Effect of viral hepatitis on type 2 diabetes:A Mendelian randomization study

BACKGROUND The effects of viral hepatitis(VH)on type 2 diabetes(T2D)remain controversial.AIM To analyze the causal correlation between different types of VH and T2D using Mendelian randomization(MR).METHODS Single nucleotide polymorphisms of VH,chronic hepatitis B(CHB),chronic hepatitis C(CHC)and T2D were obtained from the BioBank Japan Project,European Bioinformatics Institute,and FinnGen.Inverse variance weighted,MREgger,and weighted median were used to test exposure-outcome associations.The MR-Egger intercept analysis and Cochran’s Q test were used to assess horizontal pleiotropy and heterogeneity,respectively.Leave-one-out sensitivity analysis was used to evaluate the robustness of the MR analysis results.RESULTS The MR analysis showed no significant causal relationship between VH and T2D in Europeans[odds ratio(OR)=1.028;95%confidence interval(CI):0.995-1.062,P=0.101].There was a negative causal association between CHB and T2D among East Asians(OR=0.949;95%CI:0.931-0.968,P<0.001),while there was no significant causal association between CHC and T2D among East Asians(OR=1.018;95%CI:0.959-1.081,P=0.551).Intercept analysis and Cochran’s Q test showed no horizontal pleiotropy or heterogeneity(P>0.05).Sensitivity analysis showed that the results were robust.CONCLUSION Among East Asians,CHB is associated with a reduced T2D risk,but this association is limited by HBV load and cirrhosis.Although VH among Europeans and CHC among East Asians are not associated with the risk of T2D,focusing on blood glucose in patients with CHC is still relevant for the early detection of T2D induced by CHCmediated pathways of hepatic steatosis,liver fibrosis,and cirrhosis.

State of the HIV, Hepatitis B and C Virus Pandemic from 2003 to 2022 in Burkina Faso: Evolution of Prevalence Trends and Strategic Recommendations to Achieve the WHO’s Goal for Their Eradication by 2030

Background: The World Health Organization (WHO) has set a goal to eradicate or at least significantly reduce the prevalence the human immunodeficiency virus (HIV), hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) by 2030. The main objective was to provide an evolving overview of the prevalence of HIV, HBV and HCV infection between 2003 and 2022 in Burkina Faso. Methods: It was a retrospective cross-sectional study based on data from 2003 to 2022. The data were collected using information available in the databases of the HOSCO and CERBA laboratories and included all individuals who underwent HIV and/or HBV and/or HCV testing. Data analysis was performed using SPSS version 20.0, EpiInfo 7, and R version 4.1.0. Results were considered statistically significant if p Results: The study recorded 7432 samples and the mean age of the subjects was 27.98 ± 8.50 years. During this period, the respective prevalence of HIV, HBV, and HCV were 4.66% (346/7432), 8.77% (582/6636) and 5.54% (322/5816). However, from 2003 to 2022, there was a significant decrease (P y=−1.75x+12.59;y=−0.24x+10.01and y=−0.11x+6.02, with “y” corresponding to prevalence and “x” to the years. Conclusion: Burkina Faso needs to rigorously apply prevention and control strategies recommended by the WHO by 2030.

Viral Hepatitis B and C: Epidemiological, Clinical and Paraclinical Aspects in the Internal Medicine Department of KARA University Hospital in Togo

Introduction: Viral hepatitis B and C constitute real public health problems worldwide. The objective of this work was to describe the epidemiological, clinical and paraclinical aspects of viral hepatitis B and c in the internal medicine department of Kara University Hospital. Method: this was a retrospective descriptive study carried out in the Internal Medicine department of Kara University Hospital, over a period of 3 years from March 2020 to April 2023. It included all patients seen in consultation or hospitalized for hepatitis viral B and/or C. Results: A total of 57 patients were included in our study. The average age was 44.30 years ± 16.75 and the M/F sex ratio was 1.38. Married people were in the majority 63.2%. The circumstances of the discovery of viral hepatitis B and C were dominated by abdominal pain in 35.1% of cases and hepatomegaly in 29.8% of cases and in 33.3% of cases, it was during screening voluntary. Patients with viral hepatitis B only accounted for 64.9% of cases;those with only viral hepatitis C represented 31.6% of cases and 3.5% of cases had HVB/HCV co-infection. We recorded 36.8% complications including 52.4% liver cirrhosis and 47.6% hepatocellular carcinomas. During the evolution, there were 03 deaths. Conclusion: the prevalence of hepatitis B and C virus carriage in patients followed in internal medicine at Kara University Hospital is high. It is therefore essential to put in place treatment and prevention strategies against these viruses.

Hepatitis B Surface Antigen and Hepatitis C Virus Antibodies among Drug Users in Burkina Faso

Introduction: The epidemiology of both hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among drug users (DUs) is little known in West Africa. The study aimed to assess the prevalence of hepatitis B and C viruses among drug users in Burkina Faso. Methodology: This was a cross-sectional biological and behavioral survey conducted between June and August 2022, among drug users in Ouagadougou and Bobo Dioulasso, the two main cities of Burkina Faso. A respondent-driven sampling (RDS) was used to recruit drug users. Hepatitis B surface antigen was determined using lateral flow rapid test kits and antibodies to hepatitis C virus in serum determined using an Enzyme-Linked Immunosorbent Assay. Data were entered and analyzed using Stata 17 software. Weighted binary logistic regression was used to identify the associated factors of hepatitis B and C infections and a p-value Results: A total of 323 drug users were recruited with 97.5% males. The mean age was 32.7 years old. The inhaled or smoked mode was the most used by drug users. The adjusted hepatitis B and hepatitis C prevalence among study participants were 11.1% and 2.3% respectively. The marital status (p = 0.001), and the nationality (p = 0.011) were significantly associated with hepatitis B infection. The type of drug used was not significantly associated with hepatitis B infection or hepatitis C infection. Conclusion: The prevalence of HBsAg and anti-HCV antibodies among DUs are comparable to those reported in the general population in Burkina Faso. This result suggests that the main routes of contamination by HBV and HCV among DUs are similar to those in the population, and could be explained by the low use of the injectable route by DUs in Burkina Faso.

Prevalence of Occupational Injury and Knowledge of Post-Exposure Prophylaxis Accessibility among Healthcare Workers in Mogadishu, Somalia

Introduction: Healthcare workers in Mogadishu, Somalia face significant occupational injury risks, particularly needle stick injuries, with 61.1% reporting incidents. This poses a serious threat to their health, leading to infections such as hepatitis B, hepatitis C, and HIV. Despite the high prevalence of injuries, awareness of Post-Exposure Prophylaxis (PEP) accessibility is relatively high, with 84.0% of respondents aware of it. However, there are gaps in knowledge and implementation, as evidenced by variations in availability of PEP. Improving workplace safety measures, providing comprehensive training on injury prevention and PEP protocols, and ensuring consistent availability of PEP in healthcare facilities are crucial steps to safeguard the well-being of healthcare workers in Mogadishu, Somalia. Methods: A cross-sectional study was conducted among hospital workers in Mogadishu, Somalia, focusing on professionals from various healthcare facilities. The study targeted nurses, doctors, laboratory personnel, and pharmacists. Purposive sampling was employed, resulting in a sample size of 383 calculated using Fisher’s sample size formula. Data were collected using coded questionnaires entered into Microsoft Excel 2019 and analyzed with SPSS software to generate frequencies and proportions, presented through frequency tables and pie figures. Results: The study in Mogadishu, Somalia, examined the prevalence of occupational injuries and knowledge of Post-Exposure Prophylaxis (PEP) accessibility among healthcare workers. Findings indicate a high prevalence of injuries, with 61.1% reporting incidents, predominantly needle stick injuries (60.6%). Despite the majority seeking prompt medical attention (72.0%), work-related illnesses affected 53.2% of respondents, notably work-related stress (59.5%). While most received training on injury and illness prevention (68.9%), gaps exist in PEP awareness, with 16.0% unaware of it. Nonetheless, 84.0% were aware, predominantly through health facilities (52.0%). Availability of PEP was reported by 71.3% in healthcare facilities, with variations in shift availability. The majority reported guidelines for PEP use (55.7%). Efforts are needed to bolster PEP awareness and ensure consistent availability in healthcare facilities to safeguard worker health. Conclusion: High prevalence of occupational injuries among healthcare workers, with needle stick injuries being the most common (60.6%). Despite this, 84.0% of respondents were aware of Post-Exposure Prophylaxis (PEP), primarily learning about it from health facilities (52.0%). While 71.3% reported the availability of PEP in their facility, 28.7% noted its unavailability. These results emphasize the need for improved education and accessibility of PEP to mitigate occupational injury risks.

Locked nucleic acid real-time polymerase chain reaction method identifying two polymorphisms of hepatitis B virus genotype C2 infections,rt269L and rt269I

BACKGROUND The presence of two distinct hepatitis B virus(HBV)Pol RT polymorphisms,rt269L and rt269I,could contribute to the unique clinical or virological phenotype of HBV genotype C2.Therefore,a simple and sensitive method capable of identifying both types in chronic hepatitis B(CHB)patients infected with genotype C2 should be developed.AIM To develop a novel simple and sensitive locked nucleic acid(LNA)-real timepolymerase chain reaction(RT-PCR)method capable of identifying two rt269 types in CHB genotype C2 patients.METHODS We designed proper primer and probe sets for LNA-RT-PCR for the separation of rt269 types.Using synthesized DNAs of the wild type and variant forms,melting temperature analysis,detection sensitivity,and endpoint genotyping for LNA-RT-PCR were performed.The developed LNA-RT-PCR method was applied to a total of 94 CHB patients of genotype C2 for the identification of two rt269 polymorphisms,and these results were compared with those obtained by a direct sequencing protocol.RESULTS The LNA-RT-PCR method could identify two rt269L and rt269I polymorphisms of three genotypes,two rt269L types[‘L1’(WT)and‘L2’]and one rt269I type(‘I’)in single(63 samples,72.4%)or mixed forms(24 samples,27.6%)in 87(92.6%sensitivity)of 94 samples from Korean CHB patients.When the results were compared with those obtained by the direct sequencing protocol,the LNA-RT-PCR method showed the same results in all but one of 87 positive detected samples(98.9%specificity).CONCLUSION The newly developed LNA-RT-PCR method could identify two rt269 polymorphisms,rt269L and rt269I,in CHB patients with genotype C2 infections.This method could be effectively used for the understanding of disease progression in genotype C2 endemic areas.

Clinical and Paraclinical Profiling of Patients with Viral Hepatitis B and C Attending Saint Camille Hospital in Ouagadougou (HOSCO)

The present study aims to describe the clinical and paraclinical profile of patients infected by viral hepatitis B and C and follow-up. The clinical and paraclinical data used in this description are from patients infected by viral hepatitis B and C of the HOSCO Hepato-Gastroenterological Department from May 15, 2021 to July 23, 2021. The informed consent was provided to each patient included in this study. “Univariate analyses were evaluated using Pearson’s Chi2 test” using R software version 4.0.2. During the study period, we identified 149 patients with viral hepatitis B and/or C who met our inclusion criteria. The sex ratio was 0.83 at the rate of 68 men for 81 women with the average age at 37.17 years ± 12.21 years. The most represented age group was 30 - 44 years (49.7%). The most incriminated risk factors were medical care by injection (62.58%), excision (31.90%), blood transfusion (4.29%) and scarification (1.23%). HBV infection was the majority with a frequency of 95.97%. The HBV viral load was measured in 91.95% of patients, 77.18% of whom had a detectable DNA viral load ≤ 2000 IU/mL. The clinical and biological course was good in patients after therapeutic initiation. HBV-HCV-HIV co-infection was 0.67%. Abdominal ultrasound was normal in 87.92% of patients. Fibrosis was minimal and moderate in 58.39% and 19.46% of patients. Among patients, 52.35% were on Tenofovir therapy, 2.68% on Sofosbuvir/Velpatasvir, 0.67% on ARVs and 44.29% did not require treatment. Viral hepatitis B and C are common, and both affect sex. Thus, new screening strategies need to be implemented to improve the diagnosis of hepatitis B and C. Effective strategies against viral hepatitis B and C must be developed, subsequently.

Seroprevalence and Associated Risk Factors of Hepatitis B and C among Inmates of Port Harcourt Maximum Security Custodial Centre

Hepatitis B (HBV) and Hepatitis C (HCV) are significant global public health burdens associated with liver cirrhosis, liver cancer and are responsible for over a million deaths yearly. Prisons and other confined facilities offer opportunities for the acquisition and transmission of infectious diseases such as hepatitis B and C during and after imprisonment. This study aimed to investigate the seroprevalence of Hepatitis B and Hepatitis C as well as their associated risk factors among inmates in the Port Harcourt Maximum Security Custodial Centre. A cross-sectional study was conducted among inmates incarcerated in the Port Harcourt Maximum Security Custodial Centre from July to December 2022, and 200 consenting subjects completed a structured questionnaire in addition to screening for the presence of HBsAg and anti-HCV antibodies. Data generated from this study was represented as frequency and percentages, and inferential statistics were carried out using chi-square with the aid of GraphPad Prism Software Version 9. Statistical significance was defined as a p-value of less than 0.05 at a 95% confidence interval. The seroprevalence of HBV was 4% while 3.5% was recorded for HCV with no cases of co-infections reported. HBV seroprevalence was significantly associated with blood oath and a history of surgery (p p < 0.05). The findings from the current study highlight a relatively lower prevalence of HBV and HCV amongst inmates in Port Harcourt in comparison to studies in Nigeria. These infections can be further controlled by multifaceted approaches by the prison personnel, administration, and Government by employing combative measures such as regular screening, easy access to therapy, awareness, and vaccination programs for HBV are crucial to prevent the transmission of these diseases.

Frequency of B and C Hepatitis Viruses, and Metabolic Profile in Type 2 Diabetics: A Case of the YaoundéCentral Hospital, Cameroon

Poorly controlled type 2 diabetes alters the immune system, increasing the risk of susceptibility to viral infections such as hepatitis B and C infections. This study aimed to determine the frequency of hepatitis B and C and metabolic profiles in type 2 diabetics. This was a cross-sectional study conducted over six months. It was conducted at the National Obesity Center (NOC) of the Yaoundé Central Hospital (YCH), Cameroon. 100 diabetic patients, with a mean age of 58.41 ± 10.74 years were enrolled in the study. The socio-demographic characteristics of the study population and the risk factors for virus transmission were recorded using a pre-established questionnaire. HBsAg and anti-HCV antibodies were revealed by a rapid diagnostic test. Liver function markers’ activities were determined. Commercial kits were used to evaluate the patient’s serum lipid profile, serum fasting glucose level, urea, creatinine, and albumin. With a sex ratio of 3:1, women outnumbered men. Risk factors for HCV and HBV infections evocated by the population were dental care (50%), followed by alcohol consumption (41%). HBsAg and anti-HCV antibodies frequency was 3% and 8% respectively. No cases of coinfection were found. In general, hypertriglyceridemia with a mean of 1.61 ± 0.46 g/L and hyperglycemia of 1.35 ± 0.45 g/L were noted. A significant difference (p = 0.028) was found in HDL-cholesterol values between non-co-affected diabetics and HCV+ diabetics. The effect of the duration of diabetes on biochemical parameters revealed that albumin was the only significant decrease over time (p = 0.013). Based on these results, the metabolic profile of patients was altered. It is important to take note of the prevalence of hepatitis seen in type 2 diabetes mellitus since it demonstrates the potential link between both illnesses. Thus, early detection could prevent complications related to B and C hepatitis infections in type 2 diabetics.

Prevalence of HIV, Hepatitis B, and Hepatitis C in Rivers State University, Port Harcourt: Outcome of a Medical Outreach

Background: Infectious diseases associated with Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV) continue to pose significant public health challenges that necessitate continuous surveillance and interventions. This study investigates the prevalence of HIV, HBV and HCV infections within the academic community of Rivers State University, Port Harcourt, Nigeria. Given the potential for transmission in university settings and the importance of early detection and intervention, this research explores the extent of these infections and evaluates the outcomes of a medical outreach program aimed at addressing them. Methodology: A cross-sectional study design was employed to recruit 513 participants using a convenience sampling approach between the 20th and 22nd of April 2022. Participants included students and staff members who voluntarily consented to the medical outreach and study. Serological assays were utilized to identify HIV, HBV and HCV infections. The medical outreach program’s design, implementation, and outcomes were evaluated, focusing on testing uptake, counselling utilization, and linkage to care. Statistical analysis employed GraphPad Prism version 9 software. Result: The study revealed low prevalence rates of HIV (0.6%), HBV (1.2%), and HCV (0.6%) infections within the university population. Age-based analysis indicated a slightly higher prevalence in the 15 - 24 age group. Gender-wise, HBV showed a marginal difference, with 1.3% among females and 0.9% among males. The medical outreach program achieved a testing uptake of 80.8%, with 75% utilizing counselling services, and 75% of those identified with infections successfully linked to care. Conclusion: This study provides valuable insights into the prevalence of infections and the effectiveness of a medical outreach program within a university community. While low prevalence rates are encouraging, the findings emphasize the continued importance of awareness and prevention efforts. The success of the outreach program in encouraging testing, providing counselling, and facilitating care linkage underscores its potential as a model for future interventions. Further research should delve into determinants of infection prevalence and barriers to care linkage for a more comprehensive understanding and improved intervention strategies.

Midwives’s Knowledge and Practice in Preventing Mother-to-Child Transmission on Hepatitis B Virus in Brazzaville in 2023

Background: Maternal-fetal transmission is the most frequent mode of hepatitis B virus (HBV) contamination in Africa. Prevention of mother-to-child transmission (PMTCT) of hepatitis B is still poorly understood, and training of the health workers involved, such as midwives, is rare. Objective: The aim of this study was to assess the knowledge and practices of midwives prevention of HBV’ mother-to-child transmission (PMTCT) in Brazzaville. Patients and Methods: This was a cross-sectional analytical study conducted in Brazzaville from June 1 to July 31, 2023. Midwives present at the time of the survey in the various Brazzaville health centers visited and who agreed to answer the questionnaire during a face-to-face interview with the investigator were included. Univariate analyses were performed using epi info7.2 software. Pearson’s chi-square and Student’s t-tests were used to compare proportions and means, which were significant at the 0.05 level. Results: At the end of our study, 93 midwives out of 127 agreed to take part in the study, i.e. a participation rate of 73.2%. Their median age was of 41.7 years, a median professional experience of 13.7 years, and they worked mainly in primary health care facilities. Global knowledge of HBV PMTCT was satisfactory in 51 (54.3%) midwives. Knowledge of the HBV vaccine was significantly related to professional experience (p = 0.0167). PMTCT practice was poor in 48 (51.6%) cases. Overall, the practice of PMTCT was statistically associated with the midwives’ place of practice (p = 0.0262). Conclusion: Midwives had good knowledge but insufficient practice of PMTCT in Brazzaville. Training and awareness-raising are needed to reduce mother-to-child transmission of HBV.

Performance evaluation of NeuMoDx 96 system for hepatitis B and C viral load

BACKGROUND Hepatitis B virus(HBV)and hepatitis C virus(HCV)viral load(VL)estimation is essential for the management of both HBV and HCV infections.Due to a longer turnaround time for VL estimation,many patients drop out from the cascade of care.To achieve the global goals of reducing morbidity and mortality due to HBV/HCV and moving towards their elimination by 2030,molecular diagnostic platforms with faster and random(i.e.single sample)access are needed.AIM To evaluate the performance of the recently launched NeuMoDx 96 random access system with the conventional COBAS^(■)AmpliPrep/COBAS TaqMan system for HBV and HCV VL estimation.METHODS Archived once-thawed plasma samples were retrieved and tested on both platforms.Correlation between the assays was determined by linear regression and Bland-Altman analysis.The study included samples from 186 patients,99 for HBV of which 49 were true infected HBV cases(hepatitis B surface antigen,antihepatitis B core antibody,and HBV DNA-positive)and 87 for HCV assay in which 39 were true positives for HCV infection(anti-HCV and HCV RNA-positive).RESULTS The median VL detected by NeuMoDx for HBV was 2.9(interquartile range[IQR]:2.0-4.3)log_(10)IU/mL and by COBAS it was 3.70(IQR:2.28-4.56)log_(10)IU/mL,with excellent correlation(R2=0.98).In HCV,the median VL detected by NeuMoDx was 4.9(IQR:4.2-5.4)log_(10)IU/mL and by COBAS it was 5.10(IQR:4.07-5.80)log_(10)IU/mL with good correlation(R2=0.96).CONCLUSION The overall concordance between both the systems was 100%for both HBV and HCV VL estimation.Moreover,no genotype-specific bias for HBV/HCV VL quantification was seen in both the systems.Our findings reveal that NeuMoDx HBV and HCV quantitative assays have shown overall good clinical performance and provide faster results with 100%sensitivity and specificity compared to the COBAS AmpliPrep/COBAS TaqMan system.

Prevention of hepatocellular carcinoma in chronic viral hepatitis B and C infection

Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality worldwide,with the majority of cases associated with persistent infection from hepatitis B virus(HBV)or hepatitis C virus(HCV).Natural history studies have identified risk factors associated with HCC development among chronic HBV and HCV infection.High-risk infected individuals can now be identified by the usage of risk predictive scores.Vaccination plays a central role in the prevention of HBV-related HCC.Treatment of chronic HBV infection,especially by nucleoside analogue therapy,could also reduce the risk of HBV-related HCC.Concerning HCV infection,besides the advocation of universal precautions to reduce the rate of infection,pegylated interferon and ribavirin could also reduce the risk of HCV-related HCC among those achieving a sustained virologic response.Recently there has been mounting evidence on the role of chemopreventive agents in reducing HBV-and HCV-related HCC.The continued advances in the understanding of the molecular pathogenesis of HCC would hold promise in preventing this highly lethal cancer.

Assessment on the Effects of Hepatitis B Prevention and Control Measures in Western China:A Comparison of Three Population-based Serosurveys

Objective Despite the remarkable progress in efforts to control disease spread,the nationwide elimination of hepatitis B in China is still hindered by the persistently high rate of hepatitis B virus(HBV)infection in Western China.This study aimed to evaluate the strategy of hepatitis B prevention and control in Western China and identify potential areas and strategies for improvement.Methods Susceptible population vaccination,health education,professional training of doctors,and other prevention and control measures have been implemented in Wuwei city since 2010.Data were obtained from three representative cross-sectional serosurveys conducted in 2010,2013,and 2015.The serum samples were subjected to enzyme-linked immunosorbent assays to detect the following seromarkers:HBV surface antigen(HBsAg),antibody against hepatitis B surface antigen(anti-HBs),and antibody against hepatitis B core antigen(anti-HBc).Estimates of variance were determined using Taylor series linearization methods.Results The three serosurveys revealed decreases in the prevalence of HBsAg(7.19% in 2010 vs.6.51% in 2013 vs.5.87% in 2015)and anti-HBc positivity(43.89%vs.32.87%vs.28.46%)and an increase in the prevalence of anti-HBs positivity(49.07%vs.53.66%vs.53.72%)over time.From 2010 to 2015,the legally reported incidence of hepatitis B in Wuwei city decreased from 686.53/100,000 to 53.72/100,000.Notably,persistently high HBsAg-positive rates(above 5.40%)were observed among subjects aged 20–69 years old in the three serosurveys;the prevalence of HBsAg was above 1% among children younger than 10 years old.Furthermore,rural subjects had higher rates of HBsAg and anti-HBc positivity than their urban counterparts(6.04%vs.4.83% and 30.26%vs.20.35%,respectively)in 2015 but had a lower rate of anti-HBs positivity(49.68 vs.55.18%).Multivariate regression analysis showed that age,urban and rural areas,and education level were the main factors affecting HBV infection.Conclusion Although vaccine-based prevention and control measures reduced the rate of HBV infection in Wuwei City over time,the hepatitis B infection rate in children younger than 10 years was still higher than the national average level.Therefore,the prevention and control of mother-to-child transmission and the management of the infected should be the focus of future prevention and control work.

Prevention of hepatitis B reactivation in patients requiring chemotherapy and immunosuppressive therapy

Hepatitis B virus(HBV)reactivation can lead to severe acute hepatic failure and death in patients with HBV infection.HBV reactivation(HBVr)most commonly develops in patients undergoing cancer chemotherapy,especially B cell-depleting agent therapy such as rituximab and ofatumumab for hematological or solid organ malignancies and that receiving hematopoietic stem cell transplantation without antiviral prophylaxis.In addition,the potential consequences of HBVr is particularly a concern when patients are exposed to either immunosuppressive or biologic therapies for the management of rheumatologic diseases,inammatory bowel disease and dermatologic diseases.Thus,screening with HBV serological markers and prophylactic or pre-emptive antiviral treatment with nucleos(t)ide analogues should be considered in these patients to diminish the risk of HBVr.This review discusses the clinical manifestation,prognosis and management of HBVr,risk stratifications of cancer chemotherapy and immunosuppressive therapy and international guideline recommendations for the prevention of HBVr in patients with HBV infection and resolved hepatitis B.

Epidemiology and prevention of hepatitis B virus in China

Hepatitis B virus （HBV） infection is prevalent in China. Approximately 600 million people have ever been infected by HBV. About 130 million are HBV chronic carders and 30 million HB patients. Among them, 50% of HBV carriers are caused by carrier mothers to born infants. Around 300 000 people died of liver disease including liver cirrhosis and primary hepatocellular carcinoma each year and 50% of them died of primary hepatocellular carcinoma. HBV infection is not only the health problem but also becoming a social problem. HBV chronic carriers and patients have endured the great pressure from disease burden and social discrimination. According to the report of the national screening program of HBV released by the ministry of health in 2008, China has taken many effective measures to control the HBV infection, including vaccine immunization program, strengthening the management of blood sources and blood productions, prevention of nosocomial HBV infection, strengthening health education on HBV infection and safe injection techniques. The implementation of HB vaccine immunization program, which China officially introduced into the national immunization program since 1992, has dramatically reduced the incidence of HBV infection among infants and children. Integrated with other interventions, the rate of HBV infection decreased gradually. According to the survey of the national screening program of HBV in 2006, compared with the incidence of HBV in 1992, the incidence rate of HBsAg positive has decreased 26.36%, the number of children who have ever been infected by HBV decreased 80 million since 1992. However some problems are still existing. The solutions of low rate of vaccination in rural areas and migration population, lacking of practical measures on management of hepatitis B patients, the occurrence of health care acquired HBV infection, and low rate of vaccination among high risk groups have also been recommended.

Advances in treatment and prevention of hepatitis B

Chronic hepatitis B(CHB)continues to contribute to worldwide morbidity and mortality significantly.Scientists,clinicians,pharmaceutical companies,and health organizations have dedicated substantial Intellectual and monetary resources to finding a cure,increasing immunization rates,and reducing the global burden of CHB.National and international health-related organizations including the center for disease control,the national institute of health,the American Association for the study of liver disease(AASLD),The European association for the study of the Liver(EASL),The Asia Pacific association for the study of the Liver(APASL)and the world health organization release periodic recommendations for disease prevention and treatment.Our review of the most recent guidelines by EASL,AASLD,APASL,and Taiwan Association for the Study of the Liver revealed that an overwhelming majority of cited studies were published before 2018.We reviewed Hepatitis B-related literature published 2018 onwards to identify recent developments and current barriers that will likely direct future efforts towards eradicating hepatitis B.The breakthrough in our understanding of the hepatitis B virus life cycle and resulting drug development is encouraging with significant room for further progress.Data from high-risk populations,most vulnerable to the devastating effects of hepatitis B infection and reactivation remain sparse.Utilization of systems approach,optimization of experimental models,identification and validation of next-generation biomarkers,and precise modulation of the human immune response will be critical for future innovation.Within the foreseeable future,new treatments will likely complement conventional therapies rather than replace them.Most Importantly,pragmatic management of CHB related population health challenges must be prioritized to produce real-world results.

Hepatitis B vaccination status and associated factors among health science students

Objective:To evaluate hepatitis B virus(HBV)vaccine coverage and its associated factors among health science students in Vietnam.Methods:This cross-sectional study involving 459 health science students at Tra Vinh University was conducted between April and June 2022.Data were collected using a structured questionnaire with items on sociodemographic characteristics,knowledge and attitude about HBV,and vaccination status.A multivariable logistic regression model was used to explore the factors associated with vaccination status.Results:The majority of participants were female(65.8%)and enrolled at the medical school(56.2%).A total of 30.3%participants received the full dose of the HBV vaccine.The percentages of participants with sufficient knowledge and positive attitudes toward HBV infection were 75.2%and 43.4%,respectively.Vaccination was 11.8 times higher in sixth-year medical students than any healthcare student in their first-year[adjusted odds ratio(aOR)11.8,95%CI 3.1-45.1,P<0.001],and the coverage was also significant higher in those who had sufficient knowledge(aOR 2.0,95%CI 1.1-3.9,P<0.05)and positive attitudes(aOR 3.0,95%CI 1.9-4.8,P<0.05)than in their counterparts.Conclusions:The majority of students were not fully vaccinated against HBV,indicating they were vulnerable to the disease.Administrators and authorities should reinforce health education messages aimed at encouraging all students to get vaccinated with the HBV vaccine,enhance their awareness and knowledge of HBV,and improve attitudes toward HBV infection prevention.

Information Use and Knowledge of HIV/Hepatitis B Co-Infection in Lagos, Nigeria

Achieving the Sustainable Development Goal 3.3 is hinged on effective use of information sources for health communication interventions. This study investigated the knowledge of residents of Lagos Nigeria on HIV/HBV co-infection and the use of information sources. The study adopted the quantitative research method of survey to find out the knowledge level of residents of Lagos, Nigeria on the HIV/HBV co-infection. While the bivariate analysis presented cross tabular data on knowledge level, the multivariate was used to test highlight the hypothesis. The study indicated that more than 75% of the respondents had heard of HIV and HBV co-infection. The result established a significant relationship between the use of information sources and the knowledge on HBV/HIV co-infection. Despite the knowledge on HBV/HIV co-infection, the study concluded on the need for preventive information campaigns to create awareness to mitigate the increasing cases of HBV/HIV co-infection cum motivates individuals toward healthy lifestyle practices.

Knowledge Attitude and Practice of Viral Hepatitis B and C Screening by General Practitioners in Brazzaville

The involvement of general practitioners in the early detection of viral hepatitis B and C must be paramount. The objectives of this work were to assess GPs’ knowledge, attitude and practice with regard to screening for viral hepatitis B and C. We carried out a cross-sectional analytical study among GPs recruited by simple random sampling from the list of GPs in the city of Brazzaville. The judgement criteria were knowledge and practice of screening for viral hepatitis B and C, assessed according to a Likert scale divided into 3 categories: very good, good and bad. One hundred and twenty-one general practitioners were included, including 48 women and 73 men, with a sex ratio of 1.52;the average age was 33 years;52.89% of them worked in the private sector with an average period of activity of 4 years. The majority of the doctors had a good knowledge (69.42%) and a bad practice (56.20%) of screening for viral hepatitis B and C. The duration of activity was the factor linked to knowledge of viral hepatitis B and C (p = 0.006) while age was the factor linked to the practice of screening for viral hepatitis B and C (p = 0.0366). In conclusion, in Brazzaville, general practitioners’ knowledge of screening for viral hepatitis B and C is good in general, but the practices are poor and require targeted in-service training.