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Alali AA, Abo-Shehada MN. Prevalence of Hepatitis B Virus infection in the Gulf Cooperation Council: a systematic review and meta-analysis. BMC Infect Dis 2022; 22:819. [PMID: 36344923 PMCID: PMC9641946 DOI: 10.1186/s12879-022-07806-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is a global public-health problem. Since the introduction of an effective vaccine, the epidemiology of HBV infection is changing. We aimed to estimate the prevalence of HBV infection in the Gulf Cooperation Council (GCC) region and delineate any variation in member-countries, special sub-groups, and over time. METHODS This is a systematic review and meta-analysis to review studies of HBV prevalence in the GCC region. Databases were searched and all studies from inception to July 31st, 2021, were considered for inclusion. The pooled HBV prevalence was analyzed using the random-effect model after assessment for heterogeneity. True prevalence was adjusted using the Rogan-Gladen estimator. Pre-defined subgroup analysis was performed, and publication bias was assessed. RESULTS Overall, 99 studies (n = 1,944,200 participants) met the inclusion criteria. The overall HBV apparent prevalence was 3.05% (95% CI 2.60, 3.52) and the true prevalence was 1.67% (95% CI 1.66, 1.68). The apparent prevalence varied between subgroups. Over time, the apparent prevalence of HBV infection has declined from 9.38% (95% CI 7.26, 11.74) before 1990 to 1.56% (95% CI 1.07, 2.12) during the period 2010 to 2020. CONCLUSION Over the last four decades the overall prevalence of HBV infection in the GCC region has decreased from high- to low-endemicity level. However, due to poor methodology of the included studies, further high-quality community-based studies are needed to obtain more precise estimate of HBV infection in this region.
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Affiliation(s)
- Ali A Alali
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, UK.
- Department of Medicine, Faculty of Medicine, Kuwait University, Jabriyah, Kuwait.
| | - Mahmoud N Abo-Shehada
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, UK
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Alqahtani SM, A. Alsagaby S, Mir SA, Alaidarous M, Bin Dukhyil A, Alshehri B, Banawas S, Alturaiki W, Alharbi NK, Azad TA, Al Abdulmonem W. Seroprevalence of Viral Hepatitis B and C among Blood Donors in the Northern Region of Riyadh Province, Saudi Arabia. Healthcare (Basel) 2021; 9:healthcare9080934. [PMID: 34442071 PMCID: PMC8394786 DOI: 10.3390/healthcare9080934] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/05/2021] [Accepted: 07/14/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hepatitis B and C viral infections, which are the most common cause of liver infection worldwide, are major health issues around the globe. People with chronic hepatitis infections remain at risk of liver cirrhosis and hepatic carcinoma, while also being a risk to other diseases. These infections are highly contagious in nature, and the prevention of hepatitis B and C transmission during blood transfusion is a major challenge for healthcare workers. Although epidemiological characteristics of hepatitis B and C infections in blood donors in Saudi Arabia have been previously investigated in multiple studies, due to targeted cohorts and the vast geographical distribution of Saudi Arabia, there are a lot of missing data points, which necessitates further investigations. AIM OF THE STUDY This study aimed to determine the prevalence of hepatitis B and hepatitis C viral infections among blood donors in the northern region of Riyadh, Saudi Arabia. METHODS To determine the given objectives, a retrospective study was performed which included data gathered from serological as well as nucleic acid test (NAT) screening of blood donors. Clinical data of 3733 blood donors were collected for a period of 2 years (from January 2019 to December 2020) at the blood bank of King Khalid General Hospital and the associated blood banks and donation camps in the region. Statistical analysis of the clinical data was performed using SPSS. RESULTS The blood samples of 3733 donors were analyzed to determine the seroprevalence of hepatitis B and C among the blood donors in the northern region of Riyadh, Saudi Arabia. Among the total of 3733 blood donors, 3645 (97.65%) were men and 88 (2.36%) were women. Most of the donors were younger than 27 years of age (n = 1494). The most frequent blood group in our study was O-positive (n = 1534), and the least frequent was AB-negative (n = 29). After statistically analyzing the clinical data, we observed that 7 (0.19%), 203 (5.44%) and 260 (6.96%) donor blood samples were positive for the HBV serological markers HBsAgs, HBsAbs and HBcAbs, respectively, and 12 (0.32%) blood samples reacted positively to anti-HCV antibodies. Moreover, 10 (0.27%) and 1 (0.027%) samples were NAT-HBV positive and NAT-HCV positive, respectively. CONCLUSION In the current study, low prevalence rates of HBV and HCV were observed in the blood donors. Statistical correlations indicated that both serological tests and NATs are highly effective in screening potential blood donors for HBV and HCV, which, in turn, prevents potential transfusion-transmitted hepatitis.
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Affiliation(s)
- Saeed Mohammed Alqahtani
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.M.A.); (S.A.A.); (M.A.); (A.B.D.); (B.A.); (S.B.); (W.A.)
| | - Suliman A. Alsagaby
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.M.A.); (S.A.A.); (M.A.); (A.B.D.); (B.A.); (S.B.); (W.A.)
| | - Shabir Ahmad Mir
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.M.A.); (S.A.A.); (M.A.); (A.B.D.); (B.A.); (S.B.); (W.A.)
- Correspondence: ; Tel.: +966-(0)16-404-2838
| | - Mohammed Alaidarous
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.M.A.); (S.A.A.); (M.A.); (A.B.D.); (B.A.); (S.B.); (W.A.)
- Health and Basic Sciences Research Center, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Abdulaziz Bin Dukhyil
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.M.A.); (S.A.A.); (M.A.); (A.B.D.); (B.A.); (S.B.); (W.A.)
- Health and Basic Sciences Research Center, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Bader Alshehri
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.M.A.); (S.A.A.); (M.A.); (A.B.D.); (B.A.); (S.B.); (W.A.)
| | - Saeed Banawas
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.M.A.); (S.A.A.); (M.A.); (A.B.D.); (B.A.); (S.B.); (W.A.)
- Health and Basic Sciences Research Center, Majmaah University, Al Majmaah 11952, Saudi Arabia
- Department of Biomedical Sciences, Oregon State University, Corvallis, OR 97331, USA
| | - Wael Alturaiki
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.M.A.); (S.A.A.); (M.A.); (A.B.D.); (B.A.); (S.B.); (W.A.)
| | - Naif Khalaf Alharbi
- King Abdullah International Medical Research Center, Department of Infectious Disease Research, Riyadh 11451, Saudi Arabia;
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11451, Saudi Arabia
| | - Taif Anwar Azad
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Waleed Al Abdulmonem
- Department of Pathology, College of Medicine, Qassim University, Buraidah 51452, Saudi Arabia;
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3
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Abaalkhail FA, Al-Hamoudi WK, Khathlan A, Alghamdi S, Alghamdi M, Alqahtani SA, Sanai FM. SASLT practice guidelines for the management of Hepatitis B virus - An update. Saudi J Gastroenterol 2021; 27:115-126. [PMID: 33976009 PMCID: PMC8265399 DOI: 10.4103/sjg.sjg_539_20] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 02/23/2021] [Indexed: 12/30/2022] Open
Abstract
Infection with hepatitis B virus (HBV) remains an important public health problem with a high burden worldwide. The Saudi Association for the Study of Liver diseases and Transplantation formed a working group to develop HBV practice guidelines in Saudi Arabia. The methodology used to develop these guidelines was based on reviewing the available evidence, local data, and major international practice guidelines on the management of HBV. The aim of these guidelines is to assist healthcare providers in the management of HBV in Saudi Arabia. These updated guidelines summarize the latest local studies performed on HBV epidemiology, major changes in the prevalence of this virus, and advances in disease management.
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Affiliation(s)
- Faisal A. Abaalkhail
- Gastroenterology Section, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - Waleed K. Al-Hamoudi
- Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Medicine, Liver Transplant Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Abdullah Khathlan
- Department of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Saad Alghamdi
- Department of Medicine, Liver Transplant Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohammed Alghamdi
- Department of Medicine, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Saleh A. Alqahtani
- Department of Medicine, Liver Transplant Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, USA
| | - Faisal M. Sanai
- Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Gastroenterology Unit, Department of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
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4
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Alqahtani SA, Sanai FM, Alolayan A, Abaalkhail F, Alsuhaibani H, Hassanain M, Alhazzani W, Alsuhaibani A, Algarni A, Forner A, Finn RS, Al-hamoudi WK. Saudi Association for the Study of Liver diseases and Transplantation practice guidelines on the diagnosis and management of hepatocellular carcinoma. Saudi J Gastroenterol 2020; 26:S1-S40. [PMID: 33078723 PMCID: PMC7768980 DOI: 10.4103/sjg.sjg_477_20] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 09/10/2020] [Indexed: 01/27/2023] Open
Affiliation(s)
- Saleh A. Alqahtani
- Liver Transplant Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
| | - Faisal M. Sanai
- Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Ashwaq Alolayan
- Adult Medical Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Faisal Abaalkhail
- Department of Medicine, Gastroenterology Section, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - Hamad Alsuhaibani
- Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mazen Hassanain
- Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States
| | - Waleed Alhazzani
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Abdullah Alsuhaibani
- Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Abdullah Algarni
- Department of Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Alejandro Forner
- Barcelona Clinic Liver Cancer Group, Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBEREHD, University of Barcelona, Barcelona, Spain
| | - Richard S Finn
- Division of Hematology and Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California,United States
| | - Waleed K. Al-hamoudi
- Liver Transplant Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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5
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Sanai FM, Alghamdi M, Dugan E, Alalwan A, Al-Hamoudi W, Abaalkhail F, AlMasri N, Razavi-Shearer D, Razavi H, Schmelzer J, Alfaleh FZ. A tool to measure the economic impact of Hepatitis B elimination: A case study in Saudi Arabia. J Infect Public Health 2020; 13:1715-1723. [PMID: 32988769 DOI: 10.1016/j.jiph.2020.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/31/2020] [Accepted: 09/13/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND No virologic cure exists for hepatitis B virus (HBV) infection, and existing therapies are designed to control viral replication. We aimed to estimate the national prevalence of HBsAg in 2017 and study the impact of an enhanced diagnosis rate and universal treatment administration on HBV-related outcomes in Saudi Arabia. MATERIALS AND METHODS A dynamic transmission and disease burden model was developed to estimate the future economic burden of HBV infection. The infected population was tracked by age and gender-defined cohorts; direct costs (healthcare, screening, diagnostics and treatment) and indirect costs (disability-adjusted life years and the value of a statistical life year) were calculated. The impact of two intervention scenarios (Achieve WHO Targets: diagnose 90% of infections and treat 80% of high viral load patients by 2030; and Diagnose and Treat All: diagnose and treat all infected patients by 2022) were compared against the Base Case scenario (no policy action), with near-universal vaccination coverage rates held constant. A sensitivity analysis of future treatment cost was also conducted. RESULTS In 2017, HBsAg prevalence was estimated at 1.7%, corresponding to 574,000 infections. The same year, there was an estimated incidence of 490 cases of decompensated cirrhosis, 1500 cases of hepatocellular carcinoma (HCC) and 1740 liver-related deaths (LRD). HBsAg prevalence was 0.1% among 5-year-olds and <0.1% among infants. Disease burden outcomes by 2030, as compared with 2015, were as follows - Base Case: LRDs and HCC incidence were projected to increase by 70%. WHO Targets: A 30-35% decline in both HCC incidence and LRDs. Diagnose and Treat All: A 50-55% decline in HCC incidence and LRDs. In all scenarios, HBsAg prevalence among infants and 5-year-olds declined to <0.1% with the Diagnose and Treat all scenario resulting in a prevalence approaching zero in this age group. Annual direct costs are projected to increase and peak by 2022 in both intervention scenarios due to expansion of treatment and diagnostics. However, these are offset by the reduction of indirect economic costs, starting immediately in the WHO Targets scenario and by 2023 in the strategy to diagnose and treat all. Achieving WHO Targets is estimated to achieve a positive return on investment (ROI) by 2021 when examining direct costs and indirect economic losses at a treatment price of $2700 USD per patient yearly. Diagnosing and treating all patients, however, would require at least a 50% reduction in the unit cost of treatment to achieve a positive ROI by 2029. CONCLUSIONS Increased diagnosis and treatment rates of HBV would lead to substantial declines in HCC and LRD. This effect would be dramatically enhanced by administering treatment to all HBV cases regardless of viral load and estimated to be highly cost-effective if treatment prices can be substantially reduced.
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Affiliation(s)
- Faisal M Sanai
- Gastroenterology Unit, Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
| | - Mohammed Alghamdi
- Gastroenterology Unit, Department of Medicine, King Fahad Military Medical Complex, Dhahran, Saudi Arabia
| | - Ellen Dugan
- Center for Disease Analysis Foundation, Lafayette, CO, USA
| | - Abduljaleel Alalwan
- Department of Organ Transplant and Hepatobiliary Surgery, King Abdulaziz Medical City and King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Waleed Al-Hamoudi
- Department of Liver Transplantation and Hepatobiliary-Pancreatic Surgery, Division of Organ Transplant Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Faisal Abaalkhail
- Department of Liver Transplantation, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Nasser AlMasri
- Department of Gastroenterology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | | | - Homie Razavi
- Center for Disease Analysis Foundation, Lafayette, CO, USA
| | | | - Faleh Z Alfaleh
- Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Cooke GS, Andrieux-Meyer I, Applegate TL, Atun R, Burry JR, Cheinquer H, Dusheiko G, Feld JJ, Gore C, Griswold MG, Hamid S, Hellard ME, Hou J, Howell J, Jia J, Kravchenko N, Lazarus JV, Lemoine M, Lesi OA, Maistat L, McMahon BJ, Razavi H, Roberts T, Simmons B, Sonderup MW, Spearman CW, Taylor BE, Thomas DL, Waked I, Ward JW, Wiktor SZ. Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol 2019; 4:135-184. [PMID: 30647010 DOI: 10.1016/s2468-1253(18)30270-x] [Citation(s) in RCA: 352] [Impact Index Per Article: 70.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 08/10/2018] [Accepted: 08/13/2018] [Indexed: 01/26/2023]
Abstract
Viral hepatitis is a major public health threat and a leading cause of death worldwide. Annual mortality from viral hepatitis is similar to that of other major infectious diseases such as HIV and tuberculosis. Highly effective prevention measures and treatments have made the global elimination of viral hepatitis a realistic goal, endorsed by all WHO member states. Ambitious targets call for a global reduction in hepatitis-related mortality of 65% and a 90% reduction in new infections by 2030. This Commission draws together a wide range of expertise to appraise the current global situation and to identify priorities globally, regionally, and nationally needed to accelerate progress. We identify 20 heavily burdened countries that account for over 75% of the global burden of viral hepatitis. Key recommendations include a greater focus on national progress towards elimination with support given, if necessary, through innovative financing measures to ensure elimination programmes are fully funded by 2020. In addition to further measures to improve access to vaccination and treatment, greater attention needs to be paid to access to affordable, high-quality diagnostics if testing is to reach the levels needed to achieve elimination goals. Simplified, decentralised models of care removing requirements for specialised prescribing will be required to reach those in need, together with sustained efforts to tackle stigma and discrimination. We identify key examples of the progress that has already been made in many countries throughout the world, demonstrating that sustained and coordinated efforts can be successful in achieving the WHO elimination goals.
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Affiliation(s)
- Graham S Cooke
- Division of Infectious Diseases, Imperial College London, London, UK.
| | | | | | - Rifat Atun
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA; Harvard Medical School, Harvard University, Boston, MA, USA
| | | | - Hugo Cheinquer
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Jordan J Feld
- Toronto Center for Liver Disease, Toronto General Hospital, Toronto, Canada
| | | | - Max G Griswold
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | | | - JinLin Hou
- Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Guangzhou, China
| | - Jess Howell
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Beijing, China
| | | | - Jeffrey V Lazarus
- Health Systems Research Group, Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Maud Lemoine
- Division of Surgery and Cancer, Imperial College London, London, UK
| | | | | | - Brian J McMahon
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AL, USA
| | - Homie Razavi
- Center for Disease Analysis Foundation, Lafayette, CO, USA
| | | | - Bryony Simmons
- Division of Infectious Diseases, Imperial College London, London, UK
| | - Mark W Sonderup
- Division of Hepatology, Department of Medicine, University of Cape Town, South Africa
| | - C Wendy Spearman
- Division of Hepatology, Department of Medicine, University of Cape Town, South Africa
| | | | - David L Thomas
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Imam Waked
- National Liver Institute, Menoufiya University, Egypt
| | - John W Ward
- Program for Viral Hepatitis Elimination, Task Force for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stefan Z Wiktor
- Department of Global Health, University of Washington, Seattle, WA, USA
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7
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Sanai FM, Alghamdi H, Alswat KA, Babatin MA, Ismail MH, Alhamoudi WK, Alalwan AM, Dahlan Y, Alghamdi AS, Alfaleh FZ, Aljumah AA, Altraif IH, Albeladi K, Batwa F, Alshumrani W, Belhadi D, Genestier V, Abdo AA. Greater prevalence of comorbidities with increasing age: Cross-sectional analysis of chronic hepatitis B patients in Saudi Arabia. Saudi J Gastroenterol 2019; 25:194-200. [PMID: 30720002 PMCID: PMC6526730 DOI: 10.4103/sjg.sjg_447_18] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/AIMS Middle Eastern countries, including Saudi Arabia to some extent, are endemic for chronic hepatitis B (CHB) infection which could be associated with high mortality and comorbidities risk. However, limited data characterizing this CHB population exists. Our aim was to characterize and compare CHB patients in 2015 with those in 2010 and 2012 in Saudi Arabia. PATIENTS AND METHODS We conducted and compared three cross-sectional analyses of adult patients with CHB defined as either positive hepatitis B surface antigen or documented CHB history in 2010, 2012, and 2015. Data were accessed from the multicenter Systematic Observatory Liver Disease Registry (SOLID). RESULTS A total of 765 CHB patients were identified in 2010 (n = 274), 2012 (n = 256), and 2015 (n = 235). Median age was significantly higher in 2015 (47 years) compared to 2010 and 2012 (42 years;P < 0.05). The proportions of patients with hepatocellular carcinoma (range 1-12%) and cirrhosis (range 5-23%) were significantly higher in 2015 compared to 2010 and 2012 (P < 0.05). Compared to 2010, patients in 2015 had significantly (P < 0.05) higher prevalence of coronary artery disease (10% vs. 4%) and hyperbilirubinemia (18% vs. 9%). Although not significant, there was a numerical increase in 2015 in chronic kidney disease (9% vs. 7% in 2010;P= 0.559) and hepatic steatosis (32% vs. 25% in 2010;P= 0.074). Significantly more patients in 2015 (P < 0.05) were treatment experienced (23% vs. 5% in 2010/2012) and switched treatment (17% vs. 1-2% in 2010/2012). CONCLUSIONS Between 2010 and 2015, the CHB population in Saudi Arabia had significantly aged and was more likely to develop liver disease sequelae and other comorbidities.
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Affiliation(s)
- Faisal M. Sanai
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia,Address for correspondence: Dr. Faisal M. Sanai, Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, PO Box 9515 (IMB 1440), Jeddah - 21423, Saudi Arabia. E-mail:
| | - Hamdan Alghamdi
- Hepatology Division, Department of Hepatobiliary Sciences and Organ Transplant Center, King Abdulaziz Medical City, Riyadh,King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Khalid A. Alswat
- Department of Medicine, Gastroenterology Unit, King Fahad Hospital, Jeddah, Saudi Arabia
| | - Mohammed A. Babatin
- Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mona H. Ismail
- Department of Internal Medicine, King Fahd Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Waleed K. Alhamoudi
- Department of Medicine, Gastroenterology Unit, King Fahad Hospital, Jeddah, Saudi Arabia
| | - Abduljaleel M. Alalwan
- Hepatology Division, Department of Hepatobiliary Sciences and Organ Transplant Center, King Abdulaziz Medical City, Riyadh,King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Yaser Dahlan
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia,King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Abdullah S. Alghamdi
- Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Faleh Z. Alfaleh
- Department of Medicine, Gastroenterology Unit, King Fahad Hospital, Jeddah, Saudi Arabia
| | - Abdulrahman A. Aljumah
- Hepatology Division, Department of Hepatobiliary Sciences and Organ Transplant Center, King Abdulaziz Medical City, Riyadh,King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ibrahim H. Altraif
- Hepatology Division, Department of Hepatobiliary Sciences and Organ Transplant Center, King Abdulaziz Medical City, Riyadh,King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Khalid Albeladi
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia,King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Faisal Batwa
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia,King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Waleed Alshumrani
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia,King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Drifa Belhadi
- Amaris, Health Economics and Market Access (HEMA) Department, Levallois-Perret, France
| | - Victor Genestier
- Amaris, Health Economics and Market Access (HEMA) Department, Levallois-Perret, France
| | - Ayman A. Abdo
- Department of Medicine, Gastroenterology Unit, King Fahad Hospital, Jeddah, Saudi Arabia
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8
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Aljumah AA, Kuriry H, Faisal N, Alghamdi H. Clinicopathologic characteristics andoutcomes of hepatocellular carcinoma associated with chronic hepatitis B versus hepatitis C infection. Ann Saudi Med 2018; 38:358-365. [PMID: 30284991 PMCID: PMC6180214 DOI: 10.5144/0256-4947.2018.358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is a primary liver malignancy and one of the most common cancers worldwide. Few studies in Saudi Arabia have compared the clinicopathologic characteristics of HCC caused by hepatitis B virus (HBV) versus hepatitis C virus (HCV) and their effect on patient survival and prognosis. OBJECTIVES Identify differences in clinicopathological characteristics and outcomes of hepatocellular carcinoma (HCC) caused by HBV versus HCV. DESIGN A retrospective medical records review. SETTING Tertiary medical center in Riyadh. PATIENTS AND METHODS We included all new cases of HCC with underlying HBV and HCV infection diagnosed between January 2013 and September 2017 that met inclusion criteria. MAIN OUTCOME MEASURES Clinical, biochemical, pathological and radiological characteristics, and survival differences were compared between HCC that developed in HBV- and HCV-infected patients. SAMPLE SIZE Of 253 patients evaluated, 172 patients were included in the study. RESULTS Of the 172 patients, 110 (64%) had HCV-associated HCC and 62 (36%) had HBV-associated HCC. More patients with HBV infection were males (P=.003) and were younger (P=.015) than HCV patients. HCV-infected patients who developed HCC had more advanced cirrhosis (P=.048). The prevalence of comorbidities and pre-existing cir.rhosis was similar in both groups. Seven patients (6.8%) with underlying HCV developed HCC in the absence of cirrhosis. Patients with HBV-associated HCC were less likely to meet Milan criteria at initial diagnosis than those with HCV-associated HCC (33.9% vs. 52.7%, respectively, P=.017). HBV-associated HCC occurred at a more advanced Barcelona Clinic Liver Cancer stage. The overall median survival and treatment outcome for each modality was comparable. CONCLUSIONS HBV- and HCV-associated HCC have distinct clinical and pathological characteristics, necessitating different screening policies to optimize HCC surveillance and management. However, viral etiology did not affect the treatment outcome and long-term survival. LIMITATIONS Conducted in a single-center, retrospective and lacks information about the use of antiviral treatment. CONFLICT OF INTEREST None.
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Affiliation(s)
- Abdulrahman A Aljumah
- Dr. Abdulrahman Aljumah, Hepatology Division, Department of Hepatobiliary Sciences and Organ Transplant Center,, King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences,, Ministry of National Guard Affairs,, PO Box 225264, Riyadh 11324, Saudi Arabia, T: +966-50-5411910, , ORCID: http://orcid.org/0000-0002-6156.4921
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Ifeorah IM, Bakarey AS, Adewumi MO, Faleye TOC, Akere A, Omoruyi CE, Ogunwale AO, Uttah CC, Oketade MA, Adeniji JA. Patterns of serologic markers of hepatitis B virus infection and the risk of transmission among pregnant women in southwestern Nigeria. J Immunoassay Immunochem 2017; 38:639-651. [PMID: 29035130 DOI: 10.1080/15321819.2017.1384389] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Hepatitis B virus (HBV) infection is a major health concern in developing countries that has a high morbidity and mortality rate. Vertical transmission of HBV from mother to child has been identified as a major factor leading to chronicity with attendant liver conditions, especially in poor socioeconomic settings. This study aims to evaluate the prevalence of serological HBV markers among pregnant women in Ibadan southwestern Nigeria and to determine the implications for perinatal HBV transmission. This study revealed the presence of varied HBV serological patterns of infection or immunity among pregnant women in Ibadan, Nigeria, and thus the risk of mother to child transmission.
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Affiliation(s)
- I M Ifeorah
- a Department of Surgery, College of Medicine , University of Ibadan , Ibadan , Nigeria
| | - A S Bakarey
- b Institute for Advanced Medical Research & Training, College of Medicine , University of Ibadan , Ibadan , Nigeria
| | - M O Adewumi
- c Department of Virology, College of Medicine , University of Ibadan , Ibadan , Nigeria
| | - T O C Faleye
- c Department of Virology, College of Medicine , University of Ibadan , Ibadan , Nigeria.,d Department of Microbiology, Faculty of Science , Ekiti State University , Ado Ekiti , Nigeria
| | - A Akere
- e Department of Medicine, College of Medicine , University of Ibadan
| | - C E Omoruyi
- f Institute of Child Health, College of Medicine , University of Ibadan , Ibadan , Nigeria
| | - A O Ogunwale
- g Department of General Studies , Oyo State College of Agriculture and Technology , Igboora , Oyo State , Nigeria
| | - C C Uttah
- h Department of Science Laboratory Technology, Faculty of Science , Ekiti State University , Ado Ekiti , Nigeria
| | - M A Oketade
- d Department of Microbiology, Faculty of Science , Ekiti State University , Ado Ekiti , Nigeria
| | - J A Adeniji
- c Department of Virology, College of Medicine , University of Ibadan , Ibadan , Nigeria
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van den Ende C, Marano C, van Ahee A, Bunge EM, De Moerlooze L. The immunogenicity of GSK’s recombinant hepatitis B vaccine in children: a systematic review of 30 years of experience. Expert Rev Vaccines 2017; 16:789-809. [DOI: 10.1080/14760584.2017.1338569] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
| | | | - Ayla van Ahee
- Pallas Health Research and Consultancy, Rotterdam, The Netherlands
| | - Eveline M. Bunge
- Pallas Health Research and Consultancy, Rotterdam, The Netherlands
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Albadran A, Hibshi A, Saeed B, Coskun S, Awartani KA. Hepatitis B and C virus prevalence in couples attending an in vitro fertilization clinic in a tertiary care hospital in Saudi Arabia: comparison with ten years earlier. Ann Saudi Med 2017; 37:272-275. [PMID: 28761024 PMCID: PMC6150590 DOI: 10.5144/0256-4947.2017.272] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Viral hepatitis B (HBV) and C (HCV) are a major public health problem in Saudi Arabia. Recent data has indicated a major reduction in viral hepatitis prevalence in Saudi population. However, there is limited data for infertile Saudi couples. OBJECTIVES To determine the prevalence of HCV and HBV attending an in vitro fertilization (IVF) clinic in Saudi Arabia between 2012 and 2015 to compare with the prevalence 10 years earlier in the same center. DESIGN Retrospective prevalence study. SETTING Tertiary care center in Riyadh. PATIENTS AND METHODS Data on the prevalence of HBV and HCV was collected on all couples seen at the IVF unit between 2002-2005 and 2012-2015. MAIN OUTCOME MEASURE(S) Prevalence of HBV and HCV. RESULTS In 4442 patients during 2002-2005 and 5747 patients during 2012-2015, the prevalence of HBV was significantly less in 2012-2015 compared with 2002-2005 (1.67% [97 patients] vs 4.7% [210 patients], P < .0001), respectively, but HCV prevalence was similar for the two periods (0.7% for both periods) (P=.887). The hepatitis B seroprevalence rate was higher in males compared to females during 2002-2005 (6.3% vs 3.1%) (P < .0001) and 2012-2015 (2.4% vs 1.1% ) (P < .0001), respectively. CONCLUSION The significant drop in HBV prevalence was most likely due to the introduction of the vaccination program in 1989, while reasons for HCV prevalence remaining unchanged are unclear. LIMITATION No data on confounding factors that may have affected the prevalence.
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Affiliation(s)
- Asma Albadran
- Dr. Asma Albadran, Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211,, Saudi Arabia, T: +966-11-442-7392, F: +966-11-442-7393, , ORCID: http://orcid.org/0000-0003-4160-409X
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Al-Humayed SM. Hepatitis B and C Viral Infections in Tihamet Aseer, South-Western Saudi Arabia: Are There Gender Differences? SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2017; 5:110-115. [PMID: 30787767 PMCID: PMC6298365 DOI: 10.4103/1658-631x.204853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background Hepatitis B virus (HBV) infection is endemic in Saudi Arabia. Many studies have shown varying results in gender differences in HBV and hepatitis C virus (HCV) infection. The objective of this study was to determine if gender differences exist in HBV and HCV infection and to elucidate any related risk factors in Tihamet Aseer, south-western Saudi Arabia. Materials and Methods The study was a cross-sectional study of a representative sample of males and females in Tihamet Aseer, south-western Saudi Arabia. A comprehensive questionnaire was completed by all participants. Blood samples were taken and sera were tested for hepatitis B surface antigen and HCV antibodies by fourth-generation enzyme immunoassays. Results The study included 1532 participants from the Tihamet Aseer area. An overall seroprevalence of 7.9% and 1.7% was found for HBV and HCV infections, respectively. In logistic regression analysis, no gender differences were found for HBV seroprevalence. Identified risk factors for HBV infection included a history of blood transfusion and lack of hepatitis B vaccination. On the other hand, females were more prone to become seropositive for HCV (adjusted odds ratio = 5.034, 95% confidence interval: 1.042-9.321). Other identified risk factors for HCV infection were illiteracy and a history of blood transfusion. Conclusion The prevalence and HBV and HCV infection is high compared to the national figures. Gender differences were only observed in HCV infection. It is recommended to have an active educational and media campaign. A "catch-up" vaccination program against HBV should be introduced for adults as a strategy to achieve the herd immunity effect in the affected area.
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Affiliation(s)
- Suliman M Al-Humayed
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Al Humayed SM, El-Mekki AA, Mahfouz AA. Hepatitis B virus infection in Aseer Region, south-western Saudi Arabia: a call for an immediate action against a preventable disease. Public Health 2017; 146:24-28. [PMID: 28404469 DOI: 10.1016/j.puhe.2017.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 12/13/2016] [Accepted: 01/04/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The present study was designed as a large-scale cross-sectional study to cast some light on the magnitude of hepatitis B virus (HBV) infection in Aseer Region, south-western Saudi Arabia, a region reported to be of the highest endemicity. METHODS During the WHO hepatitis day of 2013, an aggressive health education campaign was launched in all the hospitals and primary health care centres in Aseer Region. Posters were distributed to encourage the local population to visit the health facilities to be tested for HBV. They were interviewed using a structured questionnaire. Detection of hepatitis B surface antigen (HBsAg) was done using a fourth-generation ELISA kits. RESULTS The present study included 10,234 persons. The study revealed an overall seroprevalence of 5.9% (95% confidence interval [CI] = 5.5-6.4%). A seroprevalence of 0.8% (95% CI = 0.2-2.1%) was found among persons aged less than 15 years, and a seroprevalence of 1.3% (95% CI = 0.4-2.9%) was found among persons aged 15-24 years. On the other hand, among persons aged 25 years and over (who were born before the expanded programme on immunization [EPI]), a seroprevalence of 6.3% (95% CI = 5.8-6.8%) was found. Pockets of unvaccinated individuals were identified. CONCLUSION The present study has documented the efficacy of vaccination in protecting against HBV infection. It also identified the presence of pockets of unvaccinated persons requiring further investigations. Aggressive health education programmes and 'catch-up' mass vaccination of those aged over 25 years is mandatory.
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Affiliation(s)
- S M Al Humayed
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.
| | - A A El-Mekki
- Department of Clinical Microbiology, College of Medicine, King Khalid University, Abha, Saudi Arabia.
| | - A A Mahfouz
- Department of Family & Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.
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Ott JJ, Horn J, Krause G, Mikolajczyk RT. Time trends of chronic HBV infection over prior decades - A global analysis. J Hepatol 2017; 66:48-54. [PMID: 27592304 DOI: 10.1016/j.jhep.2016.08.013] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/23/2016] [Accepted: 08/24/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Information on trends in chronic hepatitis B virus (HBV) prevalence across countries is lacking. We studied changes in chronic HBV infection over previous decades by country, and assessed patterns of change between and within WHO-defined regions. METHODS Based on data from a published systematic review on chronic HBV, we applied a linear model on the logit scale to assess time trends in country-specific prevalence. Estimated HBsAg prevalence in 2000 and relative changes in prevalence over time were evaluated by country and region. RESULTS Sufficient data were available for 50 countries, mostly showing reductions in prevalence over time. Various degrees of heterogeneity were observed within regions, with a relatively homogenous pattern in the Eastern Mediterranean region with strong decreases in HBsAg prevalence. Europe showed a mixed pattern: higher and stable chronic HBsAg prevalence in Eastern, and constantly low prevalence in Western Europe. In Africa, some countries demonstrated no change in prevalence; increases were seen in Uganda (odds ratio 1.05 per year; 95% confidence interval 1.04-1.06), Nigeria (1.02; 1.02-1.02), Senegal (1.01; 1.01-1.02), and South Africa (1.02; 1.01-1.02). With some exceptions, country-patterns overlapped among countries of South East Asian and Western Pacific regions, characterized by low-medium HBsAg decreases, most prominent in China and Malaysia. CONCLUSIONS Most countries experienced decreases in HBsAg prevalence. Dynamics varied, even within regions; decreases occurred mostly before the direct effects of childhood vaccination may have manifested. These findings together with stable and increasing HBsAg prevalence in some countries of Africa and Eastern Europe indicate the need for further tailored country-specific prevention. LAY SUMMARY This study investigated time trends in prevalence of chronic HBV infection in 50 countries worldwide over the last decade, by estimating relative changes in prevalence. Results show decreases in chronic HBV infection in most countries; no changes or increases in prevalence are noted in some African countries. Reasons for time changes need to be investigated further; based on the results, various prevention measures have contributed to reductions, and further tailored HBV prevention is required to combat the disease on a global level.
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Affiliation(s)
- Jördis J Ott
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany; Hannover Medical School, Hannover, Germany.
| | - Johannes Horn
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany; PhD Programme Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany; Hannover Medical School, Hannover, Germany; German Centre for Infection Research, Germany
| | - Rafael T Mikolajczyk
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany; Hannover Medical School, Hannover, Germany; German Centre for Infection Research, Germany
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Affiliation(s)
- Ayman A Abdo
- Gastroenterology Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Clinical Presentation, Risk Factors, and Treatment Modalities of Hepatocellular Carcinoma: A Single Tertiary Care Center Experience. Gastroenterol Res Pract 2016; 2016:1989045. [PMID: 27525001 PMCID: PMC4976192 DOI: 10.1155/2016/1989045] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 06/13/2016] [Accepted: 06/21/2016] [Indexed: 02/07/2023] Open
Abstract
Objective. To investigate the risk factors, clinical characteristics, treatment modalities, and outcomes in Saudi patients with HCC and propose points for early detection of the disease. Methods. Patients were stratified according to underlying risk factors for the development of HCC. Barcelona Clinic Liver Cancer (BCLC) was used for cancer staging. Treatment was classified into surgical resection/liver transplantation; locoregional ablation therapy; transarterial embolization; systemic chemotherapy; and best supportive care. Results. A total of 235 patients were included. Males had higher tumor size and incidence of portal vein thrombosis. Viral hepatitis was a risk factor in 75.7%. The most common BCLC stages were B (34.5%) and A (33.6%), and the most common radiological presentation was a single nodule of less than 5 cm. Metastases were present in 13.2%. Overall, 77 patients (32.8%) underwent a potentially curative treatment as the initial therapy. The most commonly utilized treatment modality was chemoembolization with 113 sessions in 71 patients. The overall median survival was 15.97 ± 27.18 months. Conclusion. HCC in Saudi Arabia is associated with high prevalence of HCV. Potentially curative therapies were underutilized in our patients. Cancer stage BCLC-B was the most frequent (34.5%) followed by BCLC-A (33.6%). The overall median survival was shorter than other studies.
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El Hadad S, Alakilli S, Rabah S, Sabir J. Sequence analysis of sub-genotype D hepatitis B surface antigens isolated from Jeddah, Saudi Arabia. Saudi J Biol Sci 2016; 25:838-847. [PMID: 29740253 PMCID: PMC5936882 DOI: 10.1016/j.sjbs.2016.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 02/16/2016] [Accepted: 03/05/2016] [Indexed: 12/20/2022] Open
Abstract
Little is known about the prevalence of HBV genotypes/sub-genotypes in Jeddah province, although the hepatitis B virus (HBV) was identified as the most predominant type of hepatitis in Saudi Arabia. To characterize HBV genotypes/sub-genotypes, serum samples from 15 patients with chronic HBV were collected and subjected to HBsAg gene amplification and sequence analysis. Phylogenetic analysis of the HBsAg gene sequences revealed that 11 (48%) isolates belonged to HBV/D while 4 (18%) were associated with HBV/C. Notably, a HBV/D sub-genotype phylogenetic tree identified that eight current isolates (72%) belonged to HBV/D1, whereas three isolates (28%) appeared to be more closely related to HBV/D5, although they formed a novel cluster supported by a branch with 99% bootstrap value. Isolates belonging to D1 were grouped in one branch and seemed to be more closely related to various strains isolated from different countries. For further determination of whether the three current isolates belonged to HBV/D5 or represented a novel sub-genotype, HBV/DA, whole HBV genome sequences would be required. In the present study, we verified that HBV/D1 is the most prevalent HBV sub-genotype in Jeddah, and identified novel variant mutations suggesting that an additional sub-genotype designated HBV/DA should be proposed. Overall, the results of the present HBsAg sequence analyses provide us with insights regarding the nucleotide differences between the present HBsAg/D isolates identified in the populace of Jeddah, Saudi Arabia and those previously isolated worldwide. Additional studies with large numbers of subjects in other areas might lead to the discovery of the specific HBV strain genotypes or even additional new sub-genotypes that are circulating in Saudi Arabia.
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Key Words
- C/pre C, HBV core/pre Core gene
- DDBJ, DNA Data Bank of Japan
- EMBL, European Molecular Biology Laboratory
- HAV, hepatitis A virus
- HBV sub-genotypes
- HBV, hepatitis B virus
- HBV/D
- HBsAg
- HBsAg, HBV surface antigen
- HCC, hepatocellular carcinoma
- HCV, hepatitis C virus
- Hepatitis B virus
- IFN, interferon
- P, HBV polymerase gene
- PCR, polymerase chain reaction
- Population studies
- Pre S1/Pre S2/S, HBsAg genes
- Viral isolates
- X, HBV X gene
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Affiliation(s)
- Sahar El Hadad
- Department of Biological Science, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Saleha Alakilli
- Department of Biological Science, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Samar Rabah
- Department of Biological Science, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jamal Sabir
- Department of Biological Science, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
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Ximenes RAA, Figueiredo GM, Cardoso MRA, Stein AT, Moreira RC, Coral G, Crespo D, dos Santos AA, Montarroyos UR, Braga MC, Pereira LMMB. Population-Based Multicentric Survey of Hepatitis B Infection and Risk Factors in the North, South, and Southeast Regions of Brazil, 10-20 Years After the Beginning of Vaccination. Am J Trop Med Hyg 2015; 93:1341-1348. [PMID: 26503280 PMCID: PMC4674256 DOI: 10.4269/ajtmh.15-0216] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/07/2015] [Indexed: 12/11/2022] Open
Abstract
A population-based hepatitis survey was carried out to estimate the prevalence of hepatitis B virus (HBV) infection and its predictive factors for the state capitals from the north, south, and southeast regions of Brazil. A multistage cluster sampling was used to select, successively, census tracts, blocks, households, and residents in the age group 10-69 years in each state capital. The prevalence of hepatitis B surface antigen (HBsAg) was lower than 1% in the north, southeast, and south regions. Socioeconomic condition was associated with HBV infection in north and south regions. Variables related to the blood route transmission were associated with HBV infection only in the south whereas those related to sexual behavior were associated with HBV infection in the north and south regions. Drug use was associated in all regions, but the type of drug differed. The findings presented herein highlight the diversity of the potential transmission routes for hepatitis B transmission in Brazil. In one hand, it reinforces the importance of national control strategies of large impact already in course (immunization of infants, adolescents, and adults up to 49 years of age and blood supply screening). On the other hand, it shows that there is still room for further control measures targeted to different groups within each region.
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Affiliation(s)
- Ricardo A. A. Ximenes
- *Address correspondence to Ricardo A. A. Ximenes, Faculdade de Ciências Médicas de Pernambuco, Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco, Rua Arnóbio Marques, 310, Santo Amaro, CEP 50100-130, Recife, Pernambuco, Brazil. E-mail:
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Al-hamoudi W, Elsiesy H, Bendahmash A, Al-masri N, Ali S, Allam N, Al Sofayan M, Al Bahili H, Al Sebayel M, Broering D, Saab S, Abaalkhail F. Liver transplantation for hepatitis B virus: Decreasing indication and changing trends. World J Gastroenterol 2015; 21:8140-8147. [PMID: 26185387 PMCID: PMC4499358 DOI: 10.3748/wjg.v21.i26.8140] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/12/2015] [Accepted: 04/17/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the indication and outcome of hepatitis B virus (HBV)-related liver transplantation (LT) in the era of newer antiviral agents.
METHODS: We collected data on all patients who underwent transplantation at King Faisal Specialist Hospital and Research Center. These data included demographic, perioperative and long-term postoperative follow-up data including viral serological markers, HBV DNA, and repeated liver imaging. Between January 1990 and January 2012, 133 patients (106 males and 27 females) underwent LT for HBV-related cirrhosis at our center. All patients were followed up frequently during the first year following transplantation, according to our standard protocol; follow-up visits occurred every 3-6 mo thereafter. Breakthrough infection was defined as re-emergence of HBV-DNA or hepatitis B surface antigen (HBsAg) while on treatment. Five patients transplanted prior to 1992 did not receive immediate posttransplant anti-HBV prophylaxis; all other patients were treated with HBIG and at least one nucleos(t)ide analog.
RESULTS: One hundred and thirty-three patients underwent LT for HBV and were followed for a median of 82 mo (range: 1-274). The rates of post-LT survival and HBV recurrence during the follow-up period were 89% and 11%, respectively. The following factors were associated with disease recurrence: younger age (44.3 ± 16.2 years vs 51.4 ± 9.9 years, P = 0.02), positive pretransplant hepatitis B e antigen (HBeAg) (60% vs 14%, P < 0.0001), detectable pretransplant HBV DNA (60% vs 27%, P = 0.03), positive posttransplant HBsAg (80% vs 4%, P < 0.0001) and positive posttransplant HBeAg (27% vs 1%, P < 0.0001). Forty-four (33%) patients had hepatocellular carcinoma (HCC). In the first (pre-2007) group, HBV was the second leading indication for LT after hepatitis C virus infection. A total of 64 transplants were performed, including 46 (72%) for decompensated HBV cirrhosis, 12 (19%) for decompensated cirrhosis complicated by HCC and 6 (10%) for compensated cirrhosis complicated by HCC. In the second group, nonalcoholic steatohepatitis surpassed HBV as the second leading indication for LT. A total of 69 HBV related transplants were performed, including 43 (62%) for decompensated HBV cirrhosis, 7 (10%) for decompensated cirrhosis complicated by HCC and 19 (27.5%) for compensated cirrhosis complicated by HCC. There was a significant (P = 0.007) increase in the number of transplants for compensated cirrhosis complicated by HCC.
CONCLUSION: The use of potent anti-HBV agents has led to a changing trend in the indications for LT. HBV is currently the third leading indication for LT in this hyperendemic area.
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Salman K, Rashmi, Priti S, Molly M, Kumar VS, Zeenat S. Hepatitis B virus infection in pregnant women and transmission to newborns. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2015. [DOI: 10.1016/s2222-1808(15)60809-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Aljarbou AN. The Emergent Concern of Hepatitis B globally with special attention to Kingdom of Saudi Arabia. Int J Health Sci (Qassim) 2014; 7:333-40. [PMID: 24533027 DOI: 10.12816/0006062] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Chronic viral hepatitis is highly prevalent and creates a substantial burden to healthcare systems globally. The World Health Organization (WHO) estimates that over 350 and 250 million people worldwide are chronic carrier of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection respectively. These two diseases are the cause of significant global mortality and morbidity with approximately 1 million deaths each year attributable to them and their sequelae, liver disease and primary liver cancer. Although the efforts have been met with the long-lasting level of success and holds the promise for large reductions in disease burden in spite of the huge numbers of HBV infected population. The viral hepatitis has also been emerged as a leading public health concern and continues to be major disease burden in the Eastern Mediterranean. The WHO, estimates that approximately 4.3 million persons are infected with HBV in the Region each year. Saudi Arabia has been classified as a country with an intermediate prevalence of HBV showed up to 7% in Saudi children in late 1980s but declined to as low as 0.3% in 1997 since the introduction of universal vaccination of all Saudi children in 1989. In spite of this remarkable decline, the burden of decompensated liver disease secondary to hepatitis B is estimated to increase drastically in the next 40 years as the previously infected children start aging.
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Affiliation(s)
- Ahmad N Aljarbou
- Department of Pharmaceutics, College of Pharmacy, Qassim University, Buraidah, Saudi Arabia
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Alqahtani JM, Abu-Eshy SA, Mahfouz AA, El-Mekki AA, Asaad AM. Seroprevalence of hepatitis B and C virus infections among health students and health care workers in the Najran region, southwestern Saudi Arabia: the need for national guidelines for health students. BMC Public Health 2014; 14:577. [PMID: 24912684 PMCID: PMC4059075 DOI: 10.1186/1471-2458-14-577] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 05/28/2014] [Indexed: 12/11/2022] Open
Abstract
Background The objectives of the study were to study the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among health college students (HS) and health care workers (HCWs) in the Najran Region of south-western Saudi Arabia and to study the students’ knowledge of occupational exposure to blood-borne viral infections. Methods A cross-sectional study of a representative sample of 300 HS and 300 HCWs was conducted. Results An overall seroprevalence of HBV of 1.7% and 8.7% was found among HS and HCWs, respectively. Two-thirds of HS (66.7%, 200) and 23.3% (70) of HCWs lack anti-HBs and are susceptible to HBV infection. An overall seroprevalence of HCV of 0% and 0.3% was found among the HS and HCWs, respectively. The present study indicates poor knowledge among HS and moderate knowledge among HCWs regarding occupationally transmitted blood-borne diseases, safe injection practices, and standard precautions to prevent occupationally transmitted blood-borne infections. Conclusion It is mandatory to develop a structured program to raise awareness among HS, and current health colleges’ curricula should be upgraded to address these issues early. The HS should be considered new recruits to health services in terms of their initial screening for blood-borne infections and vaccination against HBV. The development of a novel continuing medical education and pre-employment awareness program for HCWs is recommended to address the following: blood-borne diseases transmitted occupationally, standard precautions to prevent occupationally transmitted blood borne infections, and safe injection practices.
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Affiliation(s)
| | | | - Ahmed A Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, P,O, Box 641, Saudi Arabia.
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Al Ghamdi SS, Fallatah HI, Fetyani DM, Al-Mughales JA, Gelaidan AT. Long-term efficacy of the hepatitis B vaccine in a high-risk group. J Med Virol 2014; 85:1518-22. [PMID: 23852676 DOI: 10.1002/jmv.23658] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2013] [Indexed: 12/26/2022]
Abstract
Chronic infection with hepatitis B virus (HBV) is a global health problem. In an attempt to control infection, worldwide HBV vaccination programs have been established. Saudi Arabia, an endemic area for HBV infection, established an HBV immunization program in 1989. This cross-sectional study evaluates the long-term protection of HBV vaccination 14-24 years after primary immunization in a high-risk group (clinical year medical students) at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. All participants had complete HBV immunization at birth or in early childhood. Hepatitis B surface antibody (anti-HBs) levels were obtained. An anti-HBs titer of <10 mIU/ml indicated no protection, while a titer of >10 mIU/ml was considered to represent protective immune status. A total of 238 students were included; they were predominantly females (n = 182, 76.5%). Mean age was 22.2 ± 1.1 years. Duration since primary vaccination was 19.8 ± 2.3 years. Female students were more likely to maintain long-term protection compared to males (62.1% and 58.8%, respectively). Anti-HBs levels were significantly low in many students after primary immunization. Testing medical students for anti-HBs levels may be warranted as they represent a high-risk population. The higher rate of vaccine failure in males than females requires further investigation as it may explain the higher prevalence of HBV in the male population.
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Affiliation(s)
- Sarah S Al Ghamdi
- Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
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Abaalkhail F, Elsiesy H, AlOmair A, Alghamdi MY, Alalwan A, AlMasri N, Al-Hamoudi W. SASLT practice guidelines for the management of hepatitis B virus. Saudi J Gastroenterol 2014; 20:5-25. [PMID: 24496154 PMCID: PMC3952421 DOI: 10.4103/1319-3767.126311] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Faisal Abaalkhail
- Department of Liver and Small Bowel Transplantation, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hussien Elsiesy
- Adult Transplant Hepatology, Organ Transplant Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ahmed AlOmair
- Department of Medicine, Gastroenterology Unit, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed Y. Alghamdi
- Department of Gastroenterology, King Fahad Military Medical Complex, Dharan, Saudi Arabia
| | - Abduljaleel Alalwan
- Hepatobiliary Sciences and Liver Transplantation, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Nasser AlMasri
- Department of Gastroenterology, Prince Sultan Medical Military City, Riyadh, Saudi Arabia
| | - Waleed Al-Hamoudi
- Adult Transplant Hepatology, Organ Transplant Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Gastroenterology Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Gasim GI. Hepatitis B virus in the Arab world: where do we stand? Arab J Gastroenterol 2013; 14:35-43. [PMID: 23820498 DOI: 10.1016/j.ajg.2013.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Revised: 03/28/2013] [Accepted: 04/21/2013] [Indexed: 12/12/2022]
Abstract
The epidemiology of viral hepatitis is of great importance for planning and managing health provision for all the countries in the Arab world. However, data on viral hepatitis are not readily available in a large percentage of Arab countries. Hepatitis B virus (HBV) is considered to be one of the most important causes of chronic hepatitis, cirrhosis and hepatocellular carcinoma. A systematic electronic search of published literature was conducted to extract data on epidemiology and risk factors for the analysis of HBV infection among the countries in the Arab world. The prevalence of chronic HBV infection was found to be decreasing in some Arab countries although it was still unacceptably high. This was particularly evident in the Arabian Gulf region, in Lebanon, Egypt and Libya. The age-specific prevalence varied from country to country with decline in prevalence being noted among children in the Gulf States and among Libyan women. These declines in prevalence are most likely to be related to the Expanded Immunization Programme. The alarmingly high prevalence of chronically infected patients in some areas and the widespread differences in HBV prevalence between Arab nations may be explained by the variation in risk factors involved. This situation calls for targeted approaches to tackle HBV-related mortality and morbidity. Precise HBV infection prevalence data are needed at the national and the sub-national level to estimate the disease burden, guide health intervention programmes and evaluate vaccine efficiency.
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Saadah OI, Sindi HH, Bin-Talib Y, Al-Harthi S, Al-Mughales J. Entecavir treatment of children 2-16 years of age with chronic hepatitis B infection. Arab J Gastroenterol 2012; 13:41-4. [PMID: 22980589 DOI: 10.1016/j.ajg.2012.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Revised: 01/25/2012] [Accepted: 04/02/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND STUDY AIMS Childhood acquired chronic hepatitis B is associated with a significant lifetime risk of developing cirrhosis or hepatocellular carcinoma. Our objective in this study was to report retrospectively the response to treatment with Entecavir in 8 children with chronic hepatitis B followed at the King Abdulaziz University Hospital, Jeddah, Saudi Arabia. PATIENTS AND METHODS This study is an observational hospital based chart review of children and adolescents with chronic hepatitis B treated with entecavir at the King Abdulaziz University Hospital, Jeddah, Saudi Arabia in the period between June 2007 and July 2011. RESULTS Half of the studied group was males, and the median age at the time of treatment was 4.8 years (range, 2.6-15). All subjects displayed infection with HBV genotype D and all were HBeAg positive. Half of the patients had been previously treated with lamivudine, while the remaining half was treatment naïve patients. The mean ALT±SD was 84.9±34.7IU/L (range, 46-133) and the mean HBV DNA was 5.01×10(8)±5.7×10(8) IU/mL (range, 5.5×10(7)-1.3×10(9)). Patients were treated with a daily oral dose of 0.5mg entecavir, and the mean duration of treatment was 23.8±11.9 months, (range 14.9-44.7 months). HBV DNA suppression of more than 2 log(10) was achieved in all patients. HBV DNA was undetected in 37.5%, with ALT normalization in 87.5% and lastly HBeAg seroconversion and loss occurred in 37.5%. No adverse side effects were observed during the treatment with entecavir. CONCLUSION We conclude from this limited data that 37.5% of children treated with entecavir achieved HBeAg loss and seroconversion with no side effects observed during treatment period, however long term safety and efficacy in children should be demonstrated through a multicenter study, enrolling large number of patients.
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Affiliation(s)
- Omar I Saadah
- Department of Paediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
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Abdo AA, Hassanain M, AlJumah A, Al Olayan A, Sanai FM, Alsuhaibani HA, Abdulkareem H, Abdallah K, AlMuaikeel M, Al Saghier M, Babatin M, Kabbani M, Bazarbashi S, Metrakos P, Bruix J. Saudi guidelines for the diagnosis and management of hepatocellular carcinoma: technical review and practice guidelines. Ann Saudi Med 2012; 32:174-99. [PMID: 22366832 PMCID: PMC6086640 DOI: 10.5144/0256-4947.2012.174] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Recognizing the significant prevalence of hepatocellular carcinoma (HCC) in Saudi Arabia, and the difficulties often faced in early and accurate diagnoses, evidence-based management, and the need for appropriate referral of HCC patients, the Saudi Association for the Study of Liver diseases and Transplantation (SASLT) formed a multi-disciplinary task force to evaluate and update the previously published guidelines by the Saudi Gastroenterology Association. These guidelines were later reviewed, adopted and endorsed by the Saudi Oncology Society (SOS) as its official HCC guidelines as well. The committee assigned to revise the Saudi HCC guidelines was composed of hepatologists, oncologists, liver surgeons, transplant surgeons, and interventional radiologists. Two members of the task force served as guidelines editors. A wide based search on all published reports on all aspects of the epidemiology, natural history, risk factors, diagnosis, and management of HCC was performed. All available literature was critically examined and available evidence was then classified according to its strength. The whole document and the recommendations were then discussed in detail by members and consensus was obtained. All recommendations in these guidelines were based on the best available evidence, but were tailored to the patients treated in Saudi Arabia. We hope that these guidelines will improve HCC patient care and enhance the multidisciplinary care needed for these patients.
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Affiliation(s)
- Ayman A Abdo
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Abstract
Some 400 million people worldwide are currently infected with the hepatitis B virus (HBV), and the infection is common in the Middle East. Another 170 million people around the globe presently live with chronic hepatitis C virus (HCV) infection. Both HBV and HCV represent a worldwide epidemic. Despite significant decline in the prevalence of HBV and HCV infection in Saudi Arabia, these viral diseases cause significant morbidity and mortality, and impose a great burden on the country's healthcare system. On the other hand, Saudi epidemiology studies have shown that the hepatitis A virus seroprevalence in the country has reduced considerably over the past two decades. The progress in mapping the epidemiological pattern of viral hepatitis in Saudi Arabia has not only aided our understanding of the disease, but has also exposed the small but relevant gaps in our identification of the intricate details concerning the disease's clinical expression. In this review, we aim to document the timeline of viral hepatitis epidemiology in Saudi Arabia, while summarizing the relevant published literature on the subject.
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Affiliation(s)
- Ayman A. Abdo
- Department of Medicine, Gastroenterology Unit, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia,Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia,Address for correspondence: Dr. Ayman A. Abdo, Gastroenterology Unit, Department of Medicine, King Khalid University Hospital, College of Medicine, King Saud University, PO Box 2925 (59), Riyadh - 11461, Saudi Arabia. E-mail:
| | - Faisal M. Sanai
- Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia,Hepatobiliary Sciences and Liver Transplantation, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Faleh Z. Al-Faleh
- Department of Medicine, Gastroenterology Unit, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia,Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia
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30
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Abstract
Experts from seven countries convened as a Specialist Panel for the Middle East to share information on practical issues relating to the epidemiology, diagnosis and management of chronic hepatitis B (CHB) infection. The Middle East is regarded as a region of high-to-intermediate epidemicity; however, infant vaccination programmes have successfully lowered the prevalence of hepatitis B infection in most countries to that of low-to-intermediate endemicity. Vaccine issues still to be addressed included improving coverage in some rural/poor communities, instituting hepatitis B vaccine at birth and providing vaccines for high-risk population groups. Hepatitis B infection in the Middle East primarily occurs as a result of perinatal infection, horizontal transmission between family members and transmission from injections. Blood transfusion services have broadly efficient screening programmes, but immunocompromised and haemodialysis patients are at risk. The cost of screening, monitoring and treating CHB influences practice in a number of Middle East countries, and there is a need for information on the most cost-effective options.
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Seroprevalence of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus infections in patients with hereditary hemoglobinopathies from Saudi. EGYPTIAN LIVER JOURNAL 2011. [DOI: 10.1097/01.elx.0000403169.58285.4f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Livramento AD, Cordova CMMD, Spada C, Treitinger A. Seroprevalence of hepatitis B and C infection markers among children and adolescents in the southern Brazilian region. Rev Inst Med Trop Sao Paulo 2011; 53:13-7. [PMID: 21412614 DOI: 10.1590/s0036-46652011000100003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Accepted: 10/27/2010] [Indexed: 01/04/2023] Open
Abstract
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a substantial proportion of liver diseases worldwide. The aim of this study was to determine the prevalence of HBV and HCV serological markers among children and adolescents and verify the epidemiology of the HBV infection over than a decade of the introduction of vaccination program. Serologic markers to HBsAg, total anti-HBc and anti-HCV had been tested in 393 samples. The seropositivity for HBsAg was 0.76% and for total anti-HBc was 1.02%. Copositivity between HBsAg and total anti-HBc was verified in 0.76% of the analyzed samples. There was no seropositivity for anti-HCV marker. The seroprevalence of HBV infection markers among children and adolescents in the southern Brazilian region is high compared to that reported in other countries. Preventive measures, such as educational activities in addition to the universal childhood HBV vaccination, should be initiated in order to reduce the morbimortality and the economic burden associated with the disease.
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Affiliation(s)
- Andréa do Livramento
- Programa de Pós-graduação em Farmácia, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
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34
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Abushady EA, Gameel MM, Klena JD, Ahmed SF, Abdel-Wahab KS, Fahmy SM. HBV vaccine efficacy and detection and genotyping of vaccineé asymptomatic breakthrough HBV infection in Egypt. World J Hepatol 2011; 3:147-56. [PMID: 21860674 PMCID: PMC3159495 DOI: 10.4254/wjh.v3.i6.147] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 05/15/2011] [Accepted: 05/22/2011] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the impact of mass vaccination against the hepatitis B virus (HBV) in Egypt, and to search for vaccinee asymptomatic breakthrough HBV infection and its genotype. METHODS Seven hundred serum samples from vaccinated children and adults (aged 2-47 years) were used for quantitative and qualitative detection of HBsAb by ELISA. Three hundred and sixty serum samples representing undetectable or low or high HBsAb were screened for markers of active HBV infection (HBsAg, HBcAb (IgG) and HBeAb by ELISA, plus HBsAg by AxSYM) and HBV-DNA genotyping by nested multiplex PCR and by DNA sequencing. RESULTS It was found that 65% of children aged 2-4 years, and 20.5% aged 4-13 years, as well as 45% adults were good responders to HBV vaccination mounting protective level HBsAb. Poor responders were 28%, 59.5% and 34%, and non-responders were 7%, 20% and 21% respectively, in the three studied groups. Markers of asymptomatic HBV infections were HBsAg detected by ELISA in 2.5% vs 11.39% by AxSYM. Other markers were HBcAb (IgG) in 1.38%, HBeAb in 0.83%, and HBV-DNA in 7.8%. All had HBV genotype E infection. CONCLUSION It is concluded that HBV vaccine is efficient in controlling HBV infection among children and adults. The vaccine breakthrough infection was by HBV genotype E. A booster dose of vaccine is recommended, probably four years after initial vaccination.
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Affiliation(s)
- Eman Ae Abushady
- Eman AE Abushady, Microbiology department, Faculty of Medicine Nourthern Border University, Arar 1321, Saudi Arabia
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Abstract
The combination of chronic hepatitis B virus (HBV) infection and pregnancy presents unique management questions. Aspects of care that need to be considered include effects of hepatitis B on pregnancy, effects of pregnancy itself on the course of hepatitis B infection, treatment of hepatitis B during pregnancy and prevention of mother-to-infant transmission. Chronic HBV infection is usually mild in pregnant women, but may flare shortly after delivery. Effect of HBV infection on pregnancy outcomes are generally favorable, but may depend on severity of liver disease. Mother-to-infant transmission can be minimized by current immunoprophylaxis strategies, however, high levels of viremia in mothers may be a factor in the small but reproducible failure rate of current immunoprophylaxis strategies. Use of antivirals during pregnancy needs to be individualized. Careful planning and management of pregnancy must be done among patients with chronic HBV infection.
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Affiliation(s)
- Swati Sinha
- Department of Obstetrics and Gynecology, Sitaram Bhartia Institute of Science and Research
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36
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Rots NY, Wijmenga-Monsuur AJ, Luytjes W, Kaaijk P, de Graaf TW, van der Zeijst BAM, Boog CJP. Hepatitis B vaccination strategies tailored to different endemicity levels: some considerations. Vaccine 2009; 28:893-900. [PMID: 19932217 DOI: 10.1016/j.vaccine.2009.10.125] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Revised: 05/25/2009] [Accepted: 10/23/2009] [Indexed: 01/05/2023]
Abstract
Hepatitis B is a serious public health problem. Worldwide three different levels of hepatitis B endemicity (high, intermediate and low) can be distinguished. Areas with different levels of endemicity require tailored vaccination strategies to fit the needs for individuals at risk and/or countries, depending on the infection risk per age group, vaccination rate, duration of protection after vaccination, cost effectiveness of vaccination strategies and ease of implementation in the national immunization schedules.This opinion paper evaluates these factors and proposes a combination of infant risk group and universal adolescent vaccination for low endemic countries thus targeting the different groups at risk. A universal infant vaccination schedule starting with a newborn vaccination within 24h after birth is more appropriate in intermediate- and high-endemic regions.
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Affiliation(s)
- N Y Rots
- Netherlands Vaccine Institute (NVI), Regulatory and Medical Unit (RMU), Bilthoven, The Netherlands.
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Memish ZA, Knawy BA, El-Saed A. Incidence trends of viral hepatitis A, B, and C seropositivity over eight years of surveillance in Saudi Arabia. Int J Infect Dis 2009; 14:e115-20. [PMID: 19540786 DOI: 10.1016/j.ijid.2009.03.027] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2009] [Revised: 03/25/2009] [Accepted: 03/29/2009] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES In Saudi Arabia, viral hepatitis ranked the second most common reportable viral disease in 2007, with almost 9000 new cases diagnosed in that year. The objective of this study was to determine the incidence trends of viral hepatitis seropositivity among the population served by the National Guard Health Affairs (NGHA) hospitals in the central, eastern, and western Saudi Arabia regions. METHODS The surveillance system at King Abdulaziz Medical City in Riyadh receives weekly reports of laboratory confirmed hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV) cases from all NGHA-served regions. In this study the viral hepatitis surveillance data for the period from January 2000 through December 2007 were analyzed. RESULTS Between 2000 and 2007, a total of 14 224 seropositive cases of viral hepatitis were reported to the surveillance system. The average annual incidence of seropositivity per 100 000 served population was highest for HBV (104.6), followed by HCV (78.4), and lowest for HAV (13.6). Saudis had higher HBV and HAV incidence, but lower HCV incidence compared to non-Saudis. Over the eight years (2000-2007), the incidence of all three viral hepatitis types showed a 20-30% declining trend. Only HAV incidence followed a clear seasonal cyclic pattern. CONCLUSIONS Despite the declining trend over the eight-year period, viral hepatitis, especially that caused by HBV and HCV, remains a major public health problem in Saudi Arabia, and has probably been underestimated in previous reports. There is a need for more comprehensive prevention strategies.
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Affiliation(s)
- Ziad A Memish
- Department of Infection Prevention and Control, King Abdulaziz Medical City, PO Box 22490, Riyadh 11426, Saudi Arabia.
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Jimenez AP, El-Din NS, El-Hoseiny M, El-Daly M, Abdel-Hamid M, El Aidi S, Sultan Y, El-Sayed N, Mohamed MK, Fontanet A. Community transmission of hepatitis B virus in Egypt: results from a case-control study in Greater Cairo. Int J Epidemiol 2009; 38:757-65. [DOI: 10.1093/ije/dyp194] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Resuli B, Prifti S, Kraja B, Nurka T, Basho M, Sadiku E. Epidemiology of hepatitis B virus infection in Albania. World J Gastroenterol 2009; 15:849-52. [PMID: 19230046 PMCID: PMC2653385 DOI: 10.3748/wjg.15.849] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the prevalence and socio-demographic distribution of hepatitis B virus (HBV) infection in Albania.
METHODS: Blood samples from 410 unselected schoolboys, 666 students, 500 military personnel, 1286 casual blood donors, 378 voluntary blood donors and 640 pregnant women (total 3880 non-vaccinated residents of rural and metropolitan areas from all over Albania; 2354 (60.7%) male and 1526 (39.3%) female; mean age of 26.3 years) were tested during 2004-2006 for hepatitis B surface antigen (HBsAg) and antibodies to hepatitis B virus (anti-HBs) by ELISA.
RESULTS: The HBsAg and anti-HBs prevalence were 9.5% and 28.7%, respectively. The highest HBsAg prevalence was evident in the younger age group, such as in schoolchildren (11.8%) and the military (10.6%). Consequently, the anti-HBs prevalence increased with age, from 21.2% in schoolchildren (mean age: 15.7 years), to 36.3% in pregnant women (mean age: 26.3 years) and 29.7% in voluntary blood donors (mean age: 40.1 years). There were no significant differences between males and females.
CONCLUSION: Despite the estimated two-fold reduction of HBsAg prevalence in the general population from about 18%-19% to 9.5%, Albania remains a highly endemic country (i.e. over 8% of HBsAg prevalence rate).
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Alfaleh F, Alshehri S, Alansari S, Aljeffri M, Almazrou Y, Shaffi A, Abdo AA. Long-term protection of hepatitis B vaccine 18 years after vaccination. J Infect 2008; 57:404-9. [PMID: 18829116 DOI: 10.1016/j.jinf.2008.08.008] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2008] [Accepted: 08/22/2008] [Indexed: 12/17/2022]
Abstract
INTRODUCTION This is the third evaluation study of the hepatitis B virus (HBV) vaccination program, initiated in 1989 in Saudi Arabia. AIMS This study sought to assess the efficacy and long-term protection of the hepatitis B vaccine among Saudi adolescents. METHODS School students between the ages of 16 and 18 years were randomly chosen from high endemic (Aseer), intermediate endemic (Madinah), and low endemic (Al-Qaseem) areas of the country. Hepatitis B surface antigen (HBsAg), hepatitis B core IgG antibody (anti-HBc), and hepatitis B surface antibody (anti-HBs) were measured using standard techniques. RESULTS A total of 1355 students (689 males and 666 females) were selected randomly from the three areas. No cases of positive HBsAg or anti-HBc were detected among the study population. Five hundred and ten students (38%) showed protective anti-HBs titers (>/= 10mIU/ml), while 528 (39%) students had undetectable anti-HBs titers (<1 mIU/ml). CONCLUSIONS This study shows the excellent efficacy of the HBV vaccination program in Saudi Arabia 18 years after its launch. Based on this study and others, a booster dose for the adult population appears to be unnecessary.
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Affiliation(s)
- Faleh Alfaleh
- Department of Medicine, College of Medicine, King Saud University, P.O. Box 2925(59), Riyadh 11461, Saudi Arabia
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El Beltagy KE, Al Balawi IA, Almuneef M, Memish ZA. Prevalence of hepatitis B virus markers among blood donors in a tertiary hospital in Tabuk, northwestern Saudi Arabia. Int J Infect Dis 2008; 12:495-9. [PMID: 18400539 DOI: 10.1016/j.ijid.2008.01.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Revised: 12/17/2007] [Accepted: 01/21/2008] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE This study was carried out to determine the prevalence of hepatitis B virus (HBV) markers among blood donors in a tertiary hospital in Tabuk, northwestern Saudi Arabia. MATERIALS AND METHODS A cross-sectional survey was done among male Saudi voluntary blood donors at the blood bank of the King Khalid tertiary care hospital in the northwest region of Saudi Arabia. A total of 3192 subjects were included in the study over the period from June 1, 2005 to May 31, 2006. Subjects were tested for evidence of HBV infection plus other relevant blood-borne pathogens. A questionnaire sheet for the collection of personal information (such as name, age, and sex), socioeconomic data (such as marital status, education, and occupation), family history of HBV infection, history of immunization against HBV, and history of past exposure to a high risk procedure or behavior, was prepared and used for each subject. Data were tabulated and statistically analyzed. RESULTS Among the studied sample, the prevalence of HBsAg (hepatitis B surface antigen) was found to be 3.0% and the prevalence of anti-HBc (anti-hepatitis B core antigen) was found to be 18.7%. Blood donors with positive HBV markers showed significant association with increased age, being married, lower educational level, specific occupations such as blue collar worker and the military, family history of HBV infection, and lack of immunization. However, there was no significant association with history of exposure to high-risk procedure or behavior. CONCLUSIONS The prevalence of HBV infection among male Saudi blood donors in the northwest region of Saudi Arabia is high compared to that reported from the central capital area (Riyadh). Public health education programs on HBV infection, adult hepatitis B immunization programs, and raising socioeconomic standards should be initiated in order to target the high-risk groups found in this study. Furthermore, a community-based study is recommended to investigate HBV infection in the northwest region of Saudi Arabia.
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Affiliation(s)
- Kamel E El Beltagy
- Department of Infection Prevention and Control, King Abdulaziz Medical City, PO Box 22490, Riyadh 11426, Saudi Arabia
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Papaevangelou V, Hadjichristodoulou C, Cassimos DC, Pantelaki K, Tzivaras A, Hatzimichael A, Theodoridou M. Seroepidemiology of hepatitis B in Greek children 6 years after the implementation of universal vaccination. Infection 2008; 36:135-9. [PMID: 18231718 DOI: 10.1007/s15010-007-7096-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2007] [Accepted: 08/16/2007] [Indexed: 12/13/2022]
Abstract
The seroepidemiology of hepatitis B in children living in Greece 6 years post-implementation of universal infant immunization (1998) was studied. We collected 90-100 sera/year of age, stratified by geographic region. The prevalence of HbsAg(+) was 0.6% (95% CI 0.3-1.3) whereas 4.5% (95% CI 3.4-5.9%) of children over 12 months of age had evidence of past HBV infection. A significant decline in the prevalence of past infection between children born before and after 1998 (5.5% vs 2.9%; RR = 1.9, 95% CI 1.03-3.5) was noted. Conversely, the prevalence of past HBV infection did not change significantly among immigrant children. Reinforcement of early vaccination of immigrant population is necessary.
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Affiliation(s)
- V Papaevangelou
- 2nd Dept. of Pediatrics, University of Athens, "A. Kyriakou" Children's Hospital, Thivon and Livadias str, Goudi, Athens 11527, Greece.
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Madani TA. Trend in incidence of hepatitis B virus infection during a decade of universal childhood hepatitis B vaccination in Saudi Arabia. Trans R Soc Trop Med Hyg 2007; 101:278-83. [PMID: 16600318 DOI: 10.1016/j.trstmh.2005.12.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2005] [Revised: 10/21/2005] [Accepted: 12/04/2005] [Indexed: 11/19/2022] Open
Abstract
Since 1990, the national strategy to eliminate hepatitis B virus (HBV) infection in Saudi Arabia has included universal administration of HBV vaccine to all infants. From 1990 to 1995 this vaccine was also routinely administered to children at school entry. The prevalence of hepatitis B surface antigen (HBsAg) among children before this programme was reported to be 6.7%. The objective of this study was to describe the trend in incidence of HBV infection over a decade of surveillance following the introduction of this programme. From January 1990 to December 1999 a total of 30,784 cases of HBV infection (positive for HBsAg) were reported. The total number of HBV infections among children <15 years of age was 4180 cases, with a prevalence of 0.05%. The total number of HBV infections among adults was 26,604 cases, with a prevalence of 0.22%. The prevalence varied by region, ranging from 0.03% to 0.72% with a mean prevalence of 0.15%. There was a clear decline in incidence among children whereas the incidence in adults slightly rose, perhaps owing to population growth estimated to be 3.3% annually. This study showed that the universal childhood HBV vaccination programme had an enormous positive impact on HBsAg seroprevalence among children in Saudi Arabia.
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Affiliation(s)
- Tariq A Madani
- Ministry of Health, Riyadh, and Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
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Abdo AA, Al-Jarallah BM, Sanai FM, Hersi AS, Al-Swat K, Azzam NA, Al-Dukhayil M, Al-Maarik A, Al-Faleh FZ. Hepatitis B genotypes: relation to clinical outcome in patients with chronic hepatitis B in Saudi Arabia. World J Gastroenterol 2006; 12:7019-24. [PMID: 17109498 PMCID: PMC4087347 DOI: 10.3748/wjg.v12.i43.7019] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2006] [Revised: 09/15/2006] [Accepted: 09/27/2006] [Indexed: 02/06/2023] Open
Abstract
AIM To identify the most common hepatitis B virus (HBV) genotype in Saudi Arabia, and correlate the prevailing genotypes with the clinical outcome of patients. METHODS Patients were consecutively recruited from the hepatology clinics of two tertiary care referral centers. Patients were categorized into 4 different groups: group 1, patients with hepatitis B and normal liver enzymes; group 2, patients with hepatitis B and abnormal liver enzymes but without cirrhosis; group 3, patients with hepatitis B and liver cirrhosis; group 4, patients with hepatitis B and hepatocellular carcinoma. All patients had a positive hepatitis B surface antigen (HBsAg). Genotyping of HBV was performed by nested PCR-mediated amplification of the target sequence and hybridization with sequence-specific oligonucleotides. RESULTS Seventy patients were enrolled in this study. They were predominantly male (72.9%) in their mid-forty's (mean age 47 years). Forty-nine (70%) patients were hepatitis B envelope antigen (HBeAg) negative. The majority of patients (64%) acquired HBV through unknown risk factors. Hepatitis B genotyping revealed that 57 patients (81.4%) were genotype D, 1 patient (1.4%) had genotype A, 1 patient (1.4%) had genotype C, and 4 patients (5.7%) had genotype E, while 7 patients (10%) had mixed genotype (4 patients ADG, 1 patient DE, 1 patient DF, and 1 patient ADFG). Based on univariate analysis of genotype D patients, significant predictors of advanced liver disease were age, gender, aspartate transaminase, alanine transaminase, albumin, bilirubin, and alkaline phosphatase (all P < 0.001). In multivariate analysis decreased hemoglobin (r = -0.05; 95% CI: -0.08 to -0.03; P = 0.001) and albumin levels (r = -0.004; 95% CI: -0.007 to -0.001; P = 0.002) were highly significant predictors of advanced liver disease. In patients with HBV genotype D, HBeAg negativity was found to increase across advancing stages of liver disease (P = 0.024). CONCLUSION This study highlights that the vast majority of Saudi patients with chronic hepatitis B have genotype D. No correlation could be observed between the different genotypes and epidemiological or clinical factors. The relationship between genotype D and HBeAg status in terms of disease severity needs to be further elucidated in larger longitudinal studies.
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Affiliation(s)
- Ayman A Abdo
- Gastroenterology Divison, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Chongsrisawat V, Yoocharoen P, Theamboonlers A, Tharmaphornpilas P, Warinsathien P, Sinlaparatsamee S, Paupunwatana S, Chaiear K, Khwanjaipanich S, Poovorawan Y. Hepatitis B seroprevalence in Thailand: 12 years after hepatitis B vaccine integration into the national expanded programme on immunization. Trop Med Int Health 2006; 11:1496-502. [PMID: 17002723 DOI: 10.1111/j.1365-3156.2006.01709.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To evaluate the impact of the universal hepatitis B (HB) vaccination programme on the prevalence of hepatitis B surface antigen (HBsAg) carriers and immunity to HB virus infection among children <18 years and to determine the HB seroprevalence in the Thai population. METHODS We enrolled people in four provinces, including Chiangrai, Udon Thani, Chonburi and Nakhon Si Thammarat to geographically represent populations in the North, Northeast, Center and South of the country respectively. Serology for HBsAg, anti-hepatitis B surface (anti-HBs), and anti-hepatitis B core (anti-HBc) was tested using ELISA commercial kits. In total, 6213 subjects aged 6 months to 60 years from the four provincial hospitals and two to three district hospitals of each participating province participated. RESULTS Overall HBsAg, anti-HBs, and anti-HBc seropositive rates amounted to 4%, 41.6% and 26.5% respectively. Of 2887 participants aged 6 months to 18 years, 2303 were born after (group I) and 584 prior to (group II) HB vaccine integration into the expanded programme on immunization of each participating province. The HBsAg seropositive rate was 0.7% among group I children and 4.3% among group II children. The prevalence rate of anti-HBc was 2.9% in group I and 15.8% in group II. In children under 18 years, the HBsAg carrier rate was 0.98% among complete vaccinees and 1.36% among participants without vaccination. CONCLUSIONS This finding supports the efficacy of universal HB immunization in reducing the prevalence of HB infection in Thailand which is a highly endemic country.
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Affiliation(s)
- Voranush Chongsrisawat
- Center of Excellence in Viral Hepatitis Research, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Mossong J, Putz L, Patiny S, Schneider F. Seroepidemiology of hepatitis A and hepatitis B virus in Luxembourg. Epidemiol Infect 2006; 134:808-13. [PMID: 16436219 PMCID: PMC2870464 DOI: 10.1017/s0950268805005789] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2005] [Indexed: 11/07/2022] Open
Abstract
A prospective seroepidemiological survey was carried out in Luxembourg in 2000-2001 to determine the antibody status of the Luxembourg population against hepatitis A virus (HAV) and hepatitis B virus (HBV). One of the objectives of this survey was to assess the impact of the hepatitis B vaccination programme, which started in May 1996 and included a catch-up campaign for all adolescents aged 12-15 years. Venous blood from 2679 individuals was screened for the presence of antibodies to HAV antigen and antibodies to hepatitis B surface antigen (anti-HBs) using an enzyme immunoassay. Samples positive for anti-HBs were tested for antibody to hepatitis B core antigen (anti-HBc) using a chemiluminiscent microparticle immunoassay to distinguish between individuals with past exposure to vaccine or natural infection. The estimated age-standardized anti-HAV seroprevalence was 42.0% [95% confidence interval (CI) 39.8-44.1] in the population >4 years of age. Seroprevalence was age-dependent and highest in adult immigrants from Portugal and the former Yugoslavia. The age-standardized prevalence of anti-HBs and anti-HBc was estimated at 19.7% (95% CI 18.1-21.3) and 3.16% (95% CI 2.2-4.1) respectively. Anti-HBs seroprevalence exceeding 50% was found in the cohorts targeted by the routine hepatitis B vaccination programme, which started in 1996. Our study illustrates that most young people in Luxembourg are susceptible to HAV infection and that the hepatitis B vaccination programme is having a substantial impact on population immunity in children and teenagers.
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Affiliation(s)
- J Mossong
- Laboratoire National de Santé, LuxembourgCRP-Santé, Luxembourg.
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Fitzsimons D, François G, Hall A, McMahon B, Meheus A, Zanetti A, Duval B, Jilg W, Böcher WO, Lu SN, Akarca U, Lavanchy D, Goldstein S, Banatvala J, Damme PV. Long-term efficacy of hepatitis B vaccine, booster policy, and impact of hepatitis B virus mutants. Vaccine 2005; 23:4158-66. [PMID: 15964484 DOI: 10.1016/j.vaccine.2005.03.017] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2005] [Accepted: 03/09/2005] [Indexed: 01/05/2023]
Abstract
The long-term efficacy of hepatitis B vaccine, long-term effectiveness of hepatitis B immunisation programmes, immune memory induced by hepatitis B vaccine, current booster policies, and impact of hepatitis B virus mutants on immunisation programmes were reviewed at the Viral Hepatitis Prevention Board (VHPB) meeting in Sevilla, Spain, March 2004. The main focus was on universal vaccination programmes with data being presented from Italy, Saudi Arabia, Singapore, Spain, Taiwan, Thailand, The Gambia, and USA (Alaska).
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Affiliation(s)
- David Fitzsimons
- World Health Organization, Via Appia 20, CH-1211 Geneva, Switzerland
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Amini-Bavil-Olyaee S, Sarrami-Forooshani R, Mahboudi F, Sabahi F, Adeli A, Noorinayer B, Azizi M, Reza Zali M. Genotype characterization and phylogenetic analysis of hepatitis B virus isolates from Iranian patients. J Med Virol 2005; 75:227-34. [PMID: 15602742 DOI: 10.1002/jmv.20261] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Hepatitis B virus (HBV) is one of the major causative agents of acute and chronic liver disease worldwide and is believed to be responsible for a million deaths annually. Eight genotypes of HBV, A to H, have been described on the basis of similarity of the complete genomes sequence. Although, it is reported that the predominant HBV genotype in the Mediterranean area and the middle east is genotype D, there are no reports on HBV genotypes prevalent in Iran. In this study, the C and S regions of HBV from 26 chronic hepatitis B Iranian patients were amplified and sequenced. Phylogenetic analysis revealed that all Iranian HBV isolates sequences were classified into genotype D with bootstrap values of 100%, 73%, and 100% (1,000 replicates each) for S, C, and preS2 regions, respectively. The mean percent intra-distance of S and C regions were 0.8% and 2.3%, respectively. The mean percent inter-distance of S and C regions between Iranians and genotype D isolates were 1.7% and 3.0%, respectively, and the range of mean percent nucleotide distance of S and C regions between Iranians and the other reference isolates were 7.9%-17.5% and 4.8%-14.7%, respectively. Thirteen out of 23 HBV C region sequences showed nucleotide "A" at position 1896 (precore mutant) in C region. Nucleotide 1858 showed presence of "T" in all isolates. No insertion or deletion was found in both regions. SimPlot and BootScanning analyses did not show any recombination between Iranian isolates and other genotypes in both regions.
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Bashawri LAM, Fawaz NA, Ahmad MS, Qadi AA, Almawi WY. Prevalence of seromarkers of HBV and HCV among blood donors in eastern Saudi Arabia, 1998-2001. ACTA ACUST UNITED AC 2005; 26:225-8. [PMID: 15163322 DOI: 10.1111/j.1365-2257.2004.00601.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The prevalence of serological markers of HBV and HCV were determined for blood donors in eastern Saudi Arabia. Between 1998 and 2001, 13,443 donors (10,778 Saudi and 2665 non-Saudi), were screened for HBsAg, anti-HBc Ab, and anti-HCV Ab using commercial kits. There was a steady decrease in the HBsAg (2.58 and 1.67%), anti-HBc rates (15.32 and 9.15%), and anti-HCV (1.04 and 0.59%) rates between 1998 and 2001, respectively. However, there was a marked difference between Saudi and non-Saudi donors with regard to anti-HBc (P < 0.001) and anti-HCV (P < 0.01), but not HBsAg prevalence rates in the same time period.
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Affiliation(s)
- L A M Bashawri
- Department of Hematology, College of Medicine, King Faisal University, Dammam, Saudi Arabia
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