Establishing baseline framework for hepatitis B virus micro-elimination in Ho Chi Minh City, Vietnam - A community-based seroprevalence study.

Background: We conducted a community-based seroprevalence study using three HBV seromarkers (HBsAg, anti-HBs, anti-HBc) in Ho Chi Minh City (HCMC), Vietnam, to (1) determine the prevalence of HBV serologic profiles; (2) document factors associated with HBV infection or susceptibility; and (3) propose strategies toward HBV elimination by 2030. Methods: During 2019-2020, we deployed a multistage cluster design with probability proportionate to size, to recruit 20,000 adults for an HBV screening and linkage to care program citywide. Screening results with interpretation, recommendations, and health education materials were returned to participants. Post-study surveys were conducted within three months to identify gaps in linkage to care. Findings: Of the 17,600 adults invited, 15,275 (86.7%) participated in the study, 14,674 (96.1%) completing all data for final analyses. The prevalence of HBsAg (+) and HBV-naïve were 7.5% and 37.7%, respectively. HBV vaccination rates were 18.7% and about 50% of HCMC population had been exposed to HBV. Of the persons with HBsAg (+), 27.1% linked to care (76% used health insurance). There were wide variations in HBsAg (+) and HBV vaccination rates between districts, risk factors, and socio-economic statuses. Interpretation: The significant disease burden of and gaps in the continuum of care highlight the need and urgency to address the HBV public health problem in Vietnam. Using three screening seromarkers that tailor interventions to the needs of HBV micro-populations could be an effective strategy to pursue HBV elimination goals. Funding: Gilead Sciences Inc; Roche Diagnostic International Ltd; Roche Diagnostics-Vietnam; Abbott Diagnostics-Vietnam; Hepatitis B Foundation; Medic MedicalCenter, Vietnam; Center of Excellence for Liver Disease in Vietnam, Johns Hopkins University School of Medicine.

Demonstration of a population-based HCV serosurvey in Ho Chi Minh City, Viet Nam: Establishing baseline prevalence of and continuum of care for HCV micro-elimination by 2030.

Background: A baseline of hepatitis C virus (HCV) burden and other HCV epidemiological profiles is necessary for HCV micro-elimination in Ho Chi Minh City (HCMC), Viet Nam. This study aimed to determine HCV exposure and prevalence of HCV viremia as well as the proportion of HCV testing and treatment uptake among participants. Methods: From 2019 to 2020, the probability proportionate to size sampling method was deployed to representatively invite approximately 20,000 adults (18 or older) throughout HCMC to free screening and linkage to care for HCV. Findings: In HCMC, the weighted prevalence of anti-HCV was 1·3% (95% CI, 1·1%-1·6%). Individuals born from 1945 to 1964 had the anti-HCV prevalence of 3·6% (95% CI, 3·0%-4·2%) and represented 40·4% of all HCV cases. There were wide variations in anti-HCV prevalence in HCMC, including variations between districts, risk factors, and socioeconomic statuses. A baseline HCV continuum of care for the city demonstrated that only 28·5% (85/298, 95%CI 23·4-33·7%) of persons with anti-HCV (+) were aware of their HCV status, with 77.6% (66/85, 95%CI 68·8-86·5%) diagnosing HCV incidentally, 82·7% (62/75, 95%CI 74·1-91·2%) initiating anti-HCV therapy, and 53.6% (30/56, 95%CI 40·5-66·6%) achieving HCV cures. Interpretation: There remains a considerable disease burden of HCV in HCMC of which a significant proportion was in the age group born between 1945 to 1964. Additionally, there were significant gaps in HCV awareness, screening, and access to care in the community in Viet Nam. Thus, future interventions must have pragmatic targets, be tailored to the local needs, and emphasise screening. Funding: This work was supported by investigator-sponsored research grants from Gilead Sciences Inc. (Grant No: IN-US-987-5382); Roche Diagnostic International Ltd. (Grant No. SUB-000196); and in-kind donations from Abbott Diagnostic Viet Nam; Hepatitis B Foundation; Medic Medical Center, Viet Nam; Johns Hopkins University School of Medicine's Center of Excellence for Liver Disease in Viet Nam; and the Board of Directors, Viet Nam Viral Hepatitis Alliance (V-VHA).

Unmet needs in occupational health: prevention and management of viral hepatitis in healthcare workers in Ho Chi Minh City, Vietnam: a mixed-methods study.

OBJECTIVES: Vietnam is an endemic area for hepatitis B virus and hepatitis C virus infection (HBV-HCV), yet its largest city, Ho Chi Minh City (HCMC), has no comprehensive policy to educate, screen, treat and protect healthcare workers (HCWs) from viral hepatitis. We conducted a mixed-methods study to document HBV-HCV infection rates, risk factors, local barriers and opportunities for providing education, screening and medical care for HCWs. DESIGN: This mixed-methods study involved an HBV and HCV serological evaluation, knowledge, attitude and practice survey about viral hepatitis and many in-depth interviews. Descriptive statistics and thematic content analysis using inductive and deductive approaches were used. SETTING: HCMC, Vietnam. PARTICIPANTS: HCWs at risk of viral hepatitis exposure at three hospitals in HCMC. RESULTS: Of the 210 invited HCWs, 203 were enrolled. Of the 203 HCWs enrolled, 20 were hepatitis B surface antigen-positive, 1 was anti-hepatitis C antibody (anti-HCV Ab)-positive, 57 were anti-hepatitis B core Ab-positive and 152 had adequate anti-hepatitis B surface Ab (anti-HBs Ab) titre (≥10IU/mL). Only 50% of the infected HCWs reported always using gloves during a clinical activity involving handling of blood or bodily fluid. Approximately 50% of HCWs were still not vaccinated against HBV following 1 year of employment. In-depth interviews revealed two major concerns for most interviewees: the need for financial support for HBV-HCV screening and treatment in HCWs and the need for specific HBV-HCV guidelines to be independently developed. CONCLUSIONS: The high HBV infection rate in HCWs coupled with inadequate preventive occupational practices among the population in HCMC highlight the urgent needs to establish formal policy and rigorous education, screening, vaccination and treatment programmes to protect HCWs from HBV acquisition or to manage those living with chronic HBV in Vietnam.

Progressive Scale-up of HBV AND HCV Testing for Hepatitis Elimination in Vietnam.

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Global Mapping of Interventions to Improve the Quality of Life of People Living with HIV/AIDS: Implications for Priority Settings.

Enhancing the quality of life (QOL) of people living with HIV and AIDS (PLWHA) has become a significant global health goal, as combination antiretroviral therapy has helped to transform HIV/AIDS from a fatal illness to chronic disease. In this study, we aim to comprehensively describe the growth of research publications and the development of research landscapes regarding interventions to improve QOL among PLWH, as well as to characterize interdisciplinary topics and emerging interests of the research community. English articles and reviews published from 1991 to 2018 concerning interventions to improve QOL among PLWHA were retrieved from the Web of Science. Collaboration among organizations sharing coauthorships and co-occurrence network of authors' keywords was illustrated through network graphs. Latent Dirichlet Allocation was used for classifying papers into corresponding topics. A total of 2304 publications were included in the study. The USA continues to lead in research productivity, followed by South Africa, China, and India. Emerging research themes were found to be the application of multilevel interventions and long-term care, rehabilitation, along with topics relating to mental health issues, behavioral therapy and social supports for patients receiving treatments, and application of e-health approaches in designing and implementing interventions. There has been, however, a modest appearance of topics covering local, cultural, and environmental contexts of interventions. The findings of the study suggest expanding the coverage of psychosocial, behavioral, and contextualized interventions, increasing the involvement of family and community, improving the effectiveness of technology-based and e-health interventions, and developing strategies for lifelong treatment of HIV/AIDS.

Fertility Desire in HIV/AIDS Research During 1992-2019: A Systematic Text Mining of Global Literature.

There has been an increase of fertility desire among people living with HIV/AIDS (PLWH) thanks to the advancement of HIV treatment and prevention of mother-to-children transmission programs. However, the development of research focusing on this topic over the past three decades is not well documented. We aimed to explore the trend of global publications regarding fertility desires among PLWH and identify their contents through the natural language processing technique. Dataset from 1992 to 2019 was downloaded using the Web of Science Core Collection. Bibliometric indicators such as change in total publications, citations, and countries' collaboration were examined. Main topics of selected publications were determined using the latent Dirichlet allocation. There were 303 articles published during the period 1992-2019, with a rapid increase in the number of publications in the past 5 years. Common themes included determinants of fertility desire, HIV prevention for adolescents, and safer conception for couples affected with HIV. However, publications on HIV care and antenatal care for women with HIV had been still limited. Findings suggested a call for the future support and collaborations for fertility intention, as well as the promotion of HIV care and service for adolescents and pregnant women with HIV, especially in countries with poor resources and a high burden of HIV/AIDS.

A Global Bibliometric Analysis of Services for Children Affected by HIV/AIDS: Implications for Impact Mitigation Programs (GAPRESEARCH).

Tremendous progress has been made over the past three decades in the fight against the HIV epidemic; however, children experienced substantial physical and psychosocial effects of HIV infection. To inform services and policy development, we analyzed research growth and current trends in studies on children with HIV/AIDS. A total of 17,598 research papers and reviews in English, which were published on Web of Science, were downloaded. VOSviewer was used to generate an author keyword cooccurrence network and a network illustrating the connection among countries by shared coauthorships. Exploratory factor analysis was employed to identify research domains emerging from the abstracts' contents. The number of papers and their impacts had grown significantly in the past decade. The majority of study settings were in African countries. Research topics related to HIV in children were robust in areas of prevention of mother-to-child transmission and HIV and comorbidities treatments. Although psychosocial and behavioral disorders were recognized in previous studies, the number of interventions in these fields is still limited or not sustained. This study presents the global research trends and interests, points out research gaps of available publications and suggests several implications for services and intervention programs for children infected with HIV/AIDS. While preventions of mother-to-child transmission have been extensively studied, more efforts should be made to fulfill the lack of research on young people who are at risk of being infected or who are already infected with HIV. System thinking approach is needed in the design and implementation of future studies.

Pre-exposure Prophylaxis in HIV Research: A Latent Dirichlet Allocation Analysis (GAPRESEARCH).

Pre-exposure prophylaxis (PrEP) has been shown to be an effective approach to prevent human immunodeficiency virus (HIV) infections; however, implementation of the service remains challenging. This global bibliometric analysis aims to describe the current trends in HIV research prevention through PrEP to reveal the potential gaps of knowledge and to put forward recommendations for future research. A bibliometric analysis was conducted through Web of Science from 1990 to 2017. Exploratory factor analysis was also employed to find research domains emerging from the abstracts' contents. Latent Dirichlet allocation, which is a topic modeling algorithm, was utilized to perform text mining and determine relationships among text documents. A total of 4852 papers regarding HIV PrEP research were retrieved. The number of papers and their impact has significantly increased. Preventing sexual transmissions, improving access, and quality of health-care services for current users, as well as men who have sex with men, pregnant women and children, were the research domains most related to PrEP. We found a data gap in research regarding sex workers, potential side effects of PrEP, and misjudgment toward PrEP users. Despite the growth in research about HIV PrEP, there exist barriers to scaling up the implementation of PrEP worldwide and for such intervention to reach its fWull potential. International research collaboration efforts to investigate the potential safety concerns of PrEP and develop strategies to eliminate social misjudgment against PrEP users are warranted. Addressing these knowledge gaps might facilitate the development of effective global implementation strategies for PrEP in the future.

A simple questionnaire to detect chronic kidney disease patients from Long An province screening data in Vietnam.

BACKGROUND: The prevalence of chronic kidney disease (CKD) in rural Vietnam is unknown. We wished to determine the prevalence of CKD and determine whether a simple questionnaire was able to detect individuals at high risk of CKD before expensive confirmatory laboratory testing. METHODS: A cross sectional study was performed. We recruited 2037 participants from 13 communes of Long An province, Vietnam, for CKD screening with urine albumin/creatinine ratio (ACR) measured by immunoturbidimetric method and serum creatinine to estimate glomerular filtration rate (eGFR). CKD was defined as either ACR ≥ 30 mg/g or eGFR MDRD < 60 ml/min/1.73 m2. A two page questionnaire with 23 variables was administered to each participant with queries postulated to be correlated with risk of CKD. RESULTS: Of the 2037 participants, 260 (12.76%) were found to have CKD. Five questionnaire variables (age more than 50, measured hypertension, history of diabetes, history of hypertension, and history of a low salt diet) were correlated with CKD, and used to construct a risk score for CKD. CONCLUSIONS: CKD is common in Vietnam. Our questionnaire and risk score tool can be used to detect individuals with a higher likelihood of CKD, and who can then be more economically screened with routine laboratory confirmatory tests.