scholarly journals Chronic Hepatitis B in Canada

2001 ◽  
Vol 12 (6) ◽  
pp. 351-356 ◽  
Author(s):  
GY Minuk ◽  
J Uhanova

Recent developments in the treatment and prevention of hepatitis B virus (HBV) infections warrant revisiting important epidemiological questions, such as how prevalent is chronic HBV infection in Canada, in which Canadian subpopulations are HBV prevalence rates the highest, in what percentage of infected individuals is the virus actively replicating, and how many infected Canadians are candidates for antiviral therapy? Currently available data suggest the overall prevalence of HBV-infected individuals in the general population is approximately 2%, with 5% to 10% having serological evidence of previous HBV infection. In high risk groups, such as street-connected individuals, Aboriginals and immigrants from endemic areas, these rates of viral prevalence and serological evidence of previous HBV infection are approximately two to 10 and five to 10 times higher, respectively, than in the general population. Candidates for antiviral therapy range from less than 1% of infected Aboriginals to 15% to 30% of Asians with chronic HBV. From these data, it is clear that chronic HBV remains an important public health problem in this country. Hence, resources must be identified to enhance Canadians' awareness of HBV infection, maintain, if not expand, efforts to identify and implement safe and effective antiviral therapy for HBV-infected individuals, and continue programs for universal vaccination to prevent new HBV infections.

2014 ◽  
Vol 142 (10) ◽  
pp. 2140-2146 ◽  
Author(s):  
C. RICHTER ◽  
G. TER BEEST ◽  
E. H. GISOLF ◽  
P. VAN BENTUM ◽  
C. WAEGEMAEKERS ◽  
...  

SUMMARYMigrants born in hepatitis B virus (HBV) and hepatitis C virus (HCV) endemic countries are at increased risk of being infected with these viruses. The first symptoms may arise when liver damage has already occurred. The challenge is to identify these infections early, since effective treatment has become available. In 2011 we conducted a screening project in first-generation migrants (FGMs) born in Afghanistan, Iran, Iraq, the former Soviet Republics, and Vietnam and living in Arnhem and Rheden. All participants were offered free blood screening for HBV and HCV. In total 959 participants were tested, with the country of origin known for 927, equating to 28·7% of all registered FGMs from the chosen countries. Nineteen percent (n = 176) had serological signs of past or chronic HBV infection and 2·2% (n = 21) had chronic HBV infection. The highest prevalence of chronic HBV infection was found in the Vietnamese population (9·5%, n = 12). Chronic HCV was found in two persons from the former Soviet Republics and one from Vietnam. Twenty-four percent (n = 5) of the newly identified patients with chronic HBV and one of the three patients with chronic HCV received treatment. Three of the patients, two with HCV and one with HBV, already had liver cirrhosis. The highest (9·5%) HBV prevalence was found in FGMs from Vietnam, indicating a high need for focusing on that particular immigrant population in order to identify more people with silent HBV infection. The fact that three patients already had liver cirrhosis underlines the necessity of early identification of HBV and HCV infection in risk groups.


2021 ◽  
Vol 10 (11) ◽  
pp. 2320
Author(s):  
Yoon Seok Lee ◽  
Soo Min Bang ◽  
Young-Sun Lee

Hepatitis B virus (HBV) is a main cause of chronic liver disease worldwide and can lead to severe liver diseases. The World Health Organization has planned to eliminate viral hepatitis, including hepatitis caused by HBV and hepatitis C virus, by 2030. As mother-to-child transmission (MTCT) of HBV is a main cause of chronic HBV infection, MTCT prevention is the main target to reduce the risk of chronic HBV infection and eliminate the disease. Recent clinical trials and meta-analyses found that antiviral therapy could prevent MTCT effectively in mothers with ≥200,000 IU/mL of HBV DNA, in combination with serial vaccination and hepatitis B immune globulin administration in infants. Despite the preventive role of antivirals for MTCT of HBV, there are several concerns regarding antiviral therapy with respect to the safety of the mother and fetus during pregnancy. This review summarizes the benefits and risks of antiviral treatment during pregnancy in women with chronic HBV infection.


2019 ◽  
Vol 147 ◽  
Author(s):  
J. Koopsen ◽  
J. E. van Steenbergen ◽  
J. H. Richardus ◽  
M. Prins ◽  
E. L. M. Op de Coul ◽  
...  

AbstractChronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are usually asymptomatic for decades, thus targeted screening can prevent liver disease by timely diagnosis and linkage to care. More robust estimates of chronic HBV and HCV infections in the general population and risk groups are needed. Using a modified workbook method, the total number of ever chronically infected individuals in the Netherlands in 2016 was determined using population size and prevalence estimates from studies in the general and high-risk population. The estimated 2016 chronic HBV infection prevalence is 0.34% (low 0.22%, high 0.47%), corresponding to approximately 49 000 (low 31 000, high 66 000) HBV-infected individuals aged 15 years and older. The estimated ever-chronic HCV infection prevalence is 0.16% (low 0.06%, high 0.27%), corresponding to approximately 23 000 (low 8000, high 38 000) ever-chronic HCV-infected individuals. The prevalence of chronic HBV and HCV infections in the Netherlands is low. First-generation migrants account for most infections with 81% and 60% of chronic HBV and HCV infections, respectively. However, about one-fifth of HCV infections is found in the general population at low risk. This method can serve as an example for countries in need of more accurate prevalence estimates, to help the design and evaluation of prevention and control policies.


Genes ◽  
2018 ◽  
Vol 9 (11) ◽  
pp. 541 ◽  
Author(s):  
Md. uz-Zaman ◽  
Ayesha Rahman ◽  
Mahmuda Yasmin

Despite a considerable body of published research on hepatitis B in Bangladesh, researchers continue to lament the lack of reliable information about hepatitis B virus (HBV) infection epidemiology. The present review aims to provide a comprehensive survey of the literature with particular focus on a number of epidemiological questions, as well as a commentary on the trends of hepatitis B research as it has taken place in Bangladesh. The key themes to emerge from this review are: first, beyond noting a declining trend, it is difficult to provide conclusive estimates about HBV prevalence in the general population of Bangladesh. The majority of the studies, even the ones conducted on apparently healthy populations, fail to be adequately representative for the reasons explored in the article. Secondly, HBV infection in Bangladesh is sharply stratified across sociodemographic lines, which speaks to the role of awareness and risk exposure in HBV prevalence. Third, more research on occult infection rates is required to estimate the extent of risk posed by the current blood donation screening program, which relies exclusively on hepatitis B surface antigen as a biomarker. The same considerations apply for the comparative importance of vertical versus horizontal transmission and prevalence among particular risk groups like healthcare workers with high occupational exposure. Finally, while recent studies do allow us, albeit with some ambiguity, to draw conclusions about distribution of HBV genotypes in Bangladesh, there needs to be an added emphasis on molecular epidemiology. It is hoped that the present review, the first of its kind in Bangladesh, will serve as an up-to-date summary of the course HBV epidemiology research in Bangladesh has taken thus far, as well as crucial gaps to address going forward.


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e054039
Author(s):  
Justine Umutesi ◽  
Carolina Klett-Tammen ◽  
Sabin Nsanzimana ◽  
G Krause ◽  
J J Ott

ObjectivesUsing secondary data from 208 079 Rwandans, we determined the prevalence of chronic hepatitis B virus (HBV) infection among high-risk groups and its demographic, geographical and health-related determinants.DesignIn this cross-sectional study, we obtained and analysed data from a national hepatitis B vaccination and screening campaign conducted in Rwanda in 2017. We performed logistic regression to examine associations between chronic HBV infection and related factors such as risk status and geographical characteristics.SettingIndividuals were sampled nationally in all 30 districts across 4 provinces and the city of Kigali and all prisons in Rwanda.ParticipantsThe study involves 208 079 individuals at high risk including prisoners and other high-risk groups (oHRG).Main outcomeThe primary outcome for our study was hepatitis B surface antigens (HBsAg) prevalence.FindingsFrom 208 079 adults participants, 206 517 (99.2%) had valid HBsAg results, 4.3% of 64 944 prisoners and 4.0% of 140 985 oHRG were HBV positive. The prevalence was higher in Northern Province 5.1%, (95% CI 4.8 to 5.4). In multivariate analysis, the odds of infection decreased with increasing age, and hepatitis C antibody positivity reduced the odds for chronic HBV (OR 0.58, 95% CI 0.52 to 0.66 and OR 0.74, 95% CI 0.62 to 0.89 among oHRG and prisoners, respectively). In addition, being female was associated with lower odds of HBV (OR 0.70, 95% CI 0.66 to 0.74 and OR 0.80, 95% CI 0.65 to 0.98 among oHRG and prisoners, respectively).ConclusionWe found that individuals below 55 years of age and individuals who belong to high-risk groups (ie, sex workers, injection drug users, men who have sex with men, etc) have a higher probability of chronic HBV infection. Infection with chronic hepatitis C virus was not correlated with chronic HBV infection in our study population. Potential explanations include differential routes of transmission, specific immunological and pathophysiological factors or different effects of health prevention and control programmes.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Martin Moehlen ◽  
Maria De Medina ◽  
Mary Hill ◽  
Lennox Jeffers ◽  
Eugene R. Schiff ◽  
...  

Introduction. The aim of this study was to assess whether hepatitis B virus drug resistant mutations antedated the widespread use of nucleos(t)ide analogues in treatment naïve patients. A number of reports have suggested that drug resistant mutants can be detected in apparently treatment naïve patients. Study. Fifty deidentified serum samples collected from 1986 to 1992 from patients with replicative chronic HBV infection at the University of Miami were genotyped and tested for resistance mutations using a line probe assay InnoLiPA HBV DR v2/v3. Serum HBV DNA was measured. All patients had documented chronic HBV infection with a detectable viral load, HBeAg seropositivity, and absence of HIV infection. Results. Of the 50 individuals included, 86% were male, mean age was 40 ± 12 years, and mostly genotype A. The mean HBV DNA was 126 pg/mL (range 6.4 to 557.0). No mutations were identified. Conclusions. The absence of drug induced mutations in these sera collected several years prior to the introduction of oral antiviral therapy suggests that these mutations do not occur in treatment naïve populations. Detection of drug resistance in an apparently treatment naïve subject suggests either unrecognized prior antiviral therapy or infection by an inoculum from a treatment experienced patient.


2021 ◽  
Vol 8 ◽  
Author(s):  
Jing Zhou ◽  
Fa-Da Wang ◽  
Meng-Lan Wang ◽  
Ya-Chao Tao ◽  
Dong-Bo Wu ◽  
...  

ALT is one of the most sensitive biochemical indexes to reflect liver injury. It is generally believed that hepatitis B virus (HBV) infected patients with normal ALT levels are in either immune tolerance or low replication stage of the natural history of hepatitis B, and there is no or only mild inflammation in liver tissue, so antiviral therapy is not recommended. However, chronic HBV-infected patients with normal ALT levels are not always in a stable state. A considerable number of patients will develop active hepatitis or occult progress to liver fibrosis, cirrhosis, and hepatocellular carcinoma. Therefore, whether antiviral therapy should be recommended for chronic HBV infection with normal ALT level has been a hot topic in clinical practice. In this paper, the definition of immune tolerance, the relationship between ALT and liver inflammation, and the benefits of antiviral therapy were reviewed, and we hope it will be helpful for clinicians to have a deeper understanding of whether antiviral therapy should be considered for chronic HBV infection with normal ALT.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Huai Wang ◽  
Peixuan Men ◽  
Yufeng Xiao ◽  
Pei Gao ◽  
Min Lv ◽  
...  

Abstract Background Hepatitis B virus (HBV) infection is a major public health problem in China. Over a decade has passed since the last National Hepatitis Seroepidemiological Survey was conducted in 2006. The lack of updated data on hepatitis B in China makes assessing the current prevalence and burden of the disease inadequate. In response to the above situation, a systematic review and meta-analysis was conducted to provide a better understanding of hepatitis B epidemiology in the general population of China. Methods A systematic search was conducted in international databases (Medline through PubMed, EMBASE, Cochrane, Web of Science) and national databases (CBM, CNKI, WanFang Data) to retrieve primary studies published between January 1, 2013 and December 31, 2017. The pooled prevalence of HBV infection and 95% confidence intervals were calculated. Quality assessment, heterogeneity testing and publication bias assessment were also performed. Results Of the 27 studies included in the meta-analysis, the pooled estimated prevalence of HBV infection in the general population of China from 2013 to 2017 was 6.89% (95% CI:5.84–7.95%), which could be extrapolated to an estimated population of 84 million living with HBsAg in 2018. The prevalence of HBV infection in males was higher than that in females (5.88% vs 5.05%), and rural areas had a higher prevalence than urban areas (5.86% vs 3.29%). The highest prevalence of HBV infection was reported in Western provinces (8.92, 95% CI: 7.19–10.64%). In adults older than 20 years, the prevalence of HBV infection was approximately 7%, which was higher than that in children. Conclusion The prevalence of HBV infection in the general population of China was classified as higher intermediate prevalence (5–7.99%), of which more than 90% of the HBV infection population included adults older than 20 years. The blocking of mother-to-infant hepatitis B transmission and plans involving timely birth dose of hepatitis B vaccine within 24 h should be implemented. Additionally, improving the quality of life and survival rate of the infected population through antiviral therapy and high-risk adult vaccination will be the priority of our future work. Moreover, various control measures should be implemented in different provinces across China.


2020 ◽  
Vol 38 (3) ◽  
pp. 145-149
Author(s):  
Md Golam Mustafa ◽  
Md Shahinul Alam ◽  
Md Golam Azam ◽  
Md Mahabubul Alam ◽  
Md Saiful Islam ◽  
...  

Worldwide, hepatitis B virus (HBV) infection is still a major public health problem. Bangladesh having a large burden of HBV infection, should be a major contributor towards it’s elimination by 2030. The country has been making progress in reducing incidence of HBV infection during the past decades. The progresses are mainly due to large vaccination coverage among children and large coverage of timely birthdose vaccine for prevention of mother-to-child transmission of HBV. However, Bangladesh still faces challenges in achieving target of reduction in mortality from HBV. On the basis of targets of the WHO’s Global health sector strategy on viral hepatitis 2016–2021, we highlight priorities for action towards HBV elimination. To attain the target of reduced mortality we propose that, the service coverage targets of diagnosis and treatment should be prioritized along with vaccination. Firstly, improvements are needed in the diagnostic and treatment abilities of medical institutions and health workers. Secondly, the government needs to reduce the costs of health care. Thirdly, better coordination is needed across existing national program and resources to establish an integrated system for prevention, screening, diagnosis and treatment of HBV infection. In this way, we can make progress towards achieving the target of eliminating HBV from Bangladesh by 2030 J Bangladesh Coll Phys Surg 2020; 38(3): 145-149


2014 ◽  
Vol 112 (11) ◽  
pp. 1751-1768 ◽  
Author(s):  
S. Fiorino ◽  
L. Bacchi-Reggiani ◽  
S. Sabbatani ◽  
F. Grizzi ◽  
L. di Tommaso ◽  
...  

Hepatitis B virus (HBV) infection represents a serious global health problem and persistent HBV infection is associated with an increased risk of cirrhosis, hepatocellular carcinoma and liver failure. Recently, the study of the role of microRNA (miRNA) in the pathogenesis of HBV has gained considerable interest as well as new treatments against this pathogen have been approved. A few studies have investigated the antiviral activity of vitamin E (VE) in chronic HBV carriers. Herein, we review the possible role of tocopherols in the modulation of host miRNA with potential anti-HBV activity. A systematic research of the scientific literature was performed by searching the MEDLINE, Cochrane Library and EMBASE databases. The keywords used were ‘HBV therapy’, ‘HBV treatment’, ‘VE antiviral effects’, ‘tocopherol antiviral activity’, ‘miRNA antiviral activity’ and ‘VE microRNA’. Reports describing the role of miRNA in the regulation of HBV life cycle,in vitroandin vivoavailable studies reporting the effects of VE on miRNA expression profiles and epigenetic networks, and clinical trials reporting the use of VE in patients with HBV-related chronic hepatitis were identified and examined. Based on the clinical results obtained in VE-treated chronic HBV carriers, we provide a reliable hypothesis for the possible role of this vitamin in the modulation of host miRNA profiles perturbed by this viral pathogen and in the regulation of some cellular miRNA with a suggested potential anti-HBV activity. This approach may contribute to the improvement of our understanding of pathogenetic mechanisms involved in HBV infection and increase the possibility of its management and treatment.


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