Factors Correlating to the Development of Hepatitis C Virus Infection among Drug Users-Findings from a Systematic Review and Meta-Analysis.

Hepatitis C remains a significant public health threat. However, the main routes of transmission have changed since the early 1990s. Currently, drug use is the main source of hepatitis C virus (HCV) infection, and some measures have been successively implemented and additional studies have been published. However, the factors correlating with HCV infection failed to clearly define. Our study pooled the odds ratios (ORs) with 95% confidence intervals (CIs) and analyzed sensitivity by searching data in the PubMed, Elsevier, Springer, Wiley, and EBSCO databases. Publication bias was determined by Egger's test. In our meta-analysis, HCV-infected and non-HCV-infected patients from 49 studies were analyzed. The pooled ORs with 95% CIs for study factors were as follows: Injecting drug use 10.11 (8.54, 11.97); sharing needles and syringes 2.24 (1.78, 2.83); duration of drug use >5 years 2.39 (1.54, 3.71); unemployment 1.50 (1.22, 1.85); commercial sexual behavior 1.00 (0.73, 1.38); married or cohabiting with a regular partner 0.88 (0.79, 0.98), and sexual behavior without a condom 1.72 (1.07, 2.78). This study found that drug users with histories of injecting drug use, sharing needles and syringes, drug use duration of >5 years, and unemployment, were at increased risk of HCV infection. Our findings indicate that sterile needles and syringes should be made available to ensure safe injection. In view of that, methadone maintenance treatment can reduce or put an end to risky drug-use behaviors, and should be scaled up further, thereby reducing HCV infection.

Immunological effects of a 10-µg dose of domestic hepatitis B vaccine in adults.

OBJECTIVE: To evaluate the immunological effects of three types of domestic 10-µg/dose hepatitis B vaccines in adults compared with a foreign vaccine, and to provide scientific evidence in support of adult hepatitis B vaccination. METHODS: Adults from five counties (Deqing, Changxing, Nanxun, Wuxing, Anji) in Huzhou City, Shaoxing County and Tongxiang County, Zhejiang Province, China were selected. Blood samples were taken to assess serum HBsAg, anti-HBs, and anti-HBc using a chemiluminescence immunoassay. Adults, aged 16 to 49 years and who were anti-HBs negative at baseline, received hepatitis B immunizations at 0, 1, and 6 months. Anti-HBs levels were assessed one month after the third and final vaccination. RESULTS: A total of 1872 adults were immunized and the average positive rate was 89.5%. Four types of hepatitis B vaccine were used, including three from Chinese companies (Shenzhen Kangtai, Dalian High-Tech, and North China Pharmaceutical) and one from a UK company (GlaxoSmithKline). Their seroconversion rates were 81.67%, 95.05%, 89.64%, and 86.81%, respectively. There was a significant difference between the anti-HBs positive conversion rates of the four types (P<0.005) but the seroconversion rates among the different vaccines were not significantly different (χ(2)=2.123, P=0.145). The average anti-HBs geometric mean titers (GMTs) of non-immune adults immunized with each of the four vaccines were 177.28, 473.23, 246.13, and 332.20 mIU/ml, respectively. There were no statistically significant differences in the GMTs between the three types of domestic vaccine and the foreign vaccine (t=-1.575, P=0.116). CONCLUSIONS: Domestic recombinant hepatitis B vaccines can achieve immunization effects comparable to those of a foreign vaccine.

[Evaluation on the efficacy of recombinant hepatitis B vaccine booster immunization in 2789 children aged over 10 years].

OBJECTIVE: To study the efficiency of booster immunization with different recombinant hepatitis B vaccines. METHODS: 2789 children aged over 10 years who had completed the basic immunization of hepatitis B vaccine under 1 year old were selected. All the sampled children were classified into four groups (A, B, C and D) and immunized with different hepatitis B vaccines produced by different companies respectively. Before booster immunization, their blood plasma specimens were detected for hepatitis B virus (HBV) surface antigen (HBsAg), antibodies to HBV surface antigen (anti-HBs) and antibodies to HBV core antigen (anti-HBc) by chemiluminescence. In each group, the anti-HBs positive children were immunized with one dosage and anti-HBs negative children were immunized three dosages of the same vaccine. Their blood specimens were collected again after 1 month, and detected for anti-HBs. RESULTS: The anti-HBs positive rates of A, B, C and D group were 36.43%, 37.59%, 42.91% and 46.46% respectively before immunization while 89.20%, 91.52%, 90.96% and 85.45% respectively after immunization with one dosage, 99.12%, 99.47%, 98.87% and 98.85% respectively after immunization with three dosages. The differences of anti-HBs positive rates in the four respective groups showed statistical significances between any two rates of pre-immunization, post-immunization with one dosage and post-immunization with three dosages (all P < 0.05). The anti-HBs positive conversion rates of four groups were 83.01%, 86.41%, 84.16% and 72.82% respectively after immunization with one dosage. The anti-HBs positive conversion rate of four groups were 98.62%, 99.16%, 98.03% and 97.84% respectively after immunization with three dosages and the difference of positive conversion rates in each group showed statistical significances between booster immunization with one dosage and booster immunization with three dosages. The average GMTs in anti-HBs positive children in the four groups were 2853.21, 6254.23, 3581.40 and 3021.32 mIU/ml respectively after immunization with one dosage. The average GMTs of anti-HBs negative children in the four groups were 273.08, 648.52, 387.87 and 245.36 mIU/ml respectively after immunization with one dosage, and were 632.30, 2341.14, 563.97 and 394.08 mIU/ml respectively after immunization with three dosages. CONCLUSION: Our data showed that it would be suitable to anyone to use the four vaccines for anti-HBs positive children aged over 10 years with one dosage and for anti-HBs negative children aged over 10 years with three dosage booster immunization.