (one at hepatitis B e antigen positive stage, one at hepatitis B e antibody positive stage, and one at hepatitis B surface antigen negative and hepatitis B surface antibody positive stage) showed a gradual resolution of the inflammatory activity with loss of hepatitis B e antigen and then hepatitis B surface antigen in the serum. However, the degree of fibrosis, though mild, remained the same. With the serological clearance of hepatitis B surface antigen, a small amount of hepatitis B virus DNA was still detectable in the nuclei of liver cells.published_or_final_versio

Prevalence of hepatitis B and hepatitis C virus infection in repeatedly transfused thalassemics in a tertiary care hospital in eastern India

Background: Patients of thalassemia who are conventionally treated by a regular transfusion regimen are at a risk of developing transfusion transmissible infections, including hepatitis. The present study was conducted to assess the prevalence of hepatitis B and hepatitis C virus infections among repeatedly transfused thalassemia patients.Methods: A total of 207 patients of beta-thalassemia, who had received at least 10 transfusions were tested for hepatitis B surface antigen (HBsAg) and anti-HCV antibody using enzyme linked immunosorbant assay (ELISA).Results: The overall number of anti-hepatitis C antibody seropositive was 51 (24.6%) and that for hepatitis B surface antigen positives was 7 (3.38%). The prevalence rate for hepatitis B surface antigen was in agreement with average national values, but in case of anti-HCV antibodies the prevalence rate values were comparatively much higher.Conclusions: Stringent measures need to be taken on urgent basis while screening blood for anti-hepatitis C antibody and hepatitis B surface antigen including inclusion of other sensitive assay like nucleic acid test (NAT) as well as better donor recruitment

Risk Factors and Management of Hepatitis B Virus Reactivation in Patients With Hematological Disorders

DergiPark: 420829tmsjAims: The aim of this study is to evaluate hepatitis B virus serological status and to categorize the risks of our treatmentmodalities in patients with both benign and malignant hematological disorders.Methods: This was a retrospective study of 552 patients who were admitted to the Trakya University Hospital Hematologyunit between 01.01.2017 and 31.12.2017. All data regarding the diagnosis, treatment and HBV serologicalstatus were collected from patient files. Data were analyzed with IBM SPSS V.20 using descriptive statistical analysis.Results: Hepatitis B surface antigen was positive in 45 (8.2%) patients, antibody to the hepatitis B surface antigenwas positive in 279 (50.5%) patients and antibody to the hepatitis B core antigen was positive in 247 (44.7%) patients.According to these results, 32 patients were found to be vaccinated for hepatitis B virus. Reactivation was observed in4 (0.7%) patients who have been hepatitis B surface antigen positive and have received adequate duration of antiviralprophylaxis with tenofovir. These 4 patients have received monoclonal antibody for immunosuppressive treatment.Conclusion: To conclude, although the rate of hepatitis B surface antigen reactivation is quite low, as many patientsas possible should be vaccinated to reduce the costs of antiviral treatments and monitorization. If there is notime to vaccinate, patients should be categorized according to guidelines by their hepatitis B surface antigen serologicalstatus and by the planned immunosuppressive treatments

Solution structure and in Silico binding of a cyclic peptide with hepatitis B surface antigen

A specific ligand targeting the immunodominant region of hepatitis B virus is desired in neutralizing the infectivity of the virus. In a previous study, a disulfide constrained cyclic peptide cyclo S1,S9 Cys-Glu-Thr-Gly-Ala-Lys-Pro-His-Cys (S1, S9-cyclo-CETGAKPHC) was isolated from a phage displayed cyclic peptide library using an affinity selection method against hepatitis B surface antigen. The cyclic peptide binds tightly to hepatitis B surface antigen with a relative dissociation constant (KDrel) of 2.9 nm. The binding site of the peptide was located at the immunodominant region on hepatitis B surface antigen. Consequently, this study was aimed to elucidate the structure of the cyclic peptide and its interaction with hepatitis B surface antigen in silico. The solution structure of this cyclic peptide was solved using 1H, 13C, and 15N NMR spectroscopy and molecular dynamics simulations with NMR-derived distance and torsion angle restraints. The cyclic peptide adopted two distinct conformations due to the isomerization of the Pro residue with one structured region in the ETGA sequence. Docking studies of the peptide ensemble with a model structure of hepatitis B surface antigen revealed that the cyclic peptide can potentially be developed as a therapeutic drug that inhibits the virus–host interactions

Evolution of hepatitis B serological markers in HIV coinfected patients: a case study

OBJECTIVE To describe the evolution of serological markers among HIV and hepatitis B coinfected patients, with emphasis on evaluating the reactivation or seroreversion of these markers. METHODS The study population consisted of patients met in an AIDS Outpatient Clinic in São Paulo State, Brazil. We included in the analysis all HIV-infected and who underwent at least two positive hepatitis B surface antigen serological testing during clinical follow up, with tests taken six months apart. Patients were tested with commercial kits available for hepatitis B serological markers by microparticle enzyme immunoassay. Clinical variables were collected: age, sex, CD4+ T-cell count, HIV viral load, alanine aminotransferase level, exposure to antiretroviral drugs including lamivudine and/or tenofovir. RESULTS Among 2,242 HIV positive patients, we identified 105 (4.7%) patients with chronic hepatitis B. Follow up time for these patients varied from six months to 20.5 years. All patients underwent antiretroviral therapy during follow-up. Among patients with chronic hepatitis B, 58% were hepatitis B “e” antigen positive at the first assessment. Clearance of hepatitis B surface antigen occurred in 15% (16/105) of patients with chronic hepatitis B, and 50% (8/16) of these patients presented subsequent reactivation or seroreversion of hepatitis B surface antigen. Among hepatitis B “e” antigen positive patients, 57% (35/61) presented clearance of this serologic marker. During clinical follow up, 28.5% (10/35) of those who initially cleared hepatitis B “e” antigen presented seroreversion or reactivation of this marker. CONCLUSIONS Among HIV coinfected patients under antiretroviral therapy, changes of HBV serological markers were frequently observed. These results suggest that frequent monitoring of these serum markers should be recommended

Occult hepatitis B infection among vaccinated cohort

BACKGROUND: Occult hepatitis B is characterized by undetectable levels of surface antigen, but detectable levels of viral DNA and is becoming a major global threat due to: (i) the effect on the health of children born to carrier mothers despite the presence of passive immunoglobulin at birth (ii) immune escape of current vaccines; and (iii) spread through blood and blood products in post transfusion infection, organ donation, and sexual transmission. The aim of this study is to investigate occult hepatitis B virus among vaccines. METHOD: Four hundred and eight, vaccinee were recruited for this study. All samples were tested for hepatitis B surface antigen, hepatitis B surface and core antibodies using enzyme-linked immunosorbent assay kit (DRG International Inc., USA). Positive samples were re-tested to exclude false positive results. Molecular technique using a nested polymerase chain reaction was done using primers specific to the surface gene. RESULTS: Persistence of hepatitis B surface antibodies (≥10 IU/L) was found in 62.5% (255/408) with 37.5% (153/408) having anti-HBs<10 IU/L in circulation. Hepatitis B core antibodies among vaccinated cohort were found to be 5.0% (20/408). Of which 80% (16/20) of the hepatitis B core antibodies positive, have positive hepatitis B surface antibodies (≥10 IU/L) while 20% (4/20) are negative (<10 IU/L). The former is indicating immunity as a result of previous infection and the latter group are referred to as isolated anti-core, as described in previous studies (1). However none of the samples is hepatitis B surface antigen positive. Hepatitis B viral DNA was detected in all the core antigen positive individuals, contrary to studies in Turkey and Taiwan and in line with other similar studies(2). Occult hepatitis B infections have significant clinical importance since they can become reactivated when the immune system is suppressed and can be transmitted through blood or blood product transfusion, organs transplant, and sexual intercourse. CONCLUSION: The result of this study shows occult chronic HBV infection among adults who were vaccinated against hepatitis B vaccine at infant. The anti-HBs produced were induced by the vaccine they received but do not provide protection against the mutant’s variant suggesting primary infection with mutant’s hepatitis B virus

Therapeutic vaccination of woodchucks against chronic woodchuck hepatitis virus infection

BACKGROUND/AIMS: Therapeutic vaccination is a new approach to treat patients with chronic hepatitis B virus infection. We have used the woodchuck model to examine the efficacy and safety of this approach. METHODS: Seven woodchucks chronically infected with woodchuck hepatitis virus were immunized with surface antigen from this virus, purified from plasma, in conjunction with a peptide named FIS (encompassing amino acids 106-118: FISEAIIHVLHSR from sperm whale myoglobin), which is recognized by T helper lymphocytes. As controls, two woodchucks chronically infected with woodchuck hepatitis virus were immunized: one with FIS only and the other with surface antigen only. RESULTS: Co-immunization with surface antigen and FIS, but not with FIS or surface antigen alone, induced anti-surface antibodies in 7/7 immunized woodchucks. In the two woodchucks in which the highest titer of anti-surface antibody was elicited, severe liver damage was observed: one died of fulminant hepatitis and the other became seriously ill with hepatic injury and had to be sacrificed. CONCLUSIONS: Co-immunization of chronically infected woodchucks with surface antigen and a peptide recognized by T helper cells produces a good anti-surface antibody response. However, this strategy needs to be optimized before its implementation in humans. Although our experiments are not strictly comparable to vaccination of chronically hepatitis B virus-infected patients with recombinant or plasma-derived vaccines, we believe that precautions should be taken to avoid the risk of severe liver injury when immunizing hepatitis B virus carriers

Disruption of HBx-DDB1 by NTZ: New Mechanistic Insight Into an Old Drug With Broad Anti-infective Activities

Hepatitis B virus (HBV) infection leads to chronic hepatitis B (CHB) in approximately 250 million people worldwide, putting them at high risk for developing cirrhosis and hepatocellular carcinoma. HBV is a partially double-stranded DNA virus that belongs to the Hepadnaviridae family. After entry into host cells, the viral genome is transported into the nucleus and converted to a covalently closed circular DNA (cccDNA), which serves as the template for all HBV viral RNAs. Currently available HBV antiviral drugs inhibit the reverse transcription of HBV pregenomic RNA but fail to suppress the established cccDNA reservoir in infected hepatocytes, resulting in viral rebound after therapy. In addition, HBV surface antigen hepatitis B surface antigen expressed from the cccDNA maintains immune tolerance to prevent induction of antibodies to hepatitis B surface antigen, which are critical for a functional cure of CHB in patients

The study of prevalence of Hepatitis B surface antigen during pregnancy

Background: Hepatitis B virus infection is a major public health problem accounting to 400 million chronic infections worldwide and great majority of the transmission of Hepatitis B in India and other developing countries occurs by vertical transmission from an infected carrier mother to the neonate, intrapartum or antenatally. Objective: To determine the prevalence of Hepatitis B surface antigen (HBsAg) in Pregnant Women. Methods: The study was conducted at M.P. Shah Govt. medical college and G.G. hospital, Jamnagar, Gujarat, India during July 2013 to December 2013, including 1810 antenatal women. All of them were evaluated using history, examination, and test for serum HBsAg using Commercial enzyme immunoassay kits. Result: Of the total 1810 antenatal women, 15 were found to be positive for HBsAg (0.83%). Highest prevalence was found in age group 21-25 years (53.3%) followed by age group 26-30 years (33.3%), age group 17-20 and age more than 30 years (6.7%). Conclusion: Hepatitis B is highly infectious, associated with maternal complications and transmission to the child. It is mandatory that all the antenatal women should be screened for HBsAg and appropriately managed