Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 11.067
Filtrar
1.
BMJ Glob Health ; 6(1)2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33402334

RESUMO

The COVID-19 pandemic caused by the SARS-CoV-2 virus has resulted in a myriad of interventions with the urgent aim of reducing the public health impact of this virus. However, a wealth of evidence both from high-income and low-income countries is accruing on the broader consequences of such interventions on economic and public health inequalities, as well as on pre-existing programmes targeting endemic pathogens. We provide an overview of the impact of the ongoing COVID-19 pandemic on hepatitis B virus (HBV) programmes globally, focusing on the possible consequences for prevention, diagnosis and treatment. Ongoing disruptions to infrastructure, supply chains, services and interventions for HBV are likely to contribute disproportionately to the short-term incidence of chronic hepatitis B, providing a long-term source of onward transmission to future generations that threatens progress towards the 2030 elimination goals.


Assuntos
Acesso aos Serviços de Saúde , Hepatite B , Pandemias , Disparidades em Assistência à Saúde , Hepatite B/diagnóstico , Hepatite B/prevenção & controle , Hepatite B/terapia , Hepatite B/transmissão , Humanos
2.
Recent Results Cancer Res ; 217: 71-90, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33200362

RESUMO

Hepatocellular carcinoma (HCC) is one of the five leading causes of cancer death in human. Hepatitis B virus (HBV) is the most common etiologic agent of HCC in the world. Prevention is the best way to control cancer. There are three levels of liver cancer prevention, i.e., primary prevention by HBV vaccination targeting the general population starting from birth dose, secondary prevention by antiviral agent for high-risk subjects with chronic HBV infection, and tertiary prevention by antiviral agent to prevent recurrence for patients who have been successfully treated for liver cancer. Primary prevention by hepatitis B vaccination is most cost effective, the cancer preventive efficacy support it as the first successful example of cancer preventive vaccine in human. Addition of hepatitis B immunoglobulin immediately after birth and antiviral agent during the third trimester of pregnancy to block mother-to-infant transmission of HBV are existing or possible emerging strategies to enhance the prevention efficacy of HBV infection and its related liver cancer. Secondary prevention with current antiviral agents may reduce the risk or delay the onset of HCC development, but could not eradicate HBV infection and HCC. Better antiviral therapeutic agents are needed for better secondary prevention.


Assuntos
Antivirais , Carcinoma Hepatocelular , Vírus da Hepatite B , Hepatite B , Neoplasias Hepáticas , Antivirais/uso terapêutico , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/prevenção & controle , Carcinoma Hepatocelular/virologia , Feminino , Hepatite B/tratamento farmacológico , Hepatite B/prevenção & controle , Vacinas contra Hepatite B , Vírus da Hepatite B/imunologia , Vírus da Hepatite B/patogenicidade , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/prevenção & controle , Neoplasias Hepáticas/virologia , Gravidez
3.
Artigo em Alemão | MEDLINE | ID: mdl-33326051

RESUMO

BACKGROUND: In 2016, the World Health Organization (WHO) released a strategy to eliminate hepatitis B, C, and D and defined indicators to monitor the progress. The Robert Koch Institute organized an interdisciplinary working meeting in 2019 to identify data sources and gaps. OBJECTIVES: The objectives were to network, to create an overview of the data sources available in Germany on hepatitis B and C, and to discuss how to construct indicators. MATERIALS AND METHODS: We extracted the WHO indicators relevant for Germany and determined how they can be constructed on the basis of available data. Stakeholders from public health services, clinics, laboratories, health insurance companies, research institutes, data holders, and registries attended a workshop and discussed methods of constructing the indicators for which data are lacking. Data sources and data were evaluated and prioritized with regard to their quality and completeness. RESULTS: Indicators on prevalence, incidence, prevention, testing and diagnosis, treatment, cure, burden of sequelae, and mortality for the general population can be constructed using secondary data such as diagnosis, health service, and registry data, data from laboratories and hospitals as well as population-based studies. Data sources for vulnerable groups are limited to studies among drug users, men who have sex with men, and about HIV coinfected patients. Data for migrants, prisoners, and sex workers are largely lacking as well as data on burden of disease from chronic viral hepatitis in the general population. CONCLUSIONS: We identified data sources, their limitations, and methods for construction for all selected indicators. The next step is to convert the ideas developed into concrete projects with individual stakeholders.


Assuntos
Hepatite B , Hepatite C , Hepatite Viral Humana , Minorias Sexuais e de Gênero , Alemanha/epidemiologia , Hepatite B/diagnóstico , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Hepatite C/prevenção & controle , Homossexualidade Masculina , Humanos , Masculino
4.
Bull Cancer ; 108(1): 90-101, 2021 Jan.
Artigo em Francês | MEDLINE | ID: mdl-33358507

RESUMO

Hepatitis B Virus (HBV) chronic infection contributes to a high risk of hepatocellular cancer (HCC) development. HBV is a strong cancer inducer, due to natural history of infection, virological characteristics and viral DNA integrations events in host genome. Prolonged infection and high viral loads, particularly frequent in patients infected in childhood, are risk factors of HCC development for patients with HBV chronic infection. A HBV vaccine, based on immunization against the surface protein HBs, showed a strong efficacy to prevent chronic HBV infection. The development of universal neonatal vaccination programmes contributed to the decrease of HBV chronic infection incidence in children of high endemic areas. Although HBs antibodies levels diminished years after vaccination, HBV neonatal vaccination programmes led to a lower incidence of chronic HBV infection among young adults. The decrease of HBV chronic infection incidence was associated to a reduction of HCC incidence in children and young adults from areas with a high prevalence of HBV infection.


Assuntos
Carcinoma Hepatocelular/prevenção & controle , Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Neoplasias Hepáticas/prevenção & controle , Adulto , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/virologia , Criança , Hepatite B/epidemiologia , Hepatite B/imunologia , Vacinas contra Hepatite B/imunologia , Vírus da Hepatite B/fisiologia , Humanos , Incidência , Lactente , Recém-Nascido , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/virologia , Fatores de Risco , Replicação Viral , Adulto Jovem
5.
Gastroenterol. hepatol. (Ed. impr.) ; 43(10): 640-648, dic. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-ET2-7619

RESUMO

BACKGROUND: Tenofovir disoproxil fumarate (TDF) is recommended for the prevention of perinatal transmission of the hepatitis B virus (HBV). This study aimed to systematically assess the efficacy and safety of TDF in pregnant women with chronic HBV and their infants. MATERIAL AND METHODS: Database searches were performed to identify studies blocking the mother-to-child transmission of the hepatitis B virus with tenofovir. The search included pregnant women with chronic HBV infection administered with TDF compared to the no treatment controls, and data from individual studies were pooled using RevMan v5.3 for meta-analysis. RESULTS: Seven studies with a total of 911 patients met the inclusion criteria: 433 patients in the TDF group and 478 patients in the non-TDF group. The HBV mother-to-child transmission rate in the tenofovir group was effectively reduced compared to the control group (RR: 0.18, 95% CI: 0.08-0.40). HBV-DNA positivity was also significantly low in infants from TDF group (RR: 0.17, 95% CI: 0.10-0.30) and the TDF treatment resulted in significantly higher anti-HBs production (RR: 1.11, 95% CI: 1.04-1.18). Similarly, maternal HBV-DNA was suppression was significantly high in the TDF group (RR: 34.16, 95% CI: 16.40-71.13). Women treated with TDF and their infants did not result in serious adverse events that are statistically different as compared to the women who did not receive any treatment. CONCLUSION: Treatment of HBV infected pregnant women with TDF can effectively and safely prevent the perinatal transmission of chronic hepatitis B


ANTECEDENTES: El fumarato de disoproxilo de tenofovir (FDT) se recomienda para la prevención de la transmisión perinatal del virus de la hepatitis B (VHB). El objetivo de este estudio fue evaluar de manera sistemática la eficacia y la seguridad del FDT en las mujeres embarazadas con VHB crónico y en sus hijos lactantes. MATERIAL Y MÉTODOS: Se realizaron búsquedas en las bases de datos para identificar los estudios sobre el bloqueo de la transmisión del virus de la hepatitis B de madre a hijo con el tenofovir. La búsqueda incluyó a mujeres embarazadas con infección crónica por el VHB que recibieron FDT en comparación con controles sin tratamiento, y los datos de los estudios individuales se agruparon mediante el uso de RevMan v5.3 para el metaanálisis. RESULTADOS: Los criterios de inclusión se cumplieron en siete estudios con un total de 911 pacientes: 433 pacientes en el grupo de FDT y 478 pacientes en el grupo sin FDT. La tasa de transmisión de madre a hijo del VHB en el grupo de tenofovir se redujo efectivamente en comparación con el grupo de control (RR: 0,18, IC del 95 %: 0,08-0,40). Los resultados positivos del ADN del VHB también fueron significativamente bajos en los infantes del grupo de FDT (RR: 0,17, IC del 95 %: 0,10-0,30) y el tratamiento con FDT dio como resultado una producción significativamente mayor de anti-HB (RR: 1,11, IC del 95 %: 1,04-1,18). Del mismo modo, la supresión del ADN del VHB materno fue significativamente alta en el grupo del FDT (RR: 34,16, IC del 95 %: 16,40-71,13). El tratamiento de las mujeres con FDT y sus hijos lactantes no provocó acontecimientos adversos graves en ellas ni en sus hijos que fueran estadísticamente diferentes de los de las mujeres que no recibieron ningún tratamiento. CONCLUSIÓN: El tratamiento con FDT de las mujeres embarazadas infectadas por el VHB puede prevenir de manera eficaz y segura la transmisión perinatal de la hepatitis B crónica


Assuntos
Humanos , Feminino , Gravidez , Lactente , Adulto , Hepatite B/tratamento farmacológico , Hepatite B/prevenção & controle , Resultado do Tratamento , Segurança do Paciente , Tenofovir/uso terapêutico , Hepatite B/transmissão , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos
6.
Arch. prev. riesgos labor. (Ed. impr.) ; 23(4): 430-442, oct.-dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-197174

RESUMO

OBJETIVO: Estimar la prevalencia de inmunización frente al virus de la Hepatitis B del personal sanitario, vinculado a los Departamentos de Salud de Torrevieja y Elche-Crevillente, de la Comunidad Valenciana. MÉTODOS: Estudio descriptivo transversal en todos los trabajadores sanitarios de dos departamentos de Salud. Obtenida la muestra se identificó los niveles de anticuerpos de superficie del virus de la Hepatitis B a través de los resultados serológicos ubicados en las historias clínicas. Se consideró inmunizado a títulos de anti-HBs ≥ 10 mlU/ml. Las variables analizadas fueron categorizadas según: Departamento; Género; Edad (18-34; 35-49; > 50 años); categoría profesional (facultativos/Enfermería/Otro personal sanitario/Personal no sanitario); Servicio riesgo contagio (Si/No); Inmunidad (≥ 10 mlU/ml / < 10 mlU/ml / No Dato) y Vacunacion sistemática anti-HBs según fecha nacimiento (Si/No). RESULTADOS: El personal estudiado ascendió a 2674. Predominó el género femenino 68,8%, el grupo de edad 35-49 años, 52,8%, y la categoría profesional de Enfermería, 32,2%. Un 74,9% de los resultados serológicos identificaron niveles de protección anti-HBs, frente al 11,3% no inmune, y un 13,8% que no disponían de información. Del personal con información serológica (2306), obtuvieron porcentajes de no protección más elevadas la categoría masculina, 17,8%. Los niveles de protección fueron inversamente proporcionales según la variable edad, menor inmunidad a mayor edad. El personal no sanitario y los facultativos arrojaron niveles de protección más bajos, 36,9% y 11,1% respectivamente. CONCLUSIONES: A pesar de identificarse una inmunidad elevada, el porcentaje de no inmunizados y de ausencia de información inmunológica plantea la necesidad de implementar nuevas estrategias de comunicación dirigidas a este colectivo


OBJECTIVE: To estimate the prevalence of immunity against Hepatitis B virus among all healthcare workers linked to the Departments of Public Health in Torrevieja and Elx-Crevillent, two municipalities in the Valencian Community, Spain. Methods: Cross-sectional descriptive study of healthcare workers in two different public health departments. Once the sample was obtained, the anti-hepatitis B surface antibody (anti-HBsAb) levels were abstracted based on serological test results recorded in the workers’ medical records. Titers of anti-HBsAB ≥ 10 mlU / ml were considered as evience of immunity. The variables analyzed were classified by department, gender, age (18-34; 35-49; ≥ 50 years); professional category (physicians / nursing / other health personnel / non-health personnel); service at risk of contagion (Yes / No); immunity (≥ 10 mlU/ml, < 10 mlU/ml, missing) and systematic anti-HBs vaccination by date of birth (Yes / No). RESULTS: The study population consisted of 2674 workers. The highest proportions of workers were female (68.8%), between 35 and 49 years of age (52.8%), and employed in nursing,(32.2%). Overall, 74.9% of employees had evidence of hepatitis B immunity, 11.3% had no inmunity, and 13.8% was missing information on serology. Among those employees with serological information (n = 2306), lack of immunity was highest among males (17.8%). Protective titers were inversely proportional to age, with the lowest titers being found in the oldest age groups. Non-healthcare personnel and physicians also had lower levels of protection (36.9% and 11.1%, respectively). CONCLUSIONS: Despite identifying high levels of immunity among healthcare workers, the percentages of non-immunized employees and those lacking immunological information underscores the need to implement new communication strategies aimed at these at-risk groups


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Pessoal de Saúde/estatística & dados numéricos , Hepatite B/prevenção & controle , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/imunologia , Vacinação/estatística & dados numéricos , Estudos Transversais , Hepatite B/sangue , Hepatite B/imunologia , Anticorpos Anti-Hepatite B/imunologia , Vacinas contra Hepatite B/administração & dosagem , Saúde Pública , Características de Residência , Espanha/epidemiologia
8.
BMC Infect Dis ; 20(1): 806, 2020 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-33129259

RESUMO

BACKGROUND: This study aimed at determining the prevalence of and risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) among incarcerated people who inject drugs (PWID) in Iran in 2015-16. METHODS: The required data was collected from a database provided by Iranian national bio-behavioral surveillance surveys (BBSSs) on 11,988 prisoners selected from among 55 prisons in 19 provinces in 2015-16. The data on demographics and behavioral variables were collected through interviews and the status of exposure to HBV and HCV were determined using ELISA blood test. A total of 1387 individuals with a history of drug injection in their lifetime were enrolled into the study. Data were analyzed using the survey package in Stata/SE software, Version 14.0. Univariate and multivariate logistic regression tests were used to investigate the relationships between risk factors and outcomes. RESULTS: The mean age of the incarcerated PWID was 36.83 ± 8.13 years. Of all the studied subjects, 98.46% were male and 50.97% were married. The prevalence of HCV and HBV among the subjects were 40.52 and 2.46%, respectively. The prevalence of HCV was associated with age ≥ 30 years, being single, illiteracy and low level of education, prison term> 5 years, history of piercing, and extramarital sex in lifetime (P < 0.05). CONCLUSIONS: The prevalence of HCV is alarmingly high. In general, it is recommended to adopt measures to screen and treat patients with HCV and vaccinat incarcerated PWID without a history of vaccination against HBV.


Assuntos
Hepatite B/epidemiologia , Hepatite C/epidemiologia , Prisioneiros , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Estudos Transversais , Feminino , Hepacivirus , Hepatite B/complicações , Hepatite B/prevenção & controle , Vírus da Hepatite B , Hepatite C/complicações , Hepatite C/prevenção & controle , Humanos , Irã (Geográfico)/epidemiologia , Modelos Logísticos , Masculino , Prevalência , Prisioneiros/estatística & dados numéricos , Prisões , Fatores de Risco , Vacinas contra Hepatite Viral/administração & dosagem
9.
Am J Gastroenterol ; 115(11): 1797-1798, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33156097

RESUMO

Prevention of hepatitis B (HBV) infection is particularly important for patients with inflammatory bowel disease because of risks of HBV reactivation on immunosuppressive therapies. However, immune responses to standard HBV vaccination regimens are suboptimal. Chaparro et al. compared immune responses to 2 vaccines, an adjuvanted HBV vaccine (Fendrix) and double-dosed standard vaccine (Engerix-B) using an accelerated, 4-dose regimen (0, 1, 2, and 6 months). Although the study did not demonstrate superiority of one vaccine over another, several lessons can be derived regarding immune response to vaccinations among patients with inflammatory bowel disease, including the need to consider nonstandard regimens for patients on immunosuppression. These lessons can be translated broadly, including to a potential future severe acute respiratory syndrome coronavirus 2 vaccine when one becomes available.


Assuntos
Infecções por Coronavirus/prevenção & controle , Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Doenças Inflamatórias Intestinais/imunologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Vacinas Virais/administração & dosagem , Betacoronavirus , Humanos
10.
BMC Infect Dis ; 20(1): 839, 2020 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-33183254

RESUMO

BACKGROUND: Hepatitis B virus (HBV) infection is a public health problem in Togo and transmission to the child occurs mainly during childbirth. The objective of this study was to estimate the prevalence of HBV among childbearing women and infants born to HBV positive mothers in Togo. METHODS: A national cross-sectional study was carried out in six cities in Togo in the six health regions in Togo. Mother-child pairs were recruited from immunization centers or pediatric wards in Lomé, Tsévié, Atakpamé, Sokodé, Kara and Dapaong in 2017. Women aged 18 and over with one child of at least 6 months old were included. A standardized questionnaire was used for data collection and HBV screening was performed using Determine® rapid tests. The prevalence of HBV, defined by a positive HBV surface antigen (HBsAg), was estimated in mothers and then in infants of mothers who were positive for HBsAg. Logistic regression model was performed to identify risk factors for HBsAg positivity in mothers. RESULTS: A total of 2105 mothers-pairs child were recruited. The median age of mothers and infants was 29 years, interquartile range (IQR) [25-33] and 2.1 years, IQR [1-3] respectively. About 35% of women were screened for HBV during antenatal care and 85% of infants received three doses of HBV immunization. Among mothers, the prevalence of HBV was 10.6, 95% confidence interval (95% CI) [9.4-12.0%], and 177 had detectable HBV viral load (> 10 IU/mL). Among mothers with positive HBsAg, three infants also had positive HBsAg, a prevalence of 1.3, 95% CI [0.2-3.8%]. In multivariable analysis, HIV-infection (aOR = 2.19; p = 0.018), having at least three pregnancies (aOR = 1.46; p = 0.025) and living in Tsévié (aOR = 0.31; p < 0.001) compared to those living in Lomé, were associated to HBV infection in mothers. CONCLUSION: In this study, one out of 10 childbearing women were infected with HBV, but less than 2% of infant born to HBV positive mothers under 5 years' old who received immunization under the Expanded Program on Immunization were infected. Improving antenatal screening and providing targeted interventions in babies could help eliminate HBV in Togo.


Assuntos
Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Vacinação , Adulto , Pré-Escolar , Estudos Transversais , Feminino , HIV , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Hepatite B/virologia , Antígenos de Superfície da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Vírus da Hepatite B/genética , Humanos , Lactente , Masculino , Gravidez , Complicações Infecciosas na Gravidez/virologia , Cuidado Pré-Natal , Prevalência , Togo/epidemiologia , Adulto Jovem
11.
PLoS One ; 15(10): e0238987, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33052919

RESUMO

INTRODUCTION: One third of the world population has been exposed to hepatitis B virus and an estimated 257 million people are chronically infected. The main route of hepatitis B virus (HBV) infection is vertical transmission. Post exposure prophylaxis is recommended by world health organization to have free Hepatitis B infection by 2030. OBJECTIVE: The main purpose of this research project was to assess Hepatitis B virus post exposure prophylaxis coverage, rate of vertical transmission and factors among exposed newborns delivered at Arsi zone health institution. METHODS: A cross-sectional study was conducted in Arsi zone health institutions among hepatitis B virus exposed newborns delivered at Arsi zone health institutions from January 2018 to September 2019. Systematic sampling technique was used to select 422 exposed newborns into the study. A pre-tested structured questionnaire and checklist were used to collect relevant data. Data was entered and cleaned using epidata7 & analyzed using SPSS version 25 software package. Both bivariate and multivariate analyses was carried out to identify associations. Odds ratio with 95% CI and P-value <0.05 was considered statistically significant. RESULTS: The study revealed that among 401 exposed newborns only 83(20.7%), have been administered post exposure prophylaxis. But vertical transmission of hepatitis B virus (HBV) was observed in 32.4% (27.9%-36.9%) exposed newborns. Antenatal (ANC) attendance (AOR = .40, 95%CI = .23-.69), Instrumental delivery (AOR = 4.18, 95%CI = 2.05-8.51) HIV coinfection (AOR = 9.7, 95%CI = 4.37-21.34), Post exposure Prophylaxis (AOR = .20, 95%CI = .08-.50) and Knowledge on HBV (AOR = .27, 95%CI = .14-.53) are significant predictors of HBV vertical transmission. CONCLUSION: Magnitude of HBV post exposure prophylaxis coverage is very low while Rate of vertical transmission is high. Antenatal attendance, Instrumental delivery, Post exposure Prophylaxis and Knowledge on hepatitis B virus transmission are significant predictors of HBV vertical transmission.


Assuntos
Hepatite B/prevenção & controle , Hepatite B/transmissão , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Profilaxia Pós-Exposição/métodos , Complicações Infecciosas na Gravidez/epidemiologia , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Hepatite B/epidemiologia , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/administração & dosagem , Humanos , Imunoglobulinas/administração & dosagem , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Gravidez , Fatores de Risco , Adulto Jovem
12.
Nihon Shokakibyo Gakkai Zasshi ; 117(10): 896-906, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-33041301

RESUMO

We conducted a questionnaire survey on the status of implementation of hepatitis B vaccination and HBs antibody testing. It involved medical personnel covering 484 regional medical institutions in the Osaka Province. Results showed that the recognition rate was 30.1%, the hepatitis B vaccination implementation rate was 38.9%, and that of HBs antibody testing was 38.9%. Although 42.5% of the medical institutions had experienced needle-stick injuries, some medical institutions did not respond properly. The low implementation rate of hepatitis B vaccination and HBs antibody test could be explained by lack of recognition for hepatitis B infection control guidelines. Therefore, we can achieve a possible improvement in the control of infection in the Province, if sensitization programs on hepatitis B infection control are organized in the various regional medical institutions in order to provide adequate information and raise awareness on the importance of respecting these guidelines.


Assuntos
Vacinas contra Hepatite B , Hepatite B , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Humanos , Inquéritos e Questionários , Vacinação
13.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(9): 942-946, 2020 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-32907282

RESUMO

Objective: Aanalysis the effect of booster one dose of hepatitis B vaccine after 21-32 years of primary immunization in Zhengding Country of Hebei Province. Methods: A total of 322 participants who were born between 1986 and 1996, received a full course of primary vaccination with plasma-derived hepatitis B vaccine (HepB), had no experience with booster vaccination, were HBsAg, anti-HBcnegative, had anti-HBs<10 mIU/ml, completed the booster and had laboratory results were enrolled between August 2017 to February 2018. A simple random method was uesd to randomly assigned 322 subjects to two groups, receiving a booster dose of HepB derived from either Saccharomyces cerevisiae ï¼»HepB (SC), (151 cases)ï¼½ or Chinese hamster ovary-derived HepB ï¼»HepB (CHO), (171 cases)ï¼½, the dose was 20 µg. Blood samples were collected 30 days after boosting and quantitatively tested for the geometric mean concentration (GMC) of anti-HBs to assess immunological effect. The related influencing factors of GMC and seroconversion rates of anti-HBs were analyzed by multiple linear regression and multivariate logistic regression models. Results: The 266 subjects (82.61%) had anti-HBs≥ 10 mIU/ml, and GMC was (131.63±12.94) mIU/ml.The seroconversion rates of anti-HBs in the anti-HBs<2.5 mIU/ml group and 2.5-10 mIU/ml group were 74.54% (161 cases) and 99.06% (105 cases), respectively (P<0.001).The seroconversion rates of anti-HBs after one dose of HepB (CHO) was higher than that of one dose of HepB (SC), the seroconversion rates were 87.13% (149 cases) and 77.48% (117 cases), respectively (P=0.023). Participants boostered with HepB (CHO) was the factor influencing the effect of strengthening immunization compared with boostered with HepB (SC), and OR (95%CI) was 1.91 (1.02-3.56) (P=0.042).Compared with anti-HBs<2.5 mIU/ml, prebooster anti-HBs was between 2.5 mIU/ml and 10 mIU/ml was the related factor of seroconversion rates of anti-HBs after booster immunization, and OR (95%CI) was 36.15 (4.91-266.02) (P<0.001). Conclusion: Participants boostered withone dose of HepB had a good immune response. Pre-booster anti-HBs concentration and a variety of vaccine were related factors of immune response.


Assuntos
Vacinas contra Hepatite B , Hepatite B/prevenção & controle , Animais , Células CHO , Cricetinae , Cricetulus , Seguimentos , Anticorpos Anti-Hepatite B , Antígenos de Superfície da Hepatite B , Imunização Secundária , Vacinação
14.
BMC Public Health ; 20(1): 1393, 2020 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-32919467

RESUMO

BACKGROUND: Seine-Saint-Denis is a deprived departement (French administrative unit) in the North-East of Paris, France, hosting the majority of South Asian migrants in France. In recent years, the number of migrants from Pakistan, which has a high prevalence of hepatitis C globally, increased. As a corollary, this study addressed the high proportion of Pakistani patients in the infectious diseases clinic of a local hospital, diagnosed with hepatitis C, but also hepatitis B and Human Immunodeficiency Virus (HIV). It explored genealogies and beliefs about hepatitis and HIV transmission, including community, sexual and blood risk behaviours. The aim was to understand the ways these risk factors reduce or intensify both en route and once in France, in order to devise specific forms of community health intervention. METHODS: The study took place at Avicenne University-Hospital in Seine-Saint-Denis, and its environs, between July and September 2018. The design of the study was qualitative, combining semi-structured interviews, a focus group discussion, and ethnographic observations. The sample of Pakistani participants was selected from those followed-up for chronic hepatitis C, B, and/or HIV at Avicenne, and who had arrived after 2010 in Seine-Saint-Denis. RESULTS: Thirteen semi-structured interviews were conducted, until saturation was reached. All participants were men from rural Punjab province. Most took the Eastern Mediterranean human smuggling route. Findings suggest that vulnerabilities to hepatitis and HIV transmission, originating in Pakistan, are intensified along the migration route and perpetuated in France. Taboo towards sexuality, promiscuity in cohabitation conditions, lack of knowledge about transmission were amongst the factors increasing vulnerabilities. Participants suggested a number of culturally-acceptable health promotion interventions in the community, such as outreach awareness and testing campaigns in workplaces, health promotion and education in mosques, as well as web-based sexual health promotion tools to preserve anonymity. CONCLUSIONS: Our findings highlight the need to look at specific groups at risk, related to their countries of origin. In-depth understandings of such groups, using interdisciplinary approaches such as were employed here, can allow for culturally adapted, tailored interventions. However, French colour-blind policies do not easily permit such kinds of targeted approach and this limitation requires further debate.


Assuntos
Emigração e Imigração , Infecções por HIV/prevenção & controle , Promoção da Saúde , Hepatite B/prevenção & controle , Hepatite C/prevenção & controle , Assunção de Riscos , Migrantes , Adulto , Cultura , Grupos Étnicos , França , Conhecimentos, Atitudes e Prática em Saúde , Hepacivirus , Hepatite B Crônica/prevenção & controle , Hepatite C Crônica/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão , Pesquisa Qualitativa , Fatores de Risco , Comportamento Sexual , População Suburbana , Adulto Jovem
16.
Arch Virol ; 165(10): 2361-2365, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32743697

RESUMO

In this study, we investigated the seroprevalence of anti-hepatitis D virus (HDV) antibodies in hepatitis B surface antigen (HBsAg)-positive children after 25 years of obligatory vaccination of infants against hepatitis B virus. This cross-sectional study included 120 treatment-naïve HBsAg-positive children, with a male-to-female ratio of 1.8:1 and a mean age of 7.8 ± 3.8 years (range, 1-17 years). Mothers were positive for HBsAg in 96.6% of the cases. HBeAg-positive chronic infection was observed in 60% of the cases, HBeAg-positive chronic hepatitis in 12.5%, and HBeAg-negative chronic infection in 26.7%. Anti-HDV antibodies were not detected in any of the cases. Thus, there is a lack of anti-HDV antibodies in HBsAg-positive children, despite the current burden in adults.


Assuntos
Anticorpos Anti-Hepatite/sangue , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Hepatite D Crônica/epidemiologia , Vírus Delta da Hepatite/imunologia , Adolescente , Criança , Pré-Escolar , Coinfecção , Estudos Transversais , Egito/epidemiologia , Feminino , Hepatite B/imunologia , Hepatite B/prevenção & controle , Hepatite B/virologia , Vírus da Hepatite B/efeitos dos fármacos , Vírus da Hepatite B/patogenicidade , Hepatite D Crônica/sangue , Hepatite D Crônica/imunologia , Hepatite D Crônica/virologia , Vírus Delta da Hepatite/patogenicidade , Humanos , Lactente , Masculino , Estudos Soroepidemiológicos
17.
MMWR Morb Mortal Wkly Rep ; 69(34): 1161-1165, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32853186

RESUMO

In 2016, the World Health Organization (WHO) set hepatitis elimination targets of 90% reduction in incidence and 65% reduction in mortality worldwide by 2030 (1). Hepatitis B virus (HBV) and hepatitis C virus (HCV) infection prevalences are high in Uzbekistan, which lacks funding for meeting WHO's targets. In the absence of large financial donor programs for eliminating HBV and HCV infections, insufficient funding is an important barrier to achieving those targets in Uzbekistan and other low- and middle-income countries. A pilot program using a catalytic funding model, including simplified test-and-treat strategies, was launched in Tashkent, Uzbekistan, in December 2019. Catalytic funding is a mechanism by which the total cost of a program is paid for by multiple funding sources but is begun with upfront capital that is considerably less than the total program cost. Ongoing costs, including those for testing and treatment, are covered by payments from 80% of the enrolled patients, who purchase medications at a small premium that subsidizes the 20% who cannot afford treatment and therefore receive free medication. The 1-year pilot program set a target of testing 250,000 adults for HBV and HCV infection and treating all patients who have active infection, including those who had a positive test result for hepatitis B surface antigen (HBsAg) and those who had a positive test result for HCV core antigen. During the first 3 months of the program, 24,821 persons were tested for HBV and HCV infections. Among those tested, 1,084 (4.4%) had positive test results for HBsAg, and 1,075 (4.3%) had positive test results for HCV antibody (anti-HCV). Among those infected, 275 (25.4%) initiated treatment for HBV, and 163 (15.2%) initiated treatment for HCV, of whom 86.5% paid for medications and 13.5% received medications at no cost. Early results demonstrate willingness of patients to pay for treatment if costs are low, which can offset elimination costs. However, improvements across the continuum of care are needed to recover the upfront investment. Lessons learned from this program, including the effectiveness of using simplified test-and-treat guidelines, general practitioners in lieu of specialist physicians, and innovative financing to reduce costs, can guide similar initiatives in other countries and help curb the global epidemic of viral hepatitis, especially among low- and middle-income countries.


Assuntos
Erradicação de Doenças/economia , Saúde Global/economia , Hepatite B/prevenção & controle , Hepatite C/prevenção & controle , Modelos Econométricos , Adulto , Feminino , Objetivos , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Humanos , Masculino , Projetos Piloto , Prevalência , Avaliação de Programas e Projetos de Saúde , Uzbequistão/epidemiologia , Organização Mundial da Saúde
18.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(8): 854-860, 2020 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-32842315

RESUMO

Objective: To evaluate the safety and immune effect of recombinant hepatitis B vaccine (CpG ODN adjuvant). Methods: On Oct. 26, 2016, we launched volunteer recruitment in Kaihua county, Quzhou city, Zhejiang Province. In the randomized, double-blind, controlled trial, a total of 48 subjects with negative HBV screening tests and normal hepatorenal function among 18 and 60 years old were selected and divided into two groups randomly, 24 cases each. The experimental group was given 250 µg of CpG ODN recombinant (Hansenula polymorpha) Hepatitis B vaccine and the control group was given 10 µg of commercial Hepatitis B vaccine with timed at 0, 1and 6 months. The inoculation reactions were compared the difference between the two groups after observed and recorded in time periods. We also collected serum before and after immunization to compare the two groups of anti-HBs positive rate, geometric mean concentration(GMC). Results: During the study period, the incidence of adverse events was 66.67%(16/24) in the experimental group and 54.17%(13/24) in the control group, with no significant difference(P=0.556). The severities of adverse events were level 1 or level 2, and no level 3 or above adverse reactions occurred. After full-course immunization, in the FAS data set, the anti-HBs GMC in the experimental group [2 598.56(1 127.90-5 986.90) mIU/ml] was higher than that in the control group[371.97(164.54-840.91) mIU/ml] In the PPS set, the GMC of test group was 7 808.21(3 377.00-18 052.00) mIU/ml, which was higher than that of the control group [843.22(213.80-3 325.90) mIU/ml]. The anti-HBs positive rate of FAS(PPS) was 95.83%(100.00%) in the experimental group and the control group; The anti-HBs strongly positive rate of FAS(PPS) was 79.17%(90.00%) in the experimental group and 33.33%(50.00%) in the control group, with statistically significant differences among the FAS set(P=0.003) and no statistically significance differences among the PPS set(P=0.074). Conclusion: CpG Hepatitis B Vaccine is safe and shows better immunogenicity than the control vaccine.


Assuntos
Vacinas contra Hepatite B , Hepatite B/prevenção & controle , Adolescente , Adulto , Anticorpos Anti-Hepatite B , Antígenos de Superfície da Hepatite B , Humanos , Pessoa de Meia-Idade , Pichia , Adulto Jovem
19.
PLoS One ; 15(8): e0236993, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760100

RESUMO

In 1991, Peru launched the first vaccination program against hepatitis B in children aged under 5 years in the hyperendemic [hepatitis B virus (HBV) and hepatitis D virus (HDV)] province of Abancay. We conducted a cross-sectional study to determine the prevalence of HBV and HDV infections, 23 years after the launch of the vaccination program, as well as the post-vaccine response against hepatitis B in terms of prevalence of hepatitis B surface antibody (anti-HBs ≥10 mUI/ml). Among 3165 participants aged from 0 to 94 years, the prevalence rates of hepatitis B surface antigen (HBsAg), and hepatitis B core antibody (total anti-HBc) were 1.2% [95% confidence interval (CI) 0.85-1.64%], and 41.67% (95% CI 39.95-43.41%), respectively. The prevalence rate of anti-HBs at protective levels (≥10 mUI/ml) in individuals who HBsAg and anti-HBc negative was 66.36% (95% CI 64.15-68.51%). The prevalence rate of HBsAg in children aged <15 years was nil, and among adult HBsAg carriers, the prevalence of hepatitis D antibody (anti-HDV) was 5.26% (2/38; 95% CI 0.64-17.74). These findings showed that HBV prevalence has changed from high to low endemicity, 23 years following implementation of the vaccination program against hepatitis B, and HDV infection was not detected in those aged <30 years.


Assuntos
Vacinas contra Hepatite B/história , Hepatite B/prevenção & controle , Hepatite D/epidemiologia , Programas de Imunização/história , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Doenças Endêmicas , Feminino , Anticorpos Anti-Hepatite/sangue , Hepatite B/epidemiologia , Hepatite B/imunologia , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/farmacologia , Vírus da Hepatite B/imunologia , Hepatite D/imunologia , Vírus Delta da Hepatite/imunologia , História do Século XX , História do Século XXI , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Projetos Piloto , Prevalência , Adulto Jovem
20.
PLoS One ; 15(8): e0237525, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32776972

RESUMO

Hepatitis B is a global epidemic that requires carefully orchestrated vaccination initiatives in geographical regions of medium to high endemicity to reach the World Health Organization's elimination targets by 2030. This study compares two widely-used deterministic hepatitis B models-the Imperial HBV model and the CDA Foundation's PRoGReSs-based on their predicted outcomes in four countries. The impact of scaling up of the timely birth dose of the hepatitis B vaccine is also investigated. The two models predicted largely similar outcomes for the impact of vaccination programmes on the projected numbers of new cases and deaths under high levels of the infant hepatitis B vaccine series. However, scenarios for the scaling up of the infant hepatitis B vaccine series had a larger impact in the PRoGReSs model than in the Imperial model due to the infant vaccine series directly leading to the reduction of perinatal transmission in the PRoGReSs model, but not in the Imperial model. Meanwhile, scaling up of the timely birth dose vaccine had a greater impact on the outcomes of the Imperial hepatitis B model than in the PRoGReSs model due to the greater protection that the birth dose vaccine confers to infants in the Imperial model compared to the PRoGReSs model. These differences underlie the differences in projections made by the models under some circumstances. Both sets of assumptions are consistent with available data and reveal a structural uncertainty that was not apparent in either model in isolation. Those relying on projections from models should consider outputs from both models and this analysis provides further evidence of the benefits of systematic model comparison for enhancing modelling analyses.


Assuntos
Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/efeitos dos fármacos , Hepatite B/prevenção & controle , Programas de Imunização/estatística & dados numéricos , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Modelos Estatísticos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Saúde Global , Hepatite B/epidemiologia , Hepatite B/virologia , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Gravidez , Organização Mundial da Saúde , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA