Hepatitis B: Epidemiology and prevention in developing countries

Knowledge, attitude, and practices toward Hepatitis B infection among hemodialysis patients: A nationwide study in Jordan

The Hepatitis B virus (HBV) is a prevalent blood-borne illness, posing a significant risk to hemodialysis patients particularly due to their potential immunosuppressed status. This study aimed to address HBV awareness among Jordanian hemodialysis patients, filling a gap in regional research. A descriptive cross-sectional study was conducted at a multicenter governmental hospital in Jordan, with 389 participants. Among them, 61.3% were male, and 80.7% were over 38 years old. While 34% demonstrated a high level of knowledge, Participants with a higher degree of education and those working in the medical field were more informed. Although most participants had an inadequate understanding of HBV symptoms and transmission, they maintained positive attitudes and engaged in infection preventative actions. Enhanced educational efforts are required to raise awareness among hemodialysis patients, and further research is needed to address any reluctance towards preventive practices and seeking treatment.

Plant-based vaccines against viral hepatitis: A panoptic review

The traditional vaccines against hepatitis have been instrumental in reducing the incidence of some types of viral hepatitis; however, the need for cost-effective, easily distributable, and needle-free vaccine alternatives has led to the exploration of plant-based vaccines. Plant-based techniques offer a promising avenue for producing viral hepatitis vaccines due to their low-cost cultivation, scalability, and the potential for oral administration. This review highlights the successful expression of hepatitis B surface antigens in plants and the subsequent formation of virus-like particles, which have shown immunogenicity in preclinical and clinical trials. The challenges such as achieving sufficient antigen expression levels, ensuring consistent dosing, and navigating regulatory frameworks, are addressed. The review considers the potential of plant-based vaccines to meet the demands of rapid vaccine deployment in response to outbreaks and their role in global immunization strategies, particularly in resource-limited settings. This review underscores the significant strides made in plant molecular farming and the potential of plant-based vaccines to complement existing immunization methods against viral hepatitis.

Hepatitis B Management in the Middle East: A Narrative Review of Current Antiviral Treatments

Introduction: Chronic hepatitis B (CHB) is a significant public health issue worldwide, especially in the Middle East region. Around 8% to 20% of patients with CHB develop cirrhosis, which may progress to hepatocellular carcinoma. The significant morbidity and mortality associated with CHB denote the importance of high-quality treatment. Methods: We searched the PubMed, Medline, and Cochrane databases from inception to January 2024 to identify relevant studies. Search terms were generated using established treatment guidelines for CHB. We also manually searched the bibliographies of relevant literature to obtain additional papers. Results: In this narrative review, we evaluated the seven currently licensed antiviral therapies for chronic Hepatitis B treatment, including nucleos(t)ide analogs (NAs) and pegylated interferon-alpha (PEG-IFNα). NAs can be divided into two categories: high barrier to resistance and low barrier to resistance. Tenofovir disoproxil fumarate, tenofovir alafenamide, and entecavir are NAs with a high barrier to resistance. Telbivudine has shown promise in providing high efficacy with low viral resistance rates; however, it is not recommended because of insufficient evidence and lack of cost-effectiveness. Lamivudine and adefovir dipivoxil, despite being efficacious, have a low barrier to resistance, the primary reason they are no longer recommended. PEG-IFNα has high efficacy and can be completed in 48 weeks. It is not associated with resistance; however, it has been reported to have several systemic adverse effects. Conclusions: Current first-line NA treatments in the Middle East include entecavir, tenofovir disoproxil fumarate, and tenofovir alafenamide. These drugs are favored over other NAs because of their low rates of resistance. PEG-IFNα has superiority over NAs in inducing a more durable antiviral response and having a finite treatment duration. The main drawback of PEG-IFNα is an unfavorable safety profile.

Temporal Dynamics of Hepatitis B Infection and Relation of Childhood Vaccination Program in Türkiye: A Longitudinal Study

Objective

Hepatitis B is a significant infectious disease on a global scale. The implementation of vaccination programs and other preventive measures (e.g., serologic screening of blood donors) leads to lower rates of new infections with the hepatitis B virus. This study aimed to investigate and compare the evolution of hepatitis B incidence, prevalence and mortality rates along with vaccination rates in Türkiye and worldwide between 1990 and 2019.

Materials and Methods

The study analyzed open datasets (the Global Burden of Disease and Our World in Data) using descriptive and joinpoint regression analysis to uncover substantial declines in hepatitis B rates from 1990 to 2019, both in Türkiye and globally.

Results

The average annual percentage change (AAPC) for incidence rates was -1.81 in Türkiye and -1.481 in the global cohort. For prevalence, the AAPC was -2.5244 in Türkiye and -1.4104 globally.

Conclusion

The vaccination rates increased over time and remained at 95% since 2009, suggesting that vaccination efforts effectively reduced the risk of hepatitis B infection among children. This study provided important perspectives for assessing Türkiye's performance in this field and guiding future strategies.

Practice on hepatitis B virus infection prevention and associated factors in Ethiopia: systematic review and meta-analysis

BACKGROUND

Hepatitis B infection due to poor practices can result in prolonged hospital stays, long-term disability, increased microbial resistance, financial burdens and death. There has been no comprehensive study assessing the practice level of hepatitis B virus infection prevention in Ethiopia despite the high risk of exposure. Thus, this review aimed to assess practice on hepatitis B virus infection prevention in Ethiopia.

METHODS

For published studies, we conducted a thorough search of the PubMed, African Journal Online, Science Direct, Cochrane Library and Google Scholar databases. The data were exported to STATA version 11 (STATA Corp LLC) for meta-analysis. Heterogeneity between the results of the primary studies was assessed using Cochran's Q chi-square test and quantified with I2 statistics. A random effect model, specifically the DerSimonian and Laird pooled estimate method, was used due to the presence of heterogeneity between the included articles.

RESULTS AND CONCLUSIONS

Initially, 1738 articles were retrieved through electronic database searching. Of these, 910 were from Google Scholar, 4 from PubMed, 378 from Science Direct, 421 from African Journal Online and 25 from the Cochrane Library. The pooled estimate showed that 41.54% (95% CI: 33.81-49.27, P < 0.001) of individuals had a good practice towards hepatitis B virus infection prevention. Good knowledge of HBV infection prevention (POR = 1.13, 95% CI: (0.28-4.46) and urban residence (POR = 4.27, 95% CI: 1.17-15.49) were factors significantly associated with practices aimed at preventing hepatitis B virus infection. Based on the findings of the current study, most of the participants reported poor practices for hepatitis B virus infection prevention. Residence and knowledge of hepatitis B virus prevention were significantly associated with practices aimed at preventing hepatitis B virus infection. The Ministry of Health should collaborate with the health bureau for continual awareness about the mode of transmission and preventive measures of HBV.

Global hepatitis B and D community advisory board: expectations, challenges, and lessons learned

Introduction

Community Advisory Boards (CABs) play an important role in developing and delivering patient-centered care. However, the impact of participation on CAB members has not been well studied, particularly on the global scale. In 2022, the Hepatitis B Foundation (HBF) convened the first global hepatitis B and hepatitis delta CAB with 23 members from 17 countries, representing six out of the seven World Health Organization (WHO) regions, and countries with the largest hepatitis B and hepatitis delta disease burden.

Methods

To reflect on the process of assembling an effective and motivated CAB and assess the impact on CAB participants, three virtual focus group sessions were held with 16 participants in July and August 2023. Sessions were recorded and transcribed. Questions focused on motivations for joining the CAB, membership experiences, and lessons learned. Grounded theory analysis was used to generate hypotheses about reasons for CAB members' participation, as well as challenges and suggestions. Qualitative analysis using inductive reasoning identified key themes within responses. Transcripts were independently analyzed by a primary and secondary coder.

Results

Motivations for joining the CAB included participants' desire to advocate for people living with hepatitis B and hepatitis delta, and other altruistic factors. Participants reflected that through CAB membership, they gained networking and advocacy opportunities and enhanced their hepatitis B- and hepatitis delta-related knowledge. Challenges participants experienced were related to time, physical limitations, and stigma. Finally, participants discussed their limited direct engagement with drug developers and proposed ways the CAB can increase interactions with stakeholders going forward.

Discussion

Based on participants' assessments, establishing a global CAB for stigmatized infectious diseases is worth the effort. Regular internal review of community advisory boards' structure and performance is critical to ensure the CAB is fulfilling its mission.

Development of a risk prediction score for screening for HBV, HCV and HIV among migrants in France: results from a multicentre observational study (STRADA study)

OBJECTIVES

Migrants from high HIV, hepatitis B virus (HBV) or hepatitis C virus (HCV) endemicity regions have a great burden of these infections and related diseases in the host countries. This study aimed to assess the predictive capacity of the Test Rapide d'Orientation Diagnostique (TROD) Screen questionnaire for HIV, HBV and HCV infections among migrants arriving in France.

DESIGN

An observational and multicentre study was conducted among migrants. A self-questionnaire on demographic characteristics, personal medical history and sexual behaviours was completed.

SETTING

The study was conducted in the centres of the French Office for Immigration and Integration (OFII).

PARTICIPANTS

Convenience sampling was used to select and recruit adult migrants between January 2017 and March 2020.

OUTCOME MEASURES

Participants were tested for HIV, HBV and HCV with rapid tests. For each infection, the test performance was assessed using receiver operating characteristics curves, using area under the curve (AUC) as a measure of accuracy.

RESULTS

Among 21 133 regular migrants seen in OFII centres, 15 343 were included in the study. The participants' mean age was 35.6 years (SD±11.1). The prevalence (95% CI) of HBV, HCV and HIV was 2.0% (1.8% to 2.2%), 0.3% (0.2% to 0.4%) and 0.3% (0.2% to 0.4%), respectively. Based on the sensitivity-specificity curve analysis, the cut-off points (95% CI) chosen for the risk score were: 2.5 (2.5 to 7.5) for HBV infection in men; 6.5 (0.5 to 6.5) for HBV infection in women; 9.5 (9.5 to 12.5) for HCV infection; and 10.5 (10.0 to 18.5) for HIV infection. Test performance was highest for HIV (AUC=82.15% (95% CI 74.54% to 87.99%)), followed by that for HBV in men (AUC=79.22%, (95% CI 76.18% to 82.26%)), for HBV in women (AUC=78.83 (95% CI 74.54% to 82.10%)) and that for HCV (AUC=75.95% (95% CI 68.58% to 83.32%)).

CONCLUSION

The TROD screen questionnaire showed good overall performance for predicting HIV, HBV and HCV infections among migrants in OFII centres. It could be used to optimise screening for these infections and to propose rapid screening tests to those who are at high risk.

TRIAL REGISTRATION NUMBER

NCT02959684.

A systematic review and meta-analysis of sexually transmitted infections and blood-borne viruses in travellers

BACKGROUND

Sexually transmitted infections (STIs) and blood-borne viruses (BBVs) impose a global health and economic burden. International travellers facilitate the spread of infectious diseases, including STIs. Hence, this review assessed the prevalence/proportionate morbidity of travellers with STIs and sexually transmitted BBVs and factors associated with the infection in this population.

METHODS

PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and Cochrane Library were searched from inception of the databases until November 2022. Published analytical observational studies reporting the prevalence/proportionate morbidity of travellers with STIs and factors associated with STIs by type of traveller [i.e. tourists, business travellers, students, visiting friends or relatives (VFRs), international truck drivers, backpackers, expatriates and men who have sex with men (MSM)] were included. The selection of articles, data extraction and risk of bias assessment were conducted by two independent reviewers. Meta-analyses were conducted for each STI by clinical presentation and type of traveller.

RESULTS

Thirty-two studies (n = 387 731 travellers) were included; 19 evaluated the proportionate morbidity of STIs among symptomatic travellers, while 13 examined the prevalence of STIs in asymptomatic travellers. The highest proportionate morbidity was found among VFRs (syphilis, 1.67%; 95% CI: 1.03-2.81%), backpackers (Chlamydia trachomatis, 6.58%; 95% CI: 5.96-7.25%) and MSM (HIV [2.50%;95% CI: 0.44-12.88%], gonorrhoea [4.17%; 95% CI: 1.1.5-13.98%], lymphogranuloma venereum [4.17%;95% CI: 1.1.5-13.98%] and HAV [20.0%; 95% CI: 14.99-26.17%]). The highest prevalence of STIs among asymptomatic were found in MSM (HIV [25.94%; 95% CI: 22.21-30.05%] and HBV [24.90%; 95% CI: 21.23-28.96%]) and backpackers (C. trachomatis, 3.92%; 95% CI: 2.72-5.32%). Short duration of the trip (<1 month), not having pre-travel consultation, travelling to Southeast Asia and being unvaccinated for HBV were identified as risk factors for STIs.

CONCLUSION

Strategies to prevent STIs and sexually transmitted BBVs should be discussed at pre-travel consultations, and recommendations should be prioritized in high-risk groups of travellers, such as backpackers, VFRs and MSMs. Additionally, healthcare providers should tailor recommendations for safe sex practices to individual travellers' unique needs.

Knowledge and Testing of Hepatitis B Virus Infection and Vaccination Awareness among University Students in Kumasi, Ghana: A Cross-Sectional Study

Background

Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV) and major global health problem, affecting millions of people globally. Whilst college or university students could serve as a positive vehicle that may aid in the propagation of education in the communities, there is currently paucity of data on knowledge of HBV and vaccination awareness among university students in Ghana. This study therefore assessed knowledge on hepatitis B virus infection, testing, and vaccination awareness among science and non-science students in Ghana.

Method

This cross-sectional study included 386 students from the Garden City University College, Kumasi, Ghana, from February to June 2022. A well-structured questionnaire was used to obtain data on knowledge, testing, HBV vaccination status, and sociodemographic characteristics of participants. All statistical analyses were done using SPSS Version 26.0 and GraphPad prism version 8.0. A Chi-square test statistic and logistics regression analyses were used to determine factors associated with study variables among study participants. p value of <0.05 and 95% confidence interval were considered statistically significant.

Results

About half (51.5%) of the participants had adequate knowledge on hepatitis B infection with 22.3% demonstrating poor knowledge on hepatitis B infection. A little more than average (51.6%) previously tested for hepatitis B (HBV) whilst 32.9% were highly aware of hepatitis B vaccination and 33.9% were not aware of hepatitis B vaccination. This study found that ethnicity of students (p=0.0020), family history of hepatitis B infection (p=0.0160), and academic cumulative weighted average (CWA) (p=0.0020) were significantly associated with knowledge about hepatitis B infection. Also, students reading science-related programs had more than twice the odds (aOR = 2.56, 95% CI (1.03-5.08), p=0.0210) of having tested for HBV infections before compared to students who read non-science programs. Furthermore, sex (p < 0.0001), family history of HBV vaccination (p=0.0260), CWA (p=0.0060), and the program of students (p=0.0020) were significantly associated with awareness of HBV vaccination.

Conclusion

Knowledge of HBV infection among university students is satisfactory but awareness of HBV vaccination and testing is poor. There is a need to enhance educational interventions to improve the general knowledge of HBV infection, testing, and vaccination in Ghana especially among non-science students.

CCL20 and CD8A as potential diagnostic biomarkers for HBV-induced liver fibrosis in chronic hepatitis B

Background

The main cause of the liver fibrosis (LF) remains hepatitis B virus (HBV) infection, especially in China. Histologically, liver fibrosis still occurs progressively in chronic hepatitis B (CHB) patients, even if HBV-DNA is negative or undetectable. The diagnosis of LF is beneficial to control the development of it, also it may promote the reversal of LF. Although liver biopsy is the gold standard of diagnosis in LF at present, it isa traumatic diagnosis. There are no diagnostic biomarkers as yet for the condition. It is badly in need of biomarkers clinically, which is simple to test, minimally invasive, highly specific, and sensitive. Early detection of HBV-LF development is crucial in the prevention, treatment, and prognosis prediction of HBV-LF. Cytokines are closely associated with both immune regulation and inflammation in the progression of hepatitis B virus associated-liver fibrosis (HBV-LF). In this bioinformatic study, we not only analyzed the relationship between HBV-LF and immune infiltration, but also identified key genes to uncover new therapeutic targets.

Objectives

To find potential biomarkers for liver fibrosis in the development of chronic hepatic B patients.

Materials and methods

We obtained two sets of data including CHB/healthy control and CHB/HBV-LF from the Integrated Gene Expression (GEO) database to select for differential expression analysis. Protein-protein interaction (PPI) network was also generated, while key genes and important gene modules involved in the occurrence and development of HBV-LF were identified. These key genes were analyzed by functional enrichment analysis, module analysis, and survival analysis. Furthermore, the relationship between these two diseases and immune infiltration was explored.

Results

Among the identified genes, 150 were individually associated with CHB and healthy control in the differential gene expression (DGE) analysis. While 14 with CHB and HBV-LF. It was also analyzed in the Robust rank aggregation (RRA) analysis, 34 differential genes were further identified by Cytohubba. Among 34 differential genes, two core genes were determined: CCL20 and CD8A. CCL20 was able to predict CHB positivity (area under the receiver operating characteristic curve [AUC-ROC] = 0.883, 95% confidence interval [CI] 0.786-0.963), while HBV-LF positivity ([AUC-ROC] = 0.687, 95% confidence interval [CI] 0.592-0.779). And CD8A was able to predict CHB positivity ([AUC-ROC] = 0.960, 95% confidence interval [CI] 0.915-0.992), while HBV-LF positivity ([AUC-ROC] = 0.773, 95% confidence interval [CI] 0.680-0.856). Relationship between CCL20 gene expression and LF grades was P < 0.05, as well as CD8A.

Conclusion

CCL20 and CD8A were found to be potential biomarkers and therapeutic targets for HBV-LF. It is instructive for research on the progression of LF in HBV patients, suppression of chronic inflammation, and development of molecularly targeted-therapy for HBV-LF.

Hepatitis B vaccine birth dose coverage among hepatitis B-exposed and hepatitis B-unexposed infants: evidence from the Healthy Beginning Initiative program in Benue State, Nigeria

Introduction

Nigeria offers universal hepatitis B birth-dose vaccine (HepB-BD) for the prevention and control of hepatitis B (HepB). While prior studies suggest low coverage of HepB-BD in Nigeria, there is a paucity of evidence on the association between the uptake of HepB-BD and maternal HepB status. This study aimed to determine HepB-BD coverage and the associated factors among infants of HepB-positive and -negative women in Nigeria.

Methods

the study was a secondary analysis of data from the Healthy Beginning Initiative program conducted between June 2016 and October 2018 in Benue State, Nigeria. The analysis was restricted to data from a cohort of 6269 mothers who had HepB screening during pregnancy and completed the HepB infant immunization question in the post-delivery survey. The association between the coverage of HepB-BD and maternal HepB status, sociodemographic characteristics, and obstetric factors were determined using crude and adjusted relative risks.

Results

about 10% of the women tested HepB positive. The coverage of HepB-BD was 64% (63.2% among infants of HepB-positive mothers and 63.8% among HepB-negative mothers). The likelihood of infants of HepB-positive mothers receiving HepB-BD was not significantly different from infants of HepB-negative mothers (aRR=0.97, 95%CI= 0.92-1.04). Among HepB-positive mothers, infants of mothers younger than 20 years (aRR=1.49, 95%CI=1.03-2.16) or those who received antenatal care (aRR=1.41, 95%CI=1.16-1.71) were more likely to receive HepB-BD, while mothers with no previous pregnancies (aRR=0.73, 95%CI=0.59-0.91) were less likely to receive HepB-BD. Among HepB-negative mothers, infants of less-educated mothers were less likely to receive HepB-BD (aRR=0.96, 95%CI=0.92-0.99), whereas infants of mothers who received antenatal care (aRR=1.23, 95%CI=1.16-1.31) or had an institutional delivery were more likely (aRR=1.29, 95%CI=1.23-1.36) to receive HepB-BD. Conclusion: our findings highlight the need to improve HepB-BD uptake, particularly among HepB-exposed infants who are at risk of perinatal transmission of HepB.

SRPK2 Mediates HBV Core Protein Phosphorylation and Capsid Assembly via Docking Interaction

Members of the serine-arginine protein kinase (SRPK) family, SRPK1 and SRPK2, phosphorylate the hepatitis B core protein (Cp) and are crucial for pregenomic RNA encapsidation during viral nucleocapsid assembly. Among them, SRPK2 exhibits higher kinase activity toward Cp. In this study, we identified Cp sites that are phosphorylated by SRPK2 and demonstrated that the kinase utilizes an SRPK-specific docking groove to interact with and regulate the phosphorylation of the C-terminal arginine rich domain of Cp. We determined that direct interaction between the docking groove of SRPK2 and unphosphorylated Cp inhibited premature viral capsid assembly in vitro, whereas the phosphorylation of the viral protein reactivated the process. Pull-down assays together with the new cryo-electron microscopy structure of the HBV capsid in complex with SRPK2 revealed that the kinases decorate the surface of the viral capsid by interacting with the C-terminal domain of Cp, underscoring the importance of the docking interaction in regulating capsid assembly and pregenome packaging. Moreover, SRPK2-knockout in HepG2 cells suppressed Cp phosphorylation, indicating that SRPK2 is an important cellular kinase for HBV life cycle.

Informational and Practical Needs of Expectant Mothers with Chronic Hepatitis B in Ghana

Hepatitis B virus infection is a global public health problem with disproportionately high endemicity in Africa and Ghana. The current national prevalence of hepatitis B among pregnant women in Ghana stands at 7.44%, highlighting the considerable threat of chronic hepatitis B on pregnant women and their general well-being. The study explored the informational and practical needs of pregnant women with chronic hepatitis B in Ghana. Fourteen pregnant women were selected purposefully using the exploratory descriptive qualitative design. Data were analyzed using thematic analysis. The findings showed that pregnant women with chronic hepatitis B lacked knowledge about the infection and were in great need of hepatitis B-related information. The study also revealed significant financial implications for treating the infection, necessitating policy reforms and stakeholder actions. To achieve effective coping, better health-seeking, and health-promoting behaviors for better health outcomes, it is crucial to provide targeted care that comprehensively covers the specific needs of pregnant women with chronic hepatitis B. It is also essential to consider including hepatitis B management in the National Health Insurance package to improve care quality.

Medicinal Plants in Treating Hepatitis B Among Communities of Central Region of Ethiopia

Purpose

In Ethiopia, most people rely heavily on traditional therapeutic plants that have been used for years. The practice of traditional medicines use to treat hepatitis is currently gaining popularity due to the limited availability and affordability of modern drugs. The aim of this study was, therefore, to assess the traditional medicinal plants use to treat viral hepatitis among communities of Central region of Ethiopia.

Methods

Data was collected from November 2018 to December 2021 in Central Ethiopia. An open-ended semi-structured interview was used among purposively selected herbalists, traditional medicine entrepreneurs, village heads, and patients visiting traditional healers for hepatitis treatments. A 5 mL blood sample was collected from patients who visited a traditional healers' clinic for hepatitis treatment and tested for HBsAg and HCV-antibody by using ELISA. Among HBsAg-positives, further nucleic acid test for HBV-DNA load was assessed to measure the effects of prescribed medicinal plants.

Results

Herbalists cited 24 plants that were used for hepatitis treatment; of which Rumex nepalensis, Vangueria apiculata, and Solanum incanum were the most frequently cited plants. Remedies were commonly prepared by crushing or powdering, mixing them with water, and taken orally. Forty-two individuals were diagnosed and treated as hepatitis patients by herbalists, of which eight of them were HBsAg-positive but no positives for anti-HCV ELISA. At the third and sixth months of viral load assessment among HBsAg-positive, serum HBV-DNA suppression was observed in three individuals treated with different combinations of frequently cited plants.

Conclusion

In this study, traditional healers used various plants to treat hepatitis. HBV-DNA suppressive activity was detected in three NAT-positive individuals who were treated by using a mixture of these frequently cited and highest preference-ranked plants. This suggests that these plants have antiviral properties and serve as a basis for more pharmacological research in the quest for new antiviral agents.

Prevalence of Hepatitis B and Hepatitis C Viral Infections and Their Associated Factors among Diabetic Patients Visiting Debre Tabor Referral Hospital, Northwest Ethiopia, 2021: A Cross-Sectional Study

Background

Viral hepatitis is a global public health problem that affects millions of people each year, causing disability and death. Hepatitis B and C viruses are the most common causes of viral hepatitis and are associated with chronic liver disease, cirrhosis, and hepatocellular carcinoma. The primary site of infection for these viruses is the liver, the primary site of hormone and glucose metabolism closely linked to diabetes mellitus (DM), which is associated with increased morbidity and mortality worldwide. As a result, assessing the coexistence of viral hepatitis and DM could be important in disease management, prevention, and control measures in DM patients.

Objective

The aim of our study is to assess the prevalence and associated factors of HBV and HCV among diabetes patients attending Debre Tabor Referral Hospital.

Methods

An institutional-based, cross-sectional study was conducted from December 1, 2021, to February 30, 2021. A systematic sampling technique was used for selecting study participants. Serum samples were screened with a rapid test kit for hepatitis B (HBV) and hepatitis C (HCV) infections. A pretested structured questionnaire was constructed to collect the data, which were later analyzed using SPSS version 23. Inferential statistics were used to evaluate the associated risk factors for the outcome variable. A p value of <0.05 was considered statistically significant.

Result

A total of 152 diabetes patients were included in this study, with 78 (51.3%) males and 74 (48.7%) females, with a mean age of 39.24 ± 17.90 years. The prevalence of HBV and HCV was 6 (3.9%) and 2 (1.3%), respectively. Most of potential risk factors such as, histories of surgical procedures, tooth extraction, hepatitis infection in the family, blood transfusion, alcohol consumption, body tattooing, and multiple sexual partners were not statistically significant for HBV and HCV infections.

Conclusion

In this study, no association was obtained between sociodemographic, clinical, and behavioural factors and the prevalence of hepatitis B and C viruses. Furthermore, there is no significant association detected between HBV or potential HCV infection and DM. Despite these results, continuing professional training programs on HBV and HCV infection, including increased vaccination coverage rates for HBV, are required.

Multiple change point analysis of hepatitis B reports in Xinjiang, China from 2006 to 2021

Objective

Hepatitis B (HB) is a major global challenge, but there has been a lack of epidemiological studies on HB incidence in Xinjiang from a change-point perspective. This study aims to bridge this gap by identifying significant change points and trends.

Method

The datasets were obtained from the Xinjiang Information System for Disease Control and Prevention. Change points were identified using binary segmentation for full datasets and a segmented regression model for five age groups.

Results

The results showed four change points for the quarterly HB time series, with the period between the first change point (March 2007) and the second change point (March 2010) having the highest mean number of HB reports. In the subsequent segments, there was a clear downward trend in reported cases. The segmented regression model showed different numbers of change points for each age group, with the 30-50, 51-80, and 15-29 age groups having higher growth rates.

Conclusion

Change point analysis has valuable applications in epidemiology. These findings provide important information for future epidemiological studies and early warning systems for HB.

Correlation Between Vitamin D Status and HBsAg Antibody Levels in Indonesian Adolescents Immunised Against Hepatitis B

Introduction

Hepatitis B virus (HBV) infection is a global health problem. Anti-hepatitis B surface antigen (HBsAg) levels increase along with vitamin D levels in adults. However, few studies have examined this relationship in adolescents. Few studies have examined the relationship between vitamin D and HBsAg antibody levels, especially in Indonesia.

Methods

This cross-sectional study examined vitamin D and anti-HBsAg levels before and after hepatitis B immunisation. All subjects blood was taken to check for vitamin D level. This study was part of the Safety and Preliminary of Immunogenicity Following Recombinant Hepatitis B (Bio Farma) Vaccine in Adults and Children Phase I trial.

Results

This study found that 25-hydroxyvitamin D [25(OH)D] status was primarily deficient based on endocrine criteria. The children's hepatitis B antibody response was mostly <10 mIU/mL before and ≥10 mIU/mL after vaccination. There was a relationship between sex and 25(OH)D status, with median 25(OH)D levels higher in females (18.2 ng/mL) than in males (9.8 ng/mL). However, the relationship between vitamin 25(OH)D status and anti-HBsAg levels pre- and post-vaccination was not significant.

Discussion

However, some research found that vitamin D supplementation after immunisation did not impact vaccine response, several studies have reported that vitamin D can decrease HBV replication through various mechanisms, including reducing viral transcription and interfering with viral protein synthesis.

Conclusion

There was no relationship between 25(OH)D status and anti-HBsAg levels. Further research is needed to elucidate the underlying mechanisms and establish optimal treatment strategies.

Investigation of the frequencies of various B cell populations in non-responder healthcare workers in comparison with responders to hepatitis B virus vaccination

BACKGROUND

Hepatitis B is a major global health problem. More than 90% of hepatitis B-vaccinated immunocompetent adults become fully immune. The main purpose of vaccination is immunization. Whether non-responders have a lower percentage of total or antigen-specific memory B cells in comparison with responders is still controversial. We aimed to assess and compare the frequency of various B cell subpopulations in non-responders and responders.

METHODS

Fourteen responders and 14 non-responders of hospital healthcare workers were enrolled in this study. We used flow cytometry to evaluate various CD19+ B cell subpopulations using fluorescent-labeled antibodies against CD19, CD10, CD21, CD27 and IgM and ELISA to evaluate total anti-HBs antibodies.

RESULTS

We found no significant differences in the frequency of various B cell subpopulations between the non-responder and responder groups. Furthermore, the frequency of the isotype-switched memory B cell population was significantly higher in the atypical memory B cell subset compared with the classical memory B cell subset in the responder and total groups (p=0.010 and 0.003, respectively).

CONCLUSIONS

Responders and non-responders to HBsAg vaccine had comparable memory B cell populations. Whether anti-HBs Ab production has a correlation with the level of class switching in B lymphocytes in healthy vaccinated individuals needs further investigation.

Hepatitis B virus infection in Saudi Arabia and the UAE: Public health challenges and their remedial measures

BACKGROUND

Hepatitis B virus (HBV) infection is a major public health concern globally with higher prevalence in Middle Eastern countries. Both Saudi Arabia and the UAE face critical challenges in HBV treatment and management despite the implementation of a mass vaccination program. This review aimed to understand the gaps and unmet needs related to HBV infection, public health challenges associated with its diagnosis, and treatment barriers in Saudi Arabia and the UAE. Additionally, the review aimed to provide the best practices in the HBV care pathway for effective remedial measures and disease reduction.

METHODS

The literature search was done from Pubmed.

RESULTS

The lack of disease awareness and knowledge about disease transmission among patients and their family members and healthcare professionals, lack of proper screening, underdiagnosis, social stigma, lack of established referral system, and treatment cost are the primary barriers to HBV diagnosis and management.

CONCLUSION

Appropriate healthcare initiatives should be undertaken to lower the disease burden in Saudi Arabia and the UAE.

Single-cell analysis reveals HBV-specific PD-1+CD8+ TRM cells in tumor borders are associated with HBV-related hepatic damage and fibrosis in HCC patients

Immune checkpoint blockade (ICB) treatment of hepatocellular carcinoma (HCC) patients with hepatitis B virus (HBV) infection may activate viral-specific T cells to attack HBV infected hepatocytes and thus induce immune-related liver injury. Therefore, it is important to deeply understand the impacts of HBV infection on HCC immune microenvironment in order to better design effective immunotherapies for HBV⁺ (HBV infected) HCC patients. Here, We performed cytometry by time-of-flight (CyTOF) analyses to characterize the distinct immune compositions of HCC tumors, tumor borders, and their associations with HCC/HBV related clinical characteristics. We identified 31 distinct immune clusters and found significant associations between immune signatures with clinicopathological features of HCC. We further revealed the HBV infection had more effects on shaping immune compositions in tumor borders than in tumors, with the significant enrichment of HBV-specific PD-1⁺CD8⁺ tissue-resident memory T (T_RM) cells in tumor borders of HBV⁺ patients. We confirmed this subset with a more exhausted phenotype and respond more actively under anti-PD-L1 treatment, suggesting its involvement in immune-related liver injury induced by ICB treatment to HBV⁺ HCC patients. Our study shows it may be necessary to consider antiviral prophylaxis for HBV⁺ HCC patients receiving ICB treatment.

Recent Advances in Anticancer Activity of Novel Plant Extracts and Compounds from Curcuma longa in Hepatocellular Carcinoma

PURPOSE

Among all forms of cancers, hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. There are several treatment options for HCC ranging from loco-regional therapy to surgical treatment. Yet, there is high morbidity and mortality. Recent research focus has shifted towards more effective and less toxic cancer treatment options. Curcumin, the active ingredient in the Curcuma longa plant, has gained widespread attention in recent years because of its multifunctional properties as an antioxidant, anti-inflammatory, antimicrobial, and anticancer agent.

METHODS

A systematic search of PubMed, Embase and Google Scholar was performed for studies reporting incidence of HCC, risk factors associated with cirrhosis and experimental use of curcumin as an anti-cancer agent.

RESULTS

This review exclusively encompasses the anti-cancer properties of curcumin in HCC globally and it's postulated molecular targets of curcumin when used against liver cancers.

CONCLUSIONS

This review is concluded by presenting the current challenges and future perspectives of novel plant extracts derived from C. longa and the treatment options against cancers.

Hepatitis B Virus Immunity Gap: A Six-Year Laboratory Data Review of Hepatitis B Serological Profiles in Gauteng Province, South Africa

Background

In 1995, the hepatitis B vaccine in South Africa was incorporated into the childhood expanded programme of immunization. We report on immunity gaps of laboratory-based hepatitis B virus (HBV) among patients in public facilities in Gauteng Province from 1st January 2014 to 31st December 2019. Methodology. We analyzed HBV serological data extracted from the National Health Laboratory Services Central Data Warehouse (NHLS CDW). A descriptive analysis was performed for hepatitis B surface antigen (HBsAg), antibodies to HBV core (anti-HBc) total, anti-HBc IgM, and antibodies to HBV surface antigen (anti-HBs) according to annual distribution, age groups, and sex.

Results

The HBsAg positivity rate was 7.0% (75,596/1,095,561; p=0.001): 7.4% (96,532/944,077) in the 25 years and over age group and 4.0% (358/9,268 and 325/10,864) in the under 5 and 13-24 year age groups. The positivity rates of the other HBV serological markers were as follows: anti-HBc total was 37.0% (34,377/93,711; p  <  0.001), anti-HBc IgM was 2.4% (5,661/239,237; p=0.05), and anti-HBs was 37.0% (76,302/206,138; p ≤ 0.001). Naturally acquired HBV immunity was detected in 25.7% (11,188/43,536) of patients in the 25 years and over age group, and 9.7% and 8.2% (113/1,158 and 541/6,522) among those under 5 years and 13-24 year age group, respectively (p  <  0.001). Vaccine-induced immunity was 56.6% (656/1,158) in children under 5 years and 10.2% (4,425/43,536) among those 25 years and above (p  <  0.001). Fifty-six percent (29,404/52,581) of patients were HBV seronegative; predominantly among patients in the 13-24 year age group (60.6%; (3,952/6,522)) and 25 years and over (56.3% (24,524/43,536)) (p=<0.001).

Conclusion

The HBV infection seroprevalence remains high in South Africa, with Gauteng province having high intermediate endemicity. However, the HBV immunity gap has shifted from younger children to older children and adults.

Impact of methylene-tetrahydrofolate reductase gene C677T and A1298C polymorphisms as a risk factor for hepatitis B virus infection

Chronic hepatitis B infection caused by Hepatitis B virus (HBV), influences over two billion people worldwide despite having an effective vaccine. With a total prevalence of 4.57%, there are 3.3 million estimated HBV carriers in Türkiye. Methylene-tetrahydrofolate reductase (MTHFR) arrange folate metabolism through nucleic acid synthesis and DNA methylation. C677T (rs1801133, p.Ala222Val) and A1298C (rs1801131, p.Glu429Ala) polymorphisms of MTHFR gene have effect of reducing the activity of enzyme. We purposed to investigate the correlation between C677T and A1298C polymorphisms of MTHFR gene with HBV infection in a Turkish population. One hundred eighteen HBV-infected participants and ninety healthy controls were incorporated in this research. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay was applied to discover the genotypes of MTHFR polymorphisms. We demonstrated that T allele and CT + TT genotype frequencies of C677T polymorphism were significantly increased in HBV-infected participants than healthy controls [p = 0.015, OR (95% Cl) = 1.7 (1.11-2.79) and p = 0.020, OR (95% Cl) = 1.9 (1.10-3.42), respectively). No significant associations were noted concerning the A1298C polymorphism (p > 0.05). CC-AA composite genotype was observed to be significantly elevated in healthy controls than HBV-infected participants (32.2% vs. 13.6%, p = 0.001). In addition, the frequency of T-C haplotype was found to be considerably higher in the patient group than control group (15.8% vs 11.8%, p = 0.018). In conclusion, we found that T allele of C677T polymorphism poses a risk factor for HBV infection. We also discovered a protective impact of the CC-AA composite genotype against HBV infection and a risk effect of the T-A haplotype for HBV-infection.

Associations between the prevalence of chronic hepatitis B among people who inject drugs and country-level characteristics: An ecological analysis

INTRODUCTION

Globally, hepatitis B virus (HBV) is a leading cause of liver disease. People who inject drugs (PWID) are at greater risk than the general population of contracting HBV. This risk could depend on societal factors in different countries. We investigated the associations between country-level chronic HBV prevalence in PWID with national indicators of development and prevalence of HIV and hepatitis C virus (HCV).

METHODS

We used global systematic review data on chronic HBV prevalence (hepatitis B surface antigen-positive) among PWID and country-level sociodemographic characteristics from online databases. National random-effects meta-analysis estimates of HBV prevalence were the outcome in linear regression models testing for associations with country-level characteristics.

RESULTS

The study included 131,710 PWID from 304 estimates in 55 countries: the pooled HBV prevalence among PWID in the countries analysed was 4.5% (95% CI 3.9-5.1), the highest regional pooled prevalence was in East and Southeast Asia (17.6% [13.3-22.3]), and the lowest was in Western Europe (1.7% [1.4-2.1]). In multivariable models, no indicators of development were associated with HBV prevalence, but there was evidence of positive associations between HBV prevalence in the general population and among PWID, and evidence of HIV and HCV prevalence in PWID being associated with HBV prevalence in PWID: multivariable coefficients 0.03 (95% CI 0.01-0.04); p < 0.001, and 0.01 (95% CI 0.00-0.03); p = 0.01, respectively.

DISCUSSION AND CONCLUSIONS

HBV prevalence among PWID was associated with HIV and HCV prevalence among PWID and background HBV prevalence in the general population, highlighting the need for improving harm reduction in PWID and implementation of HBV vaccination, especially where HBV is endemic.

Two-dimensional shear wave elastography utilized in patients with ascites: a more reliable method than transient elastography for noninvasively detecting the liver stiffness-an original study with 170 patients

Background

Two dimensional shear wave elastography (2D-SWE) is an ultrasound elastography technique based on shear waves implemented on a diagnostic ultrasound system. Transient elastography (TE) uses an ultrasound displacement M-mode and A-mode image produced by the system. So, TE mechanically induced impulse at tissue surface and difficultly across water. This paper compared the reliability and reproducibility of 2D-SWE with that of TE in patients with chronic hepatic disease. Comparisons were made in terms of the success rate, reliability, reproducibility, operation time, and influence of operator experience.

Methods

A total of 170 patients were included in this study. Participants underwent 2D-SWE and TE performed by 2 different operators (a novice and veteran) on the same day. Nonparametric statistical tests were used to compare the technical success rate and reliable measurement rate, and inter-operator reproducibility was evaluated using intra-class correlation coefficients (ICCs).

Results

The 2D-SWE technique showed a higher technical success rate than TE. Either 2D-SWE or TE can be utilized in patients with ascites lamella of less than 10 mm or ascites lamella plus skin-capsular distance of less than 25 mm. However, although the reliability rate of liver stiffness measurement with 2D-SWE did not significantly differ between the novice and veteran operators, for TE, there was a significant difference when body mass index (BMI) ≤25 kg/m². When performed by the novice and veteran operators, 2D-SWE and TE both showed excellent inter-operator agreement, with ICCs of 0.968 and 0.973, respectively. Both 2D-SWE and TE displayed reliable measurement and excellent reproducibility in patients with chronic liver disease, were minimally influenced by operator experience.

Conclusions

2D-SWE may be a more reliable method for clinical application in noninvasive detecting the liver stiffness.

Current Challenges and Future Perspectives of Diagnosis of Hepatitis B Virus

It is estimated that approximately 260 million people worldwide are infected with the hepatitis B virus (HBV), which is one of the leading causes of liver disease and liver cancer throughout the world. Compared with developed countries, low-income and middle-income countries have limited access to resources and advanced technologies that require highly specialized staff for HBV diagnosis. In spite of the heavy burden caused by hepatitis B virus, 90% of people are still undiagnosed. The World Health Organization (WHO) goal of eliminating hepatitis B by 2030 seems very difficult to achieve due to the existing diagnostic infrastructure in low-resource regions. The majority of diagnostic laboratories still use hepatitis B surface antigen (HBsAg)-based tests. WHO's elimination plan is at risk of derailment due to phases like the window period, immune control, and occult HBV infection (OBI) not being detected by standard tests. Here, in this article, we are focusing on various diagnostic platforms for the better diagnosis of HBV. The aim of the elimination of HBV can only be achieved by detecting all phases of HBV infection, which can be executed by a combined approach of using new marker assays along with advanced pretesting and testing methods.

Barriers to Timely Administration of Hepatitis B Birth Dose Vaccine to Neonates of Mothers With Hepatitis B in Ghana: Midwives' Perspectives

Background

The global health sector strategy on viral hepatitis aims to reduce new hepatitis B infections by 90% by 2030. Yet, hepatitis B birth dose (HepB-BD) vaccination, which is effective in preventing mother-to-child transmission of hepatitis B, remains low in sub-Saharan Africa. Given the essential role that midwives play in infants' birth dose immunisation, we explore their perspectives on the reasons for delays and non-administration of HepB-BD to eligible neonates in Ghana.

Methods

We conducted interviews with 18 midwives, stratified by region (Greater Accra and Northern regions). Participants were selected purposively. The data were transcribed, coded, and analysed following the Braun and Clarke data analysis procedure.

Results

The participants conveyed a broad range of barriers to HepB-BD vaccination in Ghana. These include the mother's denial of hepatitis B seropositivity; the mother's ignorance of the impact of hepatitis B on their newborn; partners' non-involvement in post-test counselling; and the high cost of hepatitis B immunoglobulin and hepatitis B monovalent vaccine. Other reasons included vaccine unavailability and midwives' oversight and documentation lapses.

Conclusion

We recommend educating expectant mothers on the importance and effectiveness of HepB-BD vaccination during antenatal care (ANC) visits, as well as educating midwives on HepB-BD vaccination procedures. In addition, ensuring sufficient supplies and administering hepatitis B vaccines in the delivery ward should be done to guarantee that babies receive the vaccines on time. Importantly, Ghana needs policies that require HepB-BD vaccination as part of the Expanded Programme on Immunisation (EPI) to ensure the investments and funding it needs.

Burden and correlates of significant liver fibrosis among HIV-infected and uninfected adults in urban Uganda

Introduction

Following chronic inflammation and other disease specific factors, the risk of liver disease is believed to be higher among HIV-infected patients than in the general population despite shared risk factors. Understanding this differentiated burden and its drivers will inform policy and priority populations for intervention.

Methods

This was a cross sectional study among 516 adults attending care clinics in Kampala Uganda. Significant liver fibrosis (SLF) was defined as liver stiffness measurement ≥7.2 KPa identified by Fibroscan®. Data analyses were stratified by HIV status and we performed logistic regression performed to identify correlates.

Results

The prevalence of SLF was higher among HIV un-infected patients ((24% Vs 14%; p0.004). Overall HIV-uninfected patients were more likely to be overweight and or obese, with elevated serum cholesterol levels. Elevated measurement of fatty change in the liver (CAP scores >248 dB/m) was associated with SLF among HIV un-infected patients (OR 2.3 CI (1.0-5.2); p = 0.046). Low nadir CD4 counts (200cell/mm3) was predictive of SLF among HIV-infected patients (OR 3.3 CI (1.0-10.7); p = 0.05).

Conclusion

The prevalence of SLF was unexpectedly higher among HIV un-infected than HIV affected patients attending care clinics in urban Uganda. This observed burden is most likely driven by non-alcoholic fatty liver disease (NAFLD) resulting from metabolic syndrome.

Evaluation of hepatitis B knowledge, practices, and beliefs among the Jordanian population: A cross-sectional study

This study aimed to assess the knowledge, practices, and beliefs among the Jordanian population regarding hepatitis B virus (HBV) infection. A cross-sectional questionnaire was designed and used to recruit participants from October 5th through December 12th. Statistical analysis was conducted using SPSS. Descriptive statistical analysis was used to analyse the sociodemographic data, the Shapiro-Wilk test was used to assess the normality, Cronbach's α was used to evaluate the reliability of the questionnaire and Point-biserial correlation was used to figure out whether there is an association between Score of knowledge and the dichotomous variables. A random sample of 432 participated in the study. The majority were females (n = 310, 71.8%), the mean age was 21 (42.0%) years,416 (96.3%) were urban inhabitants and most of them (n = 351, 81.3%) had bachelor's degree. School/university (n = 280, 64.8%) were reported as a major source of information followed by TV/internet/social media 276 (63.9%). The total mean (± SD) of knowledge score regarding HBV infection symptoms, transmission modes and treatment was found 12.28 ± 3.2. Participants' knowledge regarding symptoms including nausea, vomiting and loss of appetite was 73 (16.9%). More than 80% had good knowledge regarding the complications of HBV infection. Only 100 participant reported vaccination (23.1%) against the virus. Poor knowledge and low vaccination rate against HBV were found thus implementing comprehensive educational program for people highlighting the importance of vaccination against the virus is crucial.

Sero-Prevalence, Infectivity, and Associated Risk Factors of Hepatitis B Virus Among Pregnant Women Attending Antenatal Care in Sankura Primary Hospital, Silte Zone, Southern Ethiopia, 2021

Background:

Hepatitis B (HBV) infection causes a major public health problem around the globe. Therefore, this study aimed to assess the Seroprevalence, infectivity, and associated factors of hepatitis B virus infection among pregnant women attending antenatal care in Sankura Primary Hospital, Southern Ethiopia.

Methods:

A cross-sectional study design was conducted in Sankura Primary Hospital, Southern Ethiopia, from April to June 2020. A total of 338 pregnant women were recruited using systematic random sampling. Sociodemographic and associated risk factors were collected through a structured questionnaire. Blood samples and plasma analysis were performed for the presence of hepatitis B surface antigen (HBsAg) and hepatitis B envelope antigen (HBeAg) using the rapid test strip method. Statistical analysis was done using SPSS version 20, and P-value < 0.05 was considered statistically significant.

Results:

The overall Seroprevalence of HBsAg was 11 (3.3%) [95% CI 1.5% - 5.0%], of whom 2 (18.2%) were positive for HBeAg. In multivariate analysis, a history of blood transfusion [AOR=4.8 95% CI (1.25-6.69)] and contact with a family history of the liver [AOR=5.7 95% CI (1.28-7.9)] was found to be significant predictors of HBV infections.

Conclusion:

The Seroprevalence of HBV infection among pregnant women in the study area was intermediate. Family history of liver disease and blood transfusion were risk factors associated with HBV infection. Hence, improving the screening of blood, increasing awareness about the transmission of HBV infection, and screening pregnant women for HBV infection should be implemented. The government will build efficient service delivery models equipped with an appropriate and well-trained workforce.

The effectiveness of 20 μg hepatitis B vaccine used for the prevention of HBV vertical transmission

To evaluate the efficiency of a 20 μg hepatitis B vaccine(HepB) for disease prevention in two counties in Henan Province, China. A questionnaire was designed to examine the information of hepatitis B surface antigen (HBsAg) positive pregnant women, and their blood samples were collected to test for hepatitis B e antigen (HBeAg), hepatitis B e antibody, and hepatitis B virus (HBV) DNA. Three doses of 20 μg HepB and one dose of hepatitis B immune globulin(HBIG) were administered to newborns. Blood samples were collected from children one month after their complete immunization to test for HBsAg and hepatitis B surface antibody(HBsAb). A total of 419 HBsAg positive-pregnant women and 430 newborns were investigated. The average age of pregnant women was 29.6 ± 4.3 years, with an HBeAg positive rate of 29.1% (122/419). All newborns received their first dose of 20 μg hepatitis B vaccine and 100 IU HBIG within 12 h after birth. Six infants (1.9%, 6/319) tested positive for HBsAg and negative for HBsAb after one month of receiving the three basic doses of HepB. The geometric mean concentration(GMC) of HBsAb-positive infants was 861.6 mIU/mL, and their HBsAb antibody titers decreased with age. Immunization of children born to HBsAg-positive mothers with 20 μg HepB got the satisfactory effect on preventing mother-to-child transmission.

Seroprevalence of Hepatitis E Virus Infection in Middle Eastern Countries: A Systematic Review and Meta-Analysis

Hepatitis E virus (HEV) is a hepatotropic virus that is a major public health concern worldwide. Autochthonous HEV is spread through oral feces in unsanitary environments, as well as vertical and, occasionally, blood transfusion. HEV is more common in developing countries, but it has recently become more widespread in developed countries as well. The Middle East (ME) has long been an endemic location for HEV infection. Therefore, the aim of this systematic review and meta-analysis was to assess the seroprevalence of anti-HEV antibodies in ME countries. The author systematically searched five databases, namely ScienceDirect, EMBASE, Scopus, PubMed, and Google Scholar, to identify English-language articles published on or before 25 April 2022. Comprehensive meta-analysis software was used for all statistical analyses (CMA, version 3, BioStat, Englewood, CO, USA). After quality control and exclusion of irrelevant studies, 80 studies were included in the qualitative synthesis and meta-analysis. A forest plot showed that the overall pooled seroprevalence of HEV infection in ME countries in the fixed-effect and random-effect models were 21.3% (95% CI: 0.209–0.216) and 11.8% (95% CI: 0.099–0.144), respectively. Furthermore, the findings showed a high level of heterogeneity (I2 = 98.733%) among the included studies. In both fixed-effect and random-effect models, the seroprevalence of HEV infection by country was high in Egypt as compared to other regions, at 35.0% (95% CI: 0.342–0.359), and 34.7% (95% CI: 0.153–0.611), respectively. The seroprevalence of HEV infection by country was high among pregnant women, at 47.9% (95% CI: 0.459–0.499) in the fixed-effect model, and in renal transplant recipients, at 30.8% (95% CI: 0.222–0.410) in the random-effect model. The seroprevalence of HEV infection varies by country and study population in the Middle East. More research is needed to determine the disease’s incidence, morbidity, and mortality in the region, where it is prevalent.

Epidemiological factors associated with HBV infection and uptake of testing in south west region of Cameroon: What can be done to scale up HBV testing in our setting?

Hepatitis B infection affects millions of people globally, partly due to its high degree of transmissibility and asymptomatic nature. This study was aimed at identifying prevailing epidemiological factors associated with HBV infection and testing uptake in the South West region of Cameroon. This hospital-based case-control study enrolled HBV infected participants and "healthy" controls ≥18 years old. Venous blood collected from participants was used to conduct HBV panel test (HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc). Data on demographic and behavioral risk factors as well as reasons for taking the HBV test for the first time were collected using a questionnaire. A total of 424 participants were enrolled (212 "healthy" controls and 212 HBV infected cases). Male sex (odds ratio [OR] = 2.08, p = 0.010), ≤ secondary education level (OR = 4.83, p<0.001), low-income level (OR = 3.79, p<0.001), rural settlement (OR = 2.17, p = 0.031), history of sexually transmitted infections (STI) (OR = 4.24, p<0.001) and ignorance of sexual partners HBsAg status (OR = 2.70, p = 0.003) all had an independent and significant association with HBV infection. Top 3 reasons for doing HBsAg test were free screening (40.3%), blood donation (15.0%) and administrative requirements (14.9%). HBV testing uptake and early detection can be improved if more sensitization and free/opportunistic screenings are implemented. A significant drop in the cost of HBV test could encourage more people to get tested.

The prevalence of hepatitis B virus infection in Bangladesh: A systematic review and meta-analysis

Despite the availability of an effective vaccine, hepatitis B virus (HBV) infection is one of the major public health problems worldwide, mostly in developing countries. This systematic review and meta-analysis were performed to estimate the pooled prevalence of HBV infection in Bangladesh. We systematically searched various electronic databases to retrieve relevant studies published until April 2021. A total of 15 studies were met the inclusion criteria and included in the meta-analysis. The pooled estimated prevalence of HBV infection in the general population of Bangladesh from 1995 to 2017 was 4.0% [95% confidence interval (CI) 3.0–5.1]. The results of subgroup analysis revealed that the prevalence of hepatitis B was higher in females than males [odds ratio (OR) 1.20, 95% CI 0.48–2.97, P = 0.70], people of age <25 years had a higher prevalence than people of age >25 years (OR 1.25, 95% CI 0.72–2.17, P = 0.42) and married people had a higher prevalence than unmarried/single people (OR 2.16, 95% CI 1.51–3.10, P < 0.0001). The Egger's test statistics (P = 0.584), Begg and Mazumdar's rank correlation test (P = 0.054) indicated the absence of publication bias. This study analysis reported a low intermediate prevalence of HBV infection (4%) in Bangladesh, which is currently higher than the global prevalence of HBV infection (3.5%).

Duration of Hepatitis B Vaccine-Induced Protection among Medical Students and Healthcare Workers following Primary Vaccination in Infancy and Rate of Immunity Decline

Since the introduction of hepatitis B virus (HBV) vaccines, the numbers of HBV infections and complications have significantly decreased. However, the evidence on whether primary vaccination of infants confers lifelong immunity varies. We aimed to assess long-term immunity among healthcare workers and medical students, and the rate of decline of HBV surface antigen antibodies (anti-HBs). Hepatitis B status among participants born after 1 January 1992 was reviewed at Chulabhorn Royal Academy, Thailand. Participants were stratified by intervals since primary vaccination. HBV immunity was determined and analyzed as anti-HBs decline rate in participants with multiple follow-ups. A total of 464 participants were analyzed, with a median age of 23. Protective immunity against HBV (anti-HBs ≥ 10 mIU/mL) at 16–20, 21–25 and 26–28 years post-primary vaccination was 28%, 51.7% and 60%, respectively. The overall declining rate of anti-HBs was −42.39 mIU/mL per year. Participants with anti-HBs levels of >100–1000 mIU/mL at baseline had a faster decline rate than those with anti-HBs levels of 10–100 mIU/mL. Primary vaccination may not provide lifelong protection since HBV immunity deteriorates over time. Individuals with higher initial HBV immunity levels may experience a faster decline rate.

Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management

BACKGROUND

Hepatitis B virus (HBV) is the leading cause of liver-related diseases. In Uganda, there is a regional disparity in the HBV burden. Our study was aimed at establishing the circulating genotypes in a low and a high endemic region to give plausible explanations for the differences in regional burden and guide the future management of the disease.

METHODS

A total of 200 HBsAg-seropositive subjects were recruited into the study by convenience sampling. The HBsAg Rapid Test Strip (Healgen Scientific Limited Liability Company, Houston, TX77047- USA) was used to screen for HBsAg while the Roche machine (Roche, Basel Switzerland/Abbot Technologies (USA)) was used to determine the viral load. The Chemistry Analyzer B120 (Mindray, China) was used for chemistry analysis. For HBV genotyping, total DNA was extracted from whole blood using the QIAamp® DNA extraction kit. Nested PCR amplification was performed using Platinum Taq DNA Polymerase (Invitrogen Corporation, USA) to amplify the 400 bp HBV polymerase gene. Purification of nested PCR products was performed using Purelink PCR product purification kit (Life Technologies, USA). Automated DNA sequencing was performed using BigDye Terminator v3.1 Cycle Sequencing Kit on 3130 Genetic Analyzer (Applied Biosystems, USA). The NCBI HBV genotyping tool (https://www.ncbi.nlm.nih.gov/projects/genotyping/formpage.cgi) was used for determination of genotype for each HBV sequence. Pearson's chi-square, multinomial logistic regression, and Mann-Whitney U tests were used for the analysis. All the analyses were done using SPSS version 26.0 and MedCalc software version 19.1.3 at 95% CI. A p < 0.05 was considered statistically significant.

RESULTS

Majority of our study subjects were female (64.5%), youth (51.0%), and married (62.0%). Overall, genotype A was the most prevalent (46%). Genotype D and the recombinant genotype D/E were proportionately more distributed in the high endemic (38.2%) and low endemic (36.5%) regions, respectively. Genotype D was significantly more prevalent in the high endemic region and among the elderly (p < 0.05). Genotype D was significantly associated with elevated viral load and direct bilirubin (p < 0.05). The recombinant genotype D/E was significantly associated with elevated viral load (p < 0.05). Similarly, genotype A was significantly associated with elevated AST and GGT, lowered viral load, and normal direct bilirubin levels (p < 0.05).

CONCLUSION

There is disproportionate distribution of genotypes A and D and the recombinant genotype D/E in the low and high endemic regions of Uganda. This probably could explain the differences in endemicity of HBV in our country signifying the need for regional specific HBV management and control strategies.

OVA-PEG-R848 nanocapsules stimulate neonatal conventional and plasmacytoid dendritic cells

Childhood mortality represents a major issue with 5. 3 million worldwide deaths of children under 5 years of age in 2019. Approximately half of those deaths can be attributed to easily preventable, infectious diseases. Currently approved neonatal vaccines are typically effective only after multiple doses leaving infants especially vulnerable during the first 6 months of life. Survival rates could be improved significantly by developing new and more potent vaccines that are capable of overcoming inherently tolerogenic neonatal immune systems. TLR agonists have garnered a great deal of attention in recent years due to their extensive capacities to activate innate immunity. Herein, the superior capacity of the TLR7/8 agonist, resiquimod (R848), to activate adult and neonatal primary peripheral blood dendritic cells is demonstrated. Moreover, R848 can be conjugated to polyethylene glycol and encapsulated in ovalbumin nanocapsules to efficiently co-deliver antigen and adjuvant in vitro. This study is among the first to demonstrate the capacity of encapsulated R848 to activate neonatal dendritic cells. These findings support the potential incorporation of R848 as adjuvant in neonatal vaccines, making them more effective in eliciting a robust immune response.

Determinants and preventive practices of midwives and physicians toward vertical transmission of hepatitis B in Ghana: a cross-sectional survey

Introduction

countries in sub-Saharan Africa, including Ghana, are disproportionately affected by hepatitis B viral (HBV) infection. In these areas, mother-to-child transmission (MTCT) is an essential mode of HBV transmission. Evidently, timely hepatitis B birth dose vaccination remains an effective preventive intervention against MTCT of HBV. Considering that midwives and physicians are the primary care providers of newborns in Ghana, we sought to examine their preventive practices toward vertical transmission of HBV in the eastern region of Ghana.

Methods

a cross-sectional survey was conducted with 126 healthcare providers (HCP; midwives and physicians). The participants were conveniently recruited from one regional hospital and four district hospitals. Statistical significance was set at 0.05 alpha level.

Results

the findings indicate that 42.9% (n = 54) of HCPs' prevention of mother to child transmission (PMTCT) practices for hepatitis B were good (X² = 2.57, p > 0.05). Explicitly, 79% indicated screening all pregnant women for hepatitis B as part of antenatal care (X² = 41.14, p < 0.001). Additionally, about half of the participants (52.4%) reported providing pre-test counselling (X² = 0.29, p > 0.05), whereas one-third (33%) reported routinely administering a birth dose of the hepatitis B vaccine to neonates of mothers with hepatitis B (X² = 14.00, p < 0.001). However, only 37% reported administering the hepatitis B vaccine to newborns within 12 hours of birth (X² = 9.18, p < 0.01). The binary logistic regression analyses identified training as the only significant predictor of good practice on PMTCT of hepatitis B at the 5% level (Wald = 3.91, p =0.05).

Conclusion

given that more than half of the participants in the study area had incorrect PMTCT practices for hepatitis B, it is imperative that a series of workshops on hepatitis B be done for healthcare providers in Ghana. In addition, hepatitis B birth dose vaccine must be incorporated into the ´Expanded Programme on Immunisation´ to remove the cost that acts as a barrier to access.

Analyses of blood donor samples from eight provinces in Lao PDR suggest considerable variation concerning HBV exposure and carriage

Introduction

Hepatitis B is endemic in Lao PDR and about 9% of the adult population is chronically infected. In this study, we investigated regional, occupational, age and sex-related differences in hepatitis B epidemiology in Lao blood donors.

Methods

5017 voluntary blood donors from 8 different provinces were tested for hepatitis B markers by ELISA. Predictors for the prevalence of hepatitis B surface antigen (HBsAg) and antibodies against the core antigen (anti-HBc) were assessed by bivariate and multivariable analyses.

Results

In total, 41% of the participants were positive for anti-HBc; the HBsAg prevalence was estimated at 6.9% among all participants (9.2% among first-time donors and 3.9% among repeat donors). Among first-time donors, HBsAg positivity was associated independently with being male (p<0.001), being from the North (p<0.001) and being soldier (p<0.001). Participants were more likely to be anti-HBc positive when they were male (p<0.001), from the Northern provinces (p<0.001) and older than 20 years (p<0.01).

Conclusion

In conclusion, our study confirmed an overall high HBsAg and anti-HBc prevalence in Lao PDR, albeit with considerable regional variation. The identification of a sizeable number of HBsAg positives among repeat donors warrants a thorough investigation of current blood screening, record keeping, donor identification and counselling practises.

Diagnosis experiences from 50 hepatitis B patients in Chongqing, China: a qualitative study

Background

The aim of this study was to provide recommendations for reducing the impact of hepatitis B infection on patients with chronic hepatitis B by describing their experiences during the diagnosis process.

Methods

We conducted face-to-face interviews with 50 hepatitis B patients recruited by convenient sampling from an infectious diseases department of a teaching hospital in Chongqing, China from July to August 2019. Thematic analysis framework included interviewees’ social demographic characteristics, diagnosis approach, signs and symptoms before diagnosis, feelings after diagnosis, and doctor’s instructions.

Results

Most patients first detected hepatitis B through various types of physical examinations when the patients were asymptomatic or had only mild symptoms. Most patients were shocked, scared, or overwhelmed when they were diagnosed with hepatitis B. They were able to remember the doctor’s instructions about maintaining a healthy lifestyle, but not impressed by the doctor’s advice about regular follow-up liver function tests. The lack of regular follow-up has caused irreversible damage to some patients.

Conclusions

Most patients are passively diagnosed with hepatitis B due to their lack of awareness on active hepatitis B prevention. Patients need professional mental health care to overcome the negative emotions that following the diagnosis. Physicians’ instruction should emphasize the importance of regular follow-up liver function tests in addition to a healthy lifestyle.

Burden and Transmission Risks of Viral Hepatitis in Southern Ethiopia: Evidence Needed for Prevention and Control Measures

BACKGROUND

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are significant causes of liver-associated morbidity and mortality for millions of people globally. Ethiopia is one of the viral hepatitis-endemic countries with no national strategy for surveillance and limited data. As such, this study aimed to investigated the extent and associated risk factors of HBV and HCV among community members in southern Ethiopia.

METHODS

A community-based cross-sectional study was conducted from January 2020 to August 2020. A structured questionnaire was used to collect behavioral and sociodemographic data. Serum samples were collected and assayed for seromarkers of HBV (HBsAg, anti-HBc, and anti-HBs) and HCV (anti-HCV) using ELISAs. In HBsAg-positive samples, HBV DNA was further quantified using RT-PCR. Data were entered into EpiData 3.1 and analyzed using SPSS 21.0. Descriptive statistics and logistic regression analysis were employed.

RESULTS

The study included 693 participants. Seromarkers for HBsAg, anti-HCV, anti-HBc, and anti-HBs were found to be 9.5%, 1.4%, 31.1%, and 14.3%, respectively. In 66 HBsAg positives, 57 (86.4%) had quantifiable HBV DNA. Prevalence of current HBV infection (HBsAg+, anti-HBc+, anti-HBs-) and lifetime exposure (positive for either HBsAg or anti-HBc) to HBV were 8.7% and 31.9%, respectively, and 63.1% of participants were vulnerable or had no evidence of prior HBV infection (HBsAg-, anti-HBc-, anti-HBs-). On multivariate logistic regression analysis, multiple sexual contacts, family history of hepatitis infection, alcohol consumption, and khat chewing were significantly associated with HBV. The seroprevalence of HBV was relatively high in this study area.

CONCLUSION

This study showed high prevalence of HBV infection, but low prevalence of HCV. This indicates that HBV is a major health problem in this community. Population-based surveillance, care, and treatment, as well as behavioral change and education programs, should be enhanced to minimize risk exposure.

Seroprevalence and Factors Associated with Risk of Hepatitis B Virus Infection among Antenatal Attendees in ABUTH Zaria, Northwestern Nigeria

Background

Nigeria is one of the sub-Saharan African countries within the World Health Organization's (WHO) hyperendemic region for hepatitis B virus infection with prevalence greater than 8%. In this region, mother-to-child transmission is the major route of infection and approximately 90% of newborns of mothers who are seropositive for HBsAg and HBeAg become chronic carriers with a 25% risk of developing chronic liver diseases. This study aimed to determine the seroprevalence, and factors associated with risk of hepatitis B virus infection among antenatal attendees in Ahmadu Bello University Teaching Hospital (ABUTH), Zaria.

Methodology

A hospital based cross sectional study was conducted among pregnant women Rattending the antenatal booking clinic of ABUTH, Zaria from August 2017 to January 2018. Systematic random sampling was used. An interviewer administered questionnaire was used to obtain data on sociodemographic characteristics and risk factors for HBV infection. Blood samples were collected and tested using the third generation ELISAkit for HBsAg (Monolisa HBsAg ULTRA BIORAD, France) and HBeAg(HBeAg & Ab, DiaPro Diagnostic Bioprobes Milano Italy). Data were analyzed using SPSS version 20 (IBM USA, 2011). Statistical testing was carried out with chi-squareand level of significance set as P<0.05.

Results

The mean age of the respondents was 26 ± 6.1 years, the highest HBV seropositivity occurred in the age group 21-25 years from a total of 192 participants. The seroprevalence of HBV obtained was 15.1%. Only1(3.4%) woman was positive for HBeAg among the 29 HBsAg seropositive women. Past history of unsafe injections was the only risk factor significantly associated with HBV seropositivity (x2= 5.628 p-value= 0.023).

Conclusions

The seropositivity of hepatitis B virus was high among pregnant women. Interventions targeted at injection safety will help reduce the risk of infection.

Risk factors associated with hepatitis B virus infection among pregnant women attending the antenatal care unit of the Bamenda Regional Hospital

Objectives

Approximately 257 million people are infected with hepatitis B virus (HBV) especially in the middle and low-income countries, despite the Global Health Sector Strategy on viral hepatitis 2016–2021 which aims to eliminate viral hepatitis as a public health threat by 2030. Hepatitis B virus (HBV) remains a common public health problem in Cameroon with a high prevalence among pregnant women. Therefore, this study was designed to assess risk factors associated with hepatitis B virus infection among pregnant women attending the antenatal care unit of the Bamenda Regional Hospital.

Study design

The study was a health facility-based cross-sectional study carried out from March to May 2020. The inclusion criteria were all pregnant women who came for their first visit.

Methods

A well-structured questionnaire and laboratory test methods were used to collect data from 221 pregnant women who were consecutively enrolled in the study. The OnSite HBsAg Rapid Test (source: CTK Biotech, Inc. REF: R0040), was used to detect HBsAg in serum. Both descriptive statistics and Chi-square (and Fisher's exact) test were used for data analysis.

Results

The prevalence of HBV infection among pregnant women was 4.98% (11/221). Although knowledge, attitude and practice towards HBV by pregnant women were not significantly associated with the risk of infection, there were higher odds of poor practice (P = 0.0152) and attitudes (P = 0.0016) among those without knowledge on HBV infection.

Conclusions

Free of charge vaccination for those with negative HBsAg test results and extensive health education campaigns against HBV is recommended among pregnant women attending the antenatal care unit of the Bamenda Regional Hospital.

A systematic review and meta-analysis of the prevalence of hepatitis B virus infection among pregnant women in Nigeria

Background

Nigeria has a high burden of hepatitis B virus (HBV) infection, commonly acquired through vertical transmission. However, there is a lack of an efficient surveillance system for monitoring and understanding the epidemiology of HBV among pregnant women. Building on a previous review on the prevalence of HBV in Nigeria (2000–2013), we conducted a systematic review and meta-analysis of HBV prevalence among pregnant women in Nigeria.

Methods

Four electronic databases PubMed, Embase, Global Health, and Scopus were systematically searched from January 2014 to February 2021. We also searched the African Journal Online and manually scanned the reference lists of the identified studies for potentially eligible articles. Observational studies that reported the prevalence of HBsAg and/or HBeAg among pregnant women in peer-reviewed journals were included in the study. We performed a meta-analysis using a random-effects model. We defined HBV infection as a positive test to HBsAg.

Results

From the 158 studies identified, 20 studies with a total sample size of 26, 548 were included in the meta-analysis. The pooled prevalence of HBV infection among pregnant women across the studies was 6.49% (95% confidence interval [CI] = 4.75–8.46%; I² = 96.7%, p = 0.001; n = 20). The prevalence of HBV was significantly lower among pregnant women with at least secondary education compared with those with no education or primary education (prevalence ratio = 0.7, 95% CI = 0.58–0.87; n = 10). However, the prevalence of HBV was not significantly different by age, religion, marital status, or tribe. The prevalence of HBV was not significantly different among pregnant women with previous surgery, blood transfusion, multiple lifetime sex partners, tribal marks, tattoos, scarification, or sexually transmitted infections, compared with those without these risk factors. From a total sample size of 128 (n = 7), the pooled prevalence of HBeAg among HBV-infected pregnant women was 14.59% (95% CI = 4.58–27.99%; I² = 65.5%, p = 0.01). Subgroup analyses of HBV infection by study region and screening method, and meta-regression analysis of the study year, sample size, and quality rating were not statistically significant.

Conclusions

There is an intermediate endemicity of HBV infection among pregnant women in Nigeria. Interventions, such as routine antenatal HBV screening, antiviral prophylaxis for eligible pregnant women, and infant HBV vaccination should be scaled up for the prevention of perinatal transmission of HBV infection in Nigeria.

Rapid Diagnostics for Hepatitis B and C Viruses in Low- and Middle-Income Countries

The global health challenge posed by hepatitis B virus (HBV) and hepatitis C virus (HCV) persists, especially in low-and-middle-income countries (LMICs), where underdiagnosis of these viral infections remains a barrier to the elimination target of 2030. HBV and HCV infections are responsible for most liver-related mortality worldwide. Infected individuals are often unaware of their condition and as a result, continue to transmit these viruses. Although conventional diagnostic tests exist, in LMIC they are largely inaccessible due to high costs or a lack of trained personnel, resulting in poor linkage to care and increased infections. Timely and accurate diagnosis is needed to achieve elimination of hepatitis B and C by the year 2030 as set out by the World Health Organization Global Health Sector Strategy. In this review rapid diagnostic tests allowing for quick and cost-effective screening and diagnosis of HBV and HCV, are discussed, as are their features, including suitability, reliability, and applicability in LMIC, particularly those within Africa.

Seroprevalence and Associated Factors of Hepatitis B and C Virus Among Pulmonary Tuberculosis Patients Attending Health Facilities in Gondar Town, Northwest Ethiopia

Background

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are hepatotropic viruses whose primary replication occurs in the liver. Despite the significant clinical importance of early screening of hepatitis B and C virus infection in decreasing the hepatotoxicity effect of anti-tuberculosis drugs, screening of hepatitis B and C virus among tuberculosis (TB) patients before treatment has not been practiced in Ethiopia. Thus, this study was conducted to determine the seroprevalence and associated factors of HBV and HCV infections among pulmonary TB (PTB) patients attending health facilities in Gondar, Northwest Ethiopia.

Methods

A cross-sectional study was conducted among 145 bacteriologically confirmed PTB patients from January 1 to May 30, 2019. After obtaining a signed informed consent from each participant, data on socio-demographic, clinical, and associated factors were collected using a structured pre-tested questionnaire. Besides, a blood sample was collected to determine HBsAg and HCV antibodies by enzyme linked immune sorbent assay (ELISA). The data were entered and analyzed using SPSS version 21. A Fisher's exact test was used to see the relationship between dependent and independent variables, and a p-value ≤0.05 was considered as statistically significant.

Results

Out of the 145 PTB patients screened, 5 (3.4%) patients tested positive for HBsAg, yet none of them were found to be positive for anti-HCV. Besides, the proportion of HIV-positive was 12 (8.3%). History of hospital admission (P= 0.005), tattooing (P= 0.009) and dental extraction (P=0.003) were significantly associated with HBsAg.

Conclusion

Although anti-HCV antibodies were not detected, the prevalence of HBV was relatively high in tuberculosis patients. This study highlights the need for the introduction of routine screening of viral hepatitis markers for all TB patients before anti-TB treatment for better management of patients. Likewise, further clinical and epidemiological studies are needed.

Hepatocellular carcinoma progression mediated by hepatitis B virus-encoded circRNA HBV_circ_1 through interaction with CDK1

Hepatitis B virus (HBV) produces circular RNA (circRNA), whose functions have not yet been clearly elucidated. In this study, a novel circRNA HBV_circ_1 produced by HBV was identified in HBV-positive HepG2.2.15 cells and HBV-related hepatocellular carcinoma (HCC) tissue (HCCT). Microarray analysis of 68 HCCT samples showed that HBV_circ_1 abundance was significantly higher than that in paracancerous tissues. In addition, survival rate of HBV_circ_1-positive patients was significantly lower compared with HBV_circ_1-negative patients. Transient expression indicated that HBV_circ_1 enhanced cell proliferation, migration, and invasion and inhibited apoptosis in vitro. Furthermore, ectopical HBV_circ_1 expression increased tumor size in vivo. HBV_circ_1 was confirmed to interact with cyclin-dependent kinase 1 (CDK1) to regulate cell proliferation. These results suggest that HCC progression may be promoted by interaction of HBV_circ_1 with CDK1. Our data not only showed a novel clue to understand carcinogenesis and progress of HBV-related HCC but also provided a new target for the development of therapeutic drugs.

Reviewing Antiviral Research Against Viruses Causing Human Diseases - A Structure Guided Approach

The littlest of all the pathogens, viruses have continuously been the foremost strange microorganisms to consider. Viral Infections can cause extreme sicknesses as archived by the HIV/AIDS widespread or the later Ebola or Zika episodes. Apprehensive framework distortions are too regularly watched results of numerous viral contaminations. Besides, numerous infections are oncoviruses, which can trigger different sorts of cancer. Nearly every year a modern infection species rises debilitating the world populace with an annihilating episode. Subsequently, the need of creating antivirals to combat such rising infections. In any case, from the innovation of to begin with antiviral medicate Idoxuridine in 1962 to the revelation of Baloxavir marboxil (Xofluza) that was FDA-approved in 2018, the hone of creating antivirals has changed significantly. In this article, different auxiliary science strategies have been described that can be referral for therapeutics innovation.