Knowledge, Awareness, and Prevention of Hepatitis B Virus Infection Among Korean American Parents

The Role of Culturally Appropriate Mediated Communication Strategies to Reduce Hepatitis B and Liver Cancer Disparities

Asian, Pacific Islander, African, and Caribbean communities in the U.S. are heavily impacted by chronic hepatitis B (HBV) and hepatocellular carcinoma (HCC). Educating these groups about the link between the two diseases is imperative to improve screening rates and health outcomes. This study aims to identify and incorporate preferred mediated communication methods into community-specific educational campaigns which emphasize the connection between the conditions, to promote uptake of prevention and management behaviors for HBV and HCC. Fifteen focus groups and two key informant interviews were conducted with Micronesian, Chinese, Hmong, Nigerian, Ghanaian, Vietnamese, Korean, Somali, Ethiopian, Filipino, Haitian, and Francophone West African communities. Data were analyzed using thematic coding and analysis. Findings demonstrate that all communities preferred materials be offered in both English and native languages and requested that materials highlight the connection between HBV and HCC. Delivery channel preferences and messaging themes varied by group. This study provides insight into community-specific preferences for learning about HBV and HCC. The findings can be used to design culturally and linguistically tailored, multi-platform, health education campaigns to facilitate improved HBV screening and vaccination rates and increase knowledge about HCC risk among highly impacted communities in the U.S.

Hepatitis B virus infection among the tribal and particularly vulnerable tribal population from an eastern state of India: Findings from the serosurvey in seven tribal dominated districts, 2021-2022

The Global Health Sector Strategy on viral hepatitis (2016-2021) endorsed by the World Health Assembly in 2016, called for the elimination of viral hepatitis as a public health threat by 2030. Odisha, an eastern state of India, has the third-highest percentage of tribal population in the country and limited information is available regarding the prevalence of HBsAg among them. The present study was undertaken to estimate the seroprevalence of hepatitis B surface antigen as well as HBV DNA almost after 12 years of the first prevalence study of HBsAg among the tribal community of Odisha. The present study attempted to estimate the prevalence of HBsAg among the 35 Scheduled tribal (ST) communities and 5 Particularly Vulnerable Tribal Group (PVTG) using the 2,737 number of sera collected as part of a statewide COVID-19 serosurvey, among the tribal populations of Odisha (residing in 7 districts) aged 6-75 years. HBsAg positivity ranged between 1.79 and 2.94% across various age groups. 42.9% of HBsAg positive individuals showed the presence of HBV DNA and the high viral load was 0.10 × 10²-6.84 × 10⁸ IU/mL, indicating a high potential to transmit the virus. The HBsAg positivity was 14.18 and 6.06% among the PVTGs, Kutia Khond and Paudi Bhuyan, who were first time surveyed for HBsAg prevalence. The present study documents the prevalence of HBsAg among the major tribal population residing in the eastern state of the country and highlights the need for a statewide survey of Hepatitis B infection and risk factors, coverage and impact of the Hepatitis B vaccination program introduced in 2010-2011 in Odisha among the ST and PVTG population of the state.

Association between health literacy and COVID-19 prevention behaviors among pregnant and postpartum women

OBJECTIVE

To investigate the association between health literacy and COVID-19 prevention behaviors among pregnant and postpartum women in Japan.

METHODS

In this cross-sectional, web-based, self-reported questionnaire survey, we investigated the association between health literacy and COVID-19 prevention behaviors among pregnant and postpartum women in Japan. A multivariable logistic regression analysis was performed to evaluate the association with adjustment for socioeconomic characteristics.

RESULTS

There were 926 respondents, comprising 368 pregnant and 558 postpartum women. Women with high health literacy scores accounted for 42% of the respondents. This group had a significantly higher proportion of actively adopting preventive behaviors than the low health literacy group (33.5 vs. 25.4%, p = .008). The multivariable logistic regression analysis showed high health literacy was significantly associated with high preventive behaviors scores compared to low health literacy (adjusted odds ratio, 1.66; 95% confidence interval, 1.22-2.27).

CONCLUSION

Higher health literacy was significantly associated with a higher proportion of COVID-19 prevention behaviors among women who are pregnant or postpartum.

Knowledge, Awareness, and Prevention of Norovirus Infection among Kindergarten Parents in Chengdu, China

Human noroviruses (HuNoVs) are a leading cause of acute gastroenteritis among children in China. However, little is known about parents' knowledge of HuNoV infection and their understanding of how to prevent and control the disease. Therefore, we performed an exploratory survey to assess the level of knowledge of HuNoV infection among kindergarten parents. A cross-sectional survey was conducted by investigating kindergarteners' parents through an online self-administered questionnaire between October 2020 and November 2020 in Chengdu, China. A total of 771 questionnaires were received with valid responses, and 81.97% of respondents had heard about NoV before. Among parents who had heard about HuNoV before, they had a poor awareness of incubation period, duration, and high-incidence seasons of HuNoV infection. The respondents also had a low-level awareness of how to clean the places contaminated by vomitus or stool. The multiple-regression analysis confirmed that factors associated with good knowledge regarding HuNoV infection were level of education, occupation, history of infection, and HuNoV learning experience. The most expected approach to learn about HuNoV among parents was the internet, followed by knowledge training in kindergartens, community information, and television. This is the first study to assess kindergarten parents' knowledge and awareness of HuNoV infection. The survey results provide insights that would help in developing effective strategies and educational materials to prevent and control the disease.

Hepatitis B Virus Awareness, Infection, and Screening Multiethnic Community Intervention for Foreign-Born Populations

Hepatitis B virus (HBV) is a potentially deadly viral infection that can lead to liver cancer. Many refugee immigrants resettled in the US come from countries known to have a high prevalence of HBV infections. Unfortunately, most infected refugee immigrants are unaware of their HBV status. The disease is highly preventable through a vaccine, but chronic HBV is incurable once the disease has developed. For the purposes of this cross-sectional study, we conducted analysis of data collected through the Building Bridges Initiative (BBI) to assess HBV awareness, vaccination status, screening, and infection among multiethnic, primarily refugee, immigrant populations living in North Texas. Overall, 74% of study participants reported having heard about HBV, but only 31% knew their HBV status. Whereas 69% of study participants lacked awareness about their HBV status and self-reported prevalence of chronic HBV among study participants was 4%. For the vaccine, only 26% reported to have received at least one dose; 53% did not know, while 21% had not ever received it. For those unaware of their HBV status, the BBI offered participants free HBV screening and assistance for vaccination as needed. 76% of participants that accepted HBV screening from BBI were never screened before (enrollment in BBI). Chronic HBV positivity rate for participants was 6%, which is twenty times higher than the national prevalence of chronic HBV (0.3%). High prevalence of HBV, low awareness and low vaccination rates seen in this study highlights the need for increased HBV prevention among foreign born populations.

Underimmunization of the solid organ transplant population: An urgent problem with potential digital health solutions

Solid organ transplant recipients are at risk for potentially life-threatening infections due to lifelong immunosuppression. Vaccine-preventable infections result in graft injury, morbidity, mortality, and significantly increased medical costs. Unfortunately, the majority of transplant recipients continue to be underimmunized at the time of transplant and thereafter. Given the rising rates of vaccine hesitancy and refusal in the general population, transplant recipients can no longer rely on herd immunity to protect them from vaccine-preventable infections. Novel tools are desperately needed to overcome transplant-specific immunization barriers to improve immunization rates in this high-risk population. Digital health technologies may offer a solution by addressing transplant-specific barriers: specifically, providing accurate information about vaccine safety, efficacy, and timing in the pre- and posttransplant periods; making a complete immunization record universally available and easily accessible; enabling communication between patients and multiple providers; and providing automated vaccine reminders to both patients and providers when vaccines are due using transplant-specific immunization guidelines. Digital health has transformed health care by empowering patients with their own health information and connecting patients, their providers, and public health officials. In doing so, it offers a potential platform to address and overcome the problem of underimmunization in the transplant population.

Gaps in Viral Hepatitis Awareness in the United States in a Population-based Study

BACKGROUND & AIMS

The benefits of highly effective therapies for chronic hepatitis B virus (HBV) or HCV infection can only be realized if infected individuals are identified and linked to care. We sought to identify gaps in awareness of diagnosis of HBV or HCV infection in a population-based sample of adults living in the United States (US).

METHODS

Using National Health and Nutrition Examinations Surveys data, we examined factors associated with HBV and HCV awareness. Participants surveyed from 2013 through 2016, age ≥20 years, with complete serologic analyses were included. HBV and HCV infections were defined by detection of serum HBsAg and anti-HCV, respectively. The primary outcome was awareness of infection-if participants replied "yes" to the question: "Has a doctor or other health professional ever told you that you have hepatitis B or C?"

RESULTS

Of 14,745 participants, 68 had HBV and 211 had HCV infection, corresponding to prevalence values of 0.7% and 1.8%, respectively. Among HBV-infected persons, 32% reported awareness, and 28% of aware persons reported treatment. Among HCV-infected persons, 49% reported awareness, 45% of aware persons were treated, and 59% of treated patients achieved a sustained virologic response. Factors associated with greater awareness in multivariable models included US citizenship, higher education, and abnormal level of alanine aminotransferase for HBV-infected participants and non-Hispanic race, income above the poverty line, not married, and history of injection drug use for HCV-infected participants.

CONCLUSIONS

Fewer than half of US adults with HBV or HCV infection are aware of their infection. Opportunities to increase awareness include provider education on cut-off values for abnormal level of alanine aminotransferase that should prompt screening, and expansion of existing screening interventions to under-recognized at-risk groups.

Antiviral Activities of Silymarin and Derivatives

Silymarin flavonolignans are well-known agents that typically possess antioxidative, anti-inflammatory, and hepatoprotective functions. Recent studies have also documented the antiviral activities of silymarin and its derivatives against several viruses, including the flaviviruses (hepatitis C virus and dengue virus), togaviruses (Chikungunya virus and Mayaro virus), influenza virus, human immunodeficiency virus, and hepatitis B virus. This review will describe some of the latest preclinical and clinical studies detailing the antiviral profiles of silymarin and its derivatives, and discuss their relevance for antiviral drug development.

The experience of discrimination of individuals living with chronic hepatitis B in four provinces of China

OBJECTIVES

To assess chronic hepatitis B (CHB) patients' knowledge about hepatitis B and their experience of discrimination with regard to study, work, and daily life.

METHODS

We administered a questionnaire to 797 CHB patients in four provinces of China and used one-way analysis of variance (ANOVA) and a generalized linear model (GLM) to identify factors associated with discrimination.

RESULTS

CHB patients had low levels of knowledge about hepatitis B. Patients under 40 years of age with a junior college education or above knew more about hepatitis B than CHB patients over 40 years of age who had only a high school education. Three-fourths of patients had experienced discrimination because of their hepatitis B infection, with no differences in the proportion experiencing discrimination by sex or age. People with more education reported less discrimination. Patients in Beijing and Henan province perceived less discrimination than those in Shaanxi and Guangdong provinces. Discrimination was significantly associated with negative emotions. CHB patients had little awareness of China's anti-discrimination laws and policies. Among patients who had experienced discrimination, fewer than 10% knew organizations or institutions that could offer help. Over 60% of CHB patients who experienced discrimination chose not to respond.

CONCLUSION

CHB patients in China commonly experienced discrimination, which was associated with significant, negative emotional stress. To mitigate the damaging effects of discrimination, our study suggests raising general population knowledge about hepatitis B, raising awareness of the availability of legal protection and organizations that can fight discrimination, and providing psychological support for CHB patients.

Inhibitory effect of silibinin on hepatitis B virus entry

Hepatitis B virus (HBV) infection is a worldwide health problem because of its potential to cause liver cirrhosis and hepatocellular carcinoma. Silibinin is a constituent of an extract of milk thistle, which is empirically used as a herbal medicine for the protection of liver, but its detailed effects on HBV are unknown. Because a previous study reported that silibinin hinders clathlin-mediated endocytosis (CME), we aimed to test whether silibinin inhibits the entry of HBV into hepatocytes. Using HepG2-NTCP-C4 cells, which overexpress sodium taurocholate cotransporting polypeptide (NTCP), it was shown that silibinin inhibited HBV infection dose-dependently. Similar effects were observed using human primary hepatocytes (PXB-cells). Additionally, a combination of silibinin and entecavir reduced HBV DNA in the culture supernatant more than either mono-treatment alone in HepG2-NTCP-C4 cells that had already been infected with HBV. Silibinin decreased transferrin uptake but did not affect the interaction between the HBV envelope and NTCP, suggesting that silibinin might inhibit HBV infection by hindering CME. In conclusion, this study showed that silibinin inhibits HBV entry in vitro.