HBeAg negative serological status and low viral replication levels characterize chronic hepatitis B virus-infected women at reproductive age in Greece: A one-year prospective single center study

AIM： To evaluate the seroprevalence of hepatitis B surface antigen （HBsAg） in 13 581 women at reproductive age and the hepatitis B e antigen （HBeAg）/anti-HBe status as well as serum hepatitis B virus （HBV）-DNA levels in a subgroup of HBsAg（＋） pregnant women at labor in Greece. METHODS： Serological markers were detected using enzyme immunoassays. Serum HBV-DNA was determined by a sensitive quantitative PCR assay. Statistical analysis of data was based on parametric methodology. RESULTS： Overall, 1.156% of women were HBsAg（＋） and the majority of them （71.3%） were Albanian. The prevalence of HBsAg was 5.1% in Albanian women, 4.2% in Asian women and 1.14% in women from Eastern European countries. The prevalence of HBsAg in African （0.36%） and Greek women （0.29%） was very low. Only 4.45% of HBsAg （＋） women were also HBeAg（＋） whereas the vast majority of them were HBeAg（-）/anti-HBe（＋）. Undetectable levels of viremia （〈200 copies/mL） were observed in 32.26% of pregnant women at labor and 29.03% exhibited extremely low levels of viral replication （〈400 copies/mL）. Only two pregnant women exhibited extremely high serum HBV- DNA levels （〉10 000 000 copies/mL）, whereas 32.26% exhibited HBV-DNA levels between 1 500 and 40 000 copies/mL. CONCLUSION： The overall prevalence of HBsAg is relatively low among women at reproductive age in Greece but is higher enough among specific populations. The HBeAg（-）/anti-HBe（＋） serological status and the extremely low or even undetectable viral replicative status in the majority/of HBsAg（＋） women of our study population, suggestthat only a small proportion of HBsAg（＋） women in Greece exhibit a high risk for vertical transmission of the infection.

Immunogenicity of recombinant hepatitis B vaccine in treatment-nave and treatment-experienced chronic hepatitis C patients: The effect of pegylated interferon plus ribavirin treatment

AIM： To retrospectively evaluate the vaccinationinduced anti-HBs seroconversion rates in treatmentnaive and treatment-experienced chronic hepatitis C （CHC） patients. Also to prospectively evaluate the seroconversion rates in CHC patients during pegylated interferon （PEG） plus ribavirin （RIB） treatment. METHODS： Seventy treatment-naive CHC patients （group A）, 22 sustained virological responders-SVR following interferon （IFN） plus RIB treatment CHC patients （group B） and 121 healthy subjects （group C） had been participated in the same HBV vaccination schedule （20 μg, 0-1-6 mo）. Seroconversion was considered if anti-HBs levels were above 10 mIU/mL within 3 mo following the third dose of the vaccine. Moreover, we prospectively selected 30 non-cirrhotic CHC patients and evaluated them for the efficacy of the same vaccine schedule randomizing them in two groups： Group-1, 15 CHC patients received the first dose of the vaccine in parallel with the initiation of PEG plus RIB treatment and Group-2, 15 patients received the same vaccination schedule without concomitant treatment. Determination of anti-HBs was performed at mo 1, 2, and 7. Statistical analysis of data was based on ANOVA student＇s t-test and chi-square analysis （P 〈 0.05）. RESULTS： Fifty-eight of 70 group A patients （82.85%）, 20/22 group B （90.9%） and 112/121 healthy subjects （92.56%） had been seroconverted. The seroconversion rates were significantly higher in the control group than in treatment-naive CHC patients （P = 0.04）. The corresponding rates were comparable between group A and group B CHC patients （P = 0.38）. The vast majority of non-responders （10/14, 71.43%） had been infected by genotype-1 of HCV. The seroconversion rates were comparable between group 1 and 2 CHC patients at mo 1 （20% versus 26.7%, P = 0.67）, mo 2 （46.7% vs 60%, P = 0.46） and mo 7 （86.7% versus 93.3%, P = 0.54） of follow-up. CONCLUSION： The immunogenicity of HBV vaccine seems to be lower in CHC patients compared to healthy subjects. SVR following IFN plus RIB treatment does not affect the antibody response to HBV vaccine. Infection by genotype-1 seems to negatively influence the seroconversion rates. Vaccination against HBV during PEG plus RIB combination treatment is not beneficial in terms of anti-HBs seroconversion rates.