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Feng W, Li Z, Fan M, Yang S, Shao Y, Liu K, Huang S, Fu S. Health economic evaluation of newborn hepatitis B immunization prevention strategies in Ningbo: a Markov modeling study. Front Public Health 2025; 13:1532604. [PMID: 40308912 PMCID: PMC12040845 DOI: 10.3389/fpubh.2025.1532604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Accepted: 03/27/2025] [Indexed: 05/02/2025] Open
Abstract
Background Hepatitis B virus (HBV) infection poses a significant public health challenge in China. The Prevention of mother-to-child Transmission (PMTCT) strategy of combining universal hepatitis B vaccination with hepatitis B immunoglobulin (HBIG) for newborns is crucial in preventing widespread infection. In this study, we conduct health economic evaluation of three strategies: PMTCT, universal vaccination, and non-vaccination for newborns in Ningbo, China. Methods This study developed a decision-Markov model and simulated a cohort of 100,000 newborns to assess the cost-effectiveness and cost-benefit of three strategies from a healthcare system perspective. The primary outputs included total costs, life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), benefit-cost ratios (BCRs). One-way and probabilistic sensitivity analyses (PSA) were performed to verify the robustness of the model. Results Among the three strategies, the PMTCT results in the least disease burden and mortality related to hepatitis B. In comparison to a cohort of 100,000 unvaccinated infants, the PMTCT is expected to prevent 6,029 cases of acute symptomatic infections, 27,348 HBV carriers, 4,170 chronic infections, 3,597 cases of cirrhosis, 2,911 cases of hepatocellular carcinoma (HCC), and 3,930 HBV-related deaths. The ICERs for PMTCT and universal vaccination were - 56,371.77 yuan/QALY and - 56,654.77 yuan/QALY, respectively. The BCRs for PMTCT and universal vaccination were 19.13 and 15.95, respectively, when compared to no vaccination. The PSA revealed that all ICER scatter points are situated within the fourth quadrant, and the probability of PMTCT being cost-effective exceeds 90%. Conclusion Implementing universal hepatitis B vaccination with HBIG for newborns in Ningbo demonstrated high cost-effectiveness, making the continuation of the PMTCT strategy highly recommended.
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Affiliation(s)
- Wei Feng
- Fenghua District Center for Disease Control and Prevention, Ningbo, China
| | - Zhengxiong Li
- School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, China
| | - Mingkuan Fan
- School of Medicine, Xiangyang Polytechnic, Xiangyang, China
| | - Sijia Yang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Yuqi Shao
- Fenghua District Center for Disease Control and Prevention, Ningbo, China
| | - Kui Liu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | | | - Sanjun Fu
- Fenghua District Center for Disease Control and Prevention, Ningbo, China
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Aremu DO, Maxim A, Aremu SO, Aremu DE, Terhemen YD, Itodo SO, Barkhadle AA. The interplay of socio-demographic factors and disease prevalence: insights into malaria, Hepatitis B, and Hepatitis C in Lafia, Nasarawa State, Nigeria. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2025; 44:67. [PMID: 40051006 PMCID: PMC11883923 DOI: 10.1186/s41043-025-00779-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2025] [Accepted: 01/29/2025] [Indexed: 03/10/2025]
Abstract
BACKGROUND Infectious diseases, including malaria, Hepatitis B surface antigen (HBsAg), and Hepatitis C virus (HCV), remain significant public health concerns in developing regions like Lafia, Nasarawa State, Nigeria. Socio-demographic factors, such as gender, age, income level, and access to healthcare resources, have been shown to influence the prevalence and outcomes of these diseases. Despite their importance, there is limited research exploring the interrelationship between these infections and socio-demographic factors within this region. The study aims to investigate the prevalence of malaria, HBsAg, and HCV among patients in Lafia, Nigeria, and to examine the relationship between these infections and socio-demographic factors. Specifically, it seeks to identify correlations between demographic variables, clinical manifestations, and health behaviors, such as mosquito net usage and vaccination status. METHOD A cross-sectional design was employed, involving 264 patients from Lafia, Nasarawa State, Nigeria. Data were collected using structured questionnaires which were pretested in a previous study to gather demographic information, vaccination status, and clinical symptoms. Laboratory assessments confirmed the presence of malaria, HBsAg, and HCV. Statistical analysis, including correlations between socio-demographic factors and disease prevalence were analyzed, and used to identify associations between socio-demographic factors, clinical manifestations, and disease prevalence. RESULTS Significant findings include a negative correlation between male sex and malaria infection (Pearson Correlation = -0.139, p = 0.024), a positive correlation between age and HCV prevalence (Pearson Correlation = 0.218, p < 0.001), and a negative correlation between the use of mosquito nets and malaria infection (Pearson Correlation = -0.231, p < 0.001). Additionally, HBsAg-positive individuals exhibited more pronounced clinical symptoms (Pearson Correlation = 0.173, p = 0.005), while higher income levels correlated with reduced mosquito net usage (Pearson Correlation = -0.144, p = 0.020). The study underscores the role of socio-demographic factors in shaping the prevalence of malaria, HBsAg, and HCV. CONCLUSION This study highlights the interplay between socio-demographic factors and the prevalence of malaria, HBsAg, and HCV in Lafia, Nigeria. It underscores the importance of comprehensive public health interventions tailored to the specific needs of the population to reduce disease burden and improve health outcomes, including health education, to address socio-economic vulnerabilities and promote preventive measures such as mosquito net usage. Addressing these factors could mitigate the burden of infectious diseases in Lafia and similar regions.
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Affiliation(s)
- Dorcas Oluwakemi Aremu
- Sechenov University, Tomsk, Russia
- Department of Microbiology, Federal University Wukari, Wukari, Taraba State, Nigeria
| | | | - Stephen Olaide Aremu
- Global Health and Infectious Disease Control Institute, Nasarawa State University, Keffi, Nasarawa State, Nigeria
| | | | | | - Samuel Olusegun Itodo
- Department of Pharmacology and Therapeutics, Benue State University, Benue State, Makurdi, Nigeria
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Paik H. Unraveling multimodality of digital health records by comparing mortality trajectories of diagnoses of diseases from over 12 million patients. PLoS One 2025; 20:e0314993. [PMID: 39903726 PMCID: PMC11793822 DOI: 10.1371/journal.pone.0314993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 11/19/2024] [Indexed: 02/06/2025] Open
Abstract
Understanding the multimodality of digital health data, including the scope of death records, is essential for adequate data acquisition to build a research framework for the health sciences. In this study, I leveraged the diverse healthcare records of over 12 million patients to reconstitute mortality trajectories that navigate the sequence of disease processes shared among patients from initial presentation through interim conditions that ultimately terminate in fatal outcomes. I conducted a comprehensive analysis of longitudinal discharge records for 10.4 million patients from US hospitals, utilizing the US State Inpatient Data (USSID) including 290,253 records of deaths in clinics. I also scrutinized the cross-sectional records of Korea from the billing reviews, specifically the National Inpatients Set of Korea (NISK), encompassing 2.1 million patients. By tracing the diagnostic timelines of patients diagnosed with significant comorbid diseases (False Discovery Rate (FDR) <0.1), I built mortality trajectories, mapping the temporal progression of disease diagnoses resulting in death. My trajectory model rewired 705 significant mortality trajectories across both datasets (USSID and NISK). The presented mortality trajectories successfully recapitulated established patterns of mortality for each country, while also revealing different trajectories leading to death, influenced by the modality of data. For example, viral hepatitis, a known predisposing feature of liver cancer in Asia, was observed to initiate in younger Koreans. Interestingly, owing to the collection of hospital records, the modeled mortality trajectories derived from the USSID converged towards sepsis. Although a substantial sequence of diagnostic processes is shared between USSID and NISK, the multimodality of these two datasets highlights different diagnoses preceded by fatal outcomes. Unraveling mortality patterns is feasible with an appropriate understanding of the multimodality of digital health data.
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Affiliation(s)
- Hyojung Paik
- Department of Data & High Performance Computing Science, University of Science and Technology (UST), Yuseong-gu, Daejeon, South Korea
- Division of National Supercomputing, Center for Biomedical Computing, Korea Institute of Science and Technology Information (KISTI), Yuseong-gu, Daejeon, South Korea
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Abdullah R, Kamarozaman NS, Ab Dullah SS, Aziz MY, Aziza HBA. Health risks evaluation of mycotoxins in plant-based supplements marketed in Malaysia. Sci Rep 2025; 15:1244. [PMID: 39774309 PMCID: PMC11707365 DOI: 10.1038/s41598-025-85280-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Accepted: 01/01/2025] [Indexed: 01/11/2025] Open
Abstract
Mycotoxins are toxic secondary metabolites produced by fungi, pose significant health risks when present in plant-based supplements (PBS), necessitating thorough risk assessment to ensure consumer safety. This study evaluates the health risks associated with mycotoxins, specifically aflatoxins (AFB1, AFB2) and ochratoxin A (OTA), in PBS sold in Malaysia. Contamination levels of AFB1, AFB2, and OTA were quantified in 14 PBS samples using Liquid Chromatography-Mass Spectrometry. All samples tested positive for AFB2, while 28.57% and 42.86% tested positive for AFB1 and OTA, respectively with some levels exceeding the regulatory limits set by the Malaysian Food Act 1983 and European regulations. The estimated daily intake of these mycotoxins was calculated based on the recommended daily intake of each supplement. To assess risk, Margin of Exposure (MOE) values were determined, showing that all AFB2-positive samples had MOE values below the critical threshold of 10,000, indicating an urgent need for risk management. A quantitative cancer risk assessment also estimated the percentage of hepatocellular carcinoma and kidney cancer attributable to mycotoxin exposure. The findings emphasize the significant public health risks posed by mycotoxins, particularly in samples B2 and B10, where all three mycotoxins studied were present at concerning levels. This study highlights the urgent need for stricter regulations and better monitoring of mycotoxin levels in PBS to protect consumer's health.
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Affiliation(s)
- Rozaini Abdullah
- Department of Environmental & Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
| | - Nur Syazwin Kamarozaman
- Department of Environmental & Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Siti Soleha Ab Dullah
- Toxicology and Pharmacology Unit, Herbal Medicine Research Centre, Institute for Medical Research, National Institute of Health, Persiaran Setia Murni, Setia Alam, 40170, Shah Alam, Selangor Darul Ehsan, Malaysia
| | - Mohd Yusmaidie Aziz
- Department of Toxicology, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, 13200, Kepala Batas, Pulau Pinang, Malaysia
| | - Hussein Bakheit Adam Aziza
- Faculty of Defense and Security, Rabdan Academy, 22401, Abu Dhabi, United Arab Emirates
- Department of Food Hygiene and Safety, Faculty of Public and Environmental Health, University of Khartoum, 11111, Khartoum, Sudan
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Posuwan N, Wasitthankasem R, Pimsing N, Phaengkha W, Ngamnimit S, Vichaiwattana P, Klinfueng S, Raksayod M, Poovorawan Y. Hepatitis B prevalence in an endemic area of hepatitis C virus: A population-based study implicated in hepatitis elimination in Thailand. J Virus Erad 2024; 10:100577. [PMID: 39760120 PMCID: PMC11699449 DOI: 10.1016/j.jve.2024.100577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Revised: 12/09/2024] [Accepted: 12/09/2024] [Indexed: 01/03/2025] Open
Abstract
Chronic hepatitis B (HBV) and C (HCV) are major health challenges in Thailand, with Phetchabun province, a known HCV-endemic area, being a key target for elimination efforts. This study aimed to assess HBV prevalence and identify associated risk factors in this province. Data was collected from three cross-sectional population studies: (1) adults in 2015 (n = 1,667, age 30-64 years), (2) young adults in 2017 (n = 1,453, age 18-30 years), both from high HCV-endemic districts, and (3) a province-wide study in 2018 (n = 4,769, age 35-64 years). Plasma samples were tested for HBsAg using the ARCHITECT assay. Results showed HBsAg seropositivity in 3.1 % of young adults in high-endemic districts, with significant associations with age, education, injecting drug use, and MSM behavior. Among adults, HBsAg prevalence was 5.9 %, linked to age and family liver disease history. Province-wide, 6.3 % of adults tested positive, with factors like gender and history of blood donation playing significant roles. Notably, age and blood donation were protective factors against HBV in adults. Analysis revealed a moderate HBV prevalence in those born before Thailand Expanded Program on Immunization (EPI) program, while those born after had rates below 1 %. The findings emphasize distinct HBV transmission patterns in different age groups, influenced by social and behavioral shifts. This knowledge is crucial for effective hepatitis elimination strategies in the Phetchabun province and nationwide.
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Affiliation(s)
- Nawarat Posuwan
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Chulahorn International College of Medicine, Thammasat University, Rangsit Campus, Patum Thani, Thailand
| | - Rujipat Wasitthankasem
- National Biobank of Thailand, National Center for Genetic Engineering and Biotechnology, Thailand Science Park, Patum Thani, Thailand
| | - Napaporn Pimsing
- Phetchabun Provincial Public Health Office, Phetchabun, Thailand
| | | | | | - Preeyaporn Vichaiwattana
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sirapa Klinfueng
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Maneerat Raksayod
- National Biobank of Thailand, National Center for Genetic Engineering and Biotechnology, Thailand Science Park, Patum Thani, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Lin WC, Lin K, Li MK, Liu X, Huang YF, Wang X, Wu B. Low level of hepatitis B viremia is associated with increased risk of hepatocellular carcinoma in compensated cirrhotic patients. World J Hepatol 2024; 16:1321-1330. [PMID: 39606169 PMCID: PMC11586753 DOI: 10.4254/wjh.v16.i11.1321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 09/09/2024] [Accepted: 10/10/2024] [Indexed: 11/06/2024] Open
Abstract
BACKGROUND Whether patients with compensated cirrhosis and low-level viremia (LLV) of hepatitis B should receive antiviral therapy (AVT) is still controversial, and published results are inconsistent. AIM To investigate the link between LLV in compensated cirrhosis and prognosis concerning hepatocellular carcinoma (HCC), decompensation, and liver-related events. METHODS The PubMed, EMBASE, and Cochrane Library databases were searched up to March 5, 2023. Outcomes of interest were assessed by pooled hazard ratios (HRs). The study was registered with PROSPERO (CRD42023405345). RESULTS Six cohort studies representing 3155 patients were included. Compared with patients with undetectable HBV DNA, patients with LLV was associated with increased risk of HCC (HR: 2.06, 95%CI: 1.36-3.13; Q-statistic-P = 0.07, I 2 = 51%) regardless of receiving AVT or not (AVT group: HR: 3.14; 95%CI: 1.73-5.69; Q-statistic-P = 0.60, I 2 = 0%; un-AVT group: HR: 1.73, 95%CI: 1.09-2.76; Q-statistic-P = 0.11, I 2 = 50%). The pooled results showed no statistical association between LLV and decompensation of cirrhosis (HR: 2.06, 95%CI: 0.89-4.76; Q-statistic-P = 0.04, I 2 = 69%), and liver-related events (HR: 1.84, 95%CI: 0.92-3.67; Q-statistic-P = 0.03, I 2 = 72%), respectively. Grading of Recommendations Assessment, Development and Evaluation assessment indicated moderate certainty for HCC, very low certainty for decompensation of cirrhosis and liver-related clinical events. CONCLUSION LLV in compensated cirrhotic patients is associated with increased risk of HCC, higher tendency for hepatic decompensation and liver-related events. Closer screening of HCC should be conducted in this population.
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Affiliation(s)
- Wei-Chun Lin
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
| | - Ke Lin
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China
| | - Ming-Kai Li
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
| | - Xiao Liu
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China
| | - Yi-Fei Huang
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
| | - Xing Wang
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
| | - Bin Wu
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China.
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Danpanichkul P, Aboona MB, Sukphutanan B, Kongarin S, Duangsonk K, Ng CH, Muthiah MD, Huang DQ, Seko Y, Díaz LA, Arab JP, Yang JD, Chen VL, Kim D, Noureddin M, Liangpunsakul S, Wijarnpreecha K. Incidence of liver cancer in young adults according to the Global Burden of Disease database 2019. Hepatology 2024; 80:828-843. [PMID: 38598364 DOI: 10.1097/hep.0000000000000872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/19/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND AND AIMS The worldwide burden of cancer is increasing in younger populations. However, the epidemiology of primary liver cancer remains understudied in young adults compared to other cancer forms. APPROACH AND RESULTS This study analyzed data from the Global Burden of Disease study between 2010 and 2019 to assess the age-standardized incidence, mortality, and disability-adjusted life years associated with primary liver cancer in the young (15-49 y), stratified by region, nation, sociodemographic index, and sex. The study found a global estimate of 78,299 primary liver cancer cases, 60,602 deaths, and 2.90 million disability-adjusted life years in the young population. The Western Pacific region exhibited the highest burden in 2019, showing the most significant increase compared to other regions between 2010 and 2019. More than half of the countries worldwide have undergone an increase in primary liver cancer incidence rates in young adults. Around 12.51% of deaths due to primary liver cancer occur in young individuals. Throughout the study period, there was a significant decline in primary liver cancer mortality due to most etiologies, except for metabolic dysfunction-associated steatotic liver disease-attributable primary liver cancer (annual percentage change + 0.87%, 95% CI: 0.70%-1.05%) and alcohol-attributable primary liver cancer (annual percentage change + 0.21%, 95% CI: 0.01%-0.42%). The limitations of the Global Burden of Disease database include reliance on the quality of primary data and possible underestimation of alcohol consumption. CONCLUSIONS Over the past decade, there has been a marked increase in the burden of primary liver cancer, especially that originating from steatotic liver disease. This trend calls for the development of urgent and comprehensive strategies to mitigate this rising burden globally.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Majd B Aboona
- Department of Internal Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | | | | | - Kwanjit Duangsonk
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Cheng Han Ng
- Department of Medicine, Division of Gastroenterology and Hepatology, National University Health System, Singapore
- Department of Medicine, Division of Gastroenterology, Kurume University School of Medicine, Kurume, Japan
| | - Mark D Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Daniel Q Huang
- Department of Medicine, Division of Gastroenterology and Hepatology, National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- MASLD Research Center, Division of Gastroenterology, University of California, San Diego, La Jolla, California, USA
| | - Yuya Seko
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyou-ku, Kyoto, Japan
| | - Luis Antonio Díaz
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
| | - Juan Pablo Arab
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Department of Medicine, Division of Gastroenterology, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Vincent L Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
| | - Mazen Noureddin
- Houston Research Institute and Houston Methodist Hospital, Houston, Texas, USA
| | - Suthat Liangpunsakul
- Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA
| | - Karn Wijarnpreecha
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Arizona College of Medicine, Phoenix, Arizona, USA
- Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA
- BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
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Belete D, Fekadie E, Kassaw M, Fenta M, Jegnie A, Mulu T, Assefa M, Adane G, Abebe W, Amare A. Seroprevalence of hepatitis B and hepatitis C virus among clinically suspected cases of viral hepatitis visiting Guhalla Primary Hospital, Northwest Ethiopia. Sci Rep 2024; 14:21956. [PMID: 39304682 DOI: 10.1038/s41598-024-71363-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 08/27/2024] [Indexed: 09/22/2024] Open
Abstract
Hepatitis B virus and hepatitis C virus remains one of the leading causes of morbidity and mortality worldwide, particularly in countries with limited resources. The two hepatotropic viruses have common mode of transmission. Hepatitis B virus and hepatitis C virus are the main causes of Cirrhosis, liver cancer and death. To determine the Seroprevalence of HBsAg and anti-HCV antibodies among clinically suspected cases of viral hepatitis visiting Guhalla Primary Hospital, Northwest Ethiopia. A hospital-based retrospective study was conducted at Guhalla Primary Hospital, Northwest Ethiopia. The study included serology registration logbook data from all patients who visited the hospital and were tested using a rapid test kit between September 1st, 2017 to August 30, 2021. Data were entered, cleaned, and analyzed using SPSS version 26 software. Bivariate analysis was computed and a multivariable analysis was conducted to provide an adjusted odds ratio (AOR). p-value < 0.05 at a 95% confidence interval was considered statistically significant. In this study, a total of 883(883 for HBV and 366 for HCV) study participants were included. The overall prevalence of HBsAg and anti-HCV were 124/883(14%) and 73/366 (19.9%), respectively. The prevalence of HBV and HCV among males from the total HBV and HCV screened was 70/410 (17.1%) and 53/366(14.4%) respectively. In this study, being female (AOR 1.53, 95% CI 1.03-2.27, p = 0.003) and age group of 31-40 years (AOR 2.85; 95% CI 1.56, 5.17, p = 0.001) were statistically significant factors to HBV infection. Similarly, being female (AOR 1.97, 95% CI 1.10-3.53, p = 0.02), age group of 21-30 years (AOR 2.71; 95% CI 1.15, 6.40, p = 0.02) and age group greater than 40 years (AOR 3.13; 95% CI 1.31, 7.44, p = 0.01) were significantly associated with HCV infection. In our study, high seroprevalence of HBV and HCV infection was detected among clinically suspected patients. Females and the age groups between 31 and 40 were more affected. Community awareness of the prevention and transmission of viral hepatitis infection should be strengthened through herd immunization and health education. The prospective study should be conducted in this area.
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Affiliation(s)
- Debaka Belete
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.Box 196, Gondar, Ethiopia.
| | - Engidayehu Fekadie
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkamu Kassaw
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Fenta
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Azanu Jegnie
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tigist Mulu
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muluneh Assefa
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.Box 196, Gondar, Ethiopia
| | - Gashaw Adane
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wondwossen Abebe
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.Box 196, Gondar, Ethiopia
| | - Azanaw Amare
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.Box 196, Gondar, Ethiopia
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Li J, Jia YM, Zhang ZL, Liu CY, Jiang ZW, Hao ZW, Peng L. Development and validation of a machine learning-based early prediction model for massive intraoperative bleeding in patients with primary hepatic malignancies. World J Gastrointest Oncol 2024; 16:90-101. [PMID: 38292843 PMCID: PMC10824121 DOI: 10.4251/wjgo.v16.i1.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/12/2023] [Accepted: 12/01/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Surgical resection remains the primary treatment for hepatic malignancies, and intraoperative bleeding is associated with a significantly increased risk of death. Therefore, accurate prediction of intraoperative bleeding risk in patients with hepatic malignancies is essential to preventing bleeding in advance and providing safer and more effective treatment. AIM To develop a predictive model for intraoperative bleeding in primary hepatic malignancy patients for improving surgical planning and outcomes. METHODS The retrospective analysis enrolled patients diagnosed with primary hepatic malignancies who underwent surgery at the Hepatobiliary Surgery Department of the Fourth Hospital of Hebei Medical University between 2010 and 2020. Logistic regression analysis was performed to identify potential risk factors for intraoperative bleeding. A prediction model was developed using Python programming language, and its accuracy was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS Among 406 primary liver cancer patients, 16.0% (65/406) suffered massive intraoperative bleeding. Logistic regression analysis identified four variables as associated with intraoperative bleeding in these patients: ascites [odds ratio (OR): 22.839; P < 0.05], history of alcohol consumption (OR: 2.950; P < 0.015), TNM staging (OR: 2.441; P < 0.001), and albumin-bilirubin score (OR: 2.361; P < 0.001). These variables were used to construct the prediction model. The 406 patients were randomly assigned to a training set (70%) and a prediction set (30%). The area under the ROC curve values for the model's ability to predict intraoperative bleeding were 0.844 in the training set and 0.80 in the prediction set. CONCLUSION The developed and validated model predicts significant intraoperative blood loss in primary hepatic malignancies using four preoperative clinical factors by considering four preoperative clinical factors: ascites, history of alcohol consumption, TNM staging, and albumin-bilirubin score. Consequently, this model holds promise for enhancing individualised surgical planning.
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Affiliation(s)
- Jin Li
- Department of Hepatological Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Yu-Ming Jia
- Department of Hepatological Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Zhi-Lei Zhang
- Department of Hepatological Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Cheng-Yu Liu
- Department of Hepatological Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Zhan-Wu Jiang
- Department of General Surgery II, Baoding First Central Hospital, Baoding 071000, Hebei Province, China
| | - Zhi-Wei Hao
- Department of General Surgery II, Baoding First Central Hospital, Baoding 071000, Hebei Province, China
| | - Li Peng
- Department of Hepatological Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
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Ab Dullah SS, Sabran MR, Hasiah AH, Abdullah R. Risk assessment of aflatoxin B 1 in herbal medicines and plant food supplements marketed in Malaysia using margin of exposure and RISK21 approaches. Genes Environ 2023; 45:31. [PMID: 37993956 PMCID: PMC10666461 DOI: 10.1186/s41021-023-00286-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/24/2023] [Indexed: 11/24/2023] Open
Abstract
Aflatoxin B1 (AFB1) is a mycotoxin produced by several species of Aspergillus fungi which can cause liver cancer in animals and humans. This study aims to perform the risk assessment of AFB1 in herbal medicines and plant food supplements (PFS) in Malaysian market. A total of 31 herbal medicines and PFS were purchased through online platforms and over the counter using a targeted sampling strategy. Of 31 samples analysed using the ELISA method, 25 (80.6%) were contaminated with AFB1 at levels ranged from 0.275 to 13.941 μg/kg. The Benchmark Dose Lower Confidence level of 10 (BMDL10) of 63.46 ng/kg bw/day and the estimated dietary intake of the adult population ranged from 0.006 to 10.456 ng/kg bw/day were used to calculate the Margin of Exposure (MOE). The MOEs for 24 (96%) out of the 25 positive samples were lower than 10,000. The RISK21 matrix revealed that AFB1 exposure levels from herbal medicines and PFS differed greatly over the world. The calculated population risk of acquiring liver cancer from AFB1 exposure ranged from 0 to 0.261 cancers/100,000 populations/year and accounted for an estimated percentage of liver cancer incidence ranged from 0.002 to 4.149%. This study revealed a moderate risk of liver cancer attributable to AFB1 from herbal medicine and PFS among Malaysian populations and emphasised an urgency for risk management actions.
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Affiliation(s)
- Siti Soleha Ab Dullah
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, 43400 UPM, Serdang, Selangor Darul Ehsan, Malaysia
- Biomedical Research Policy and Strategic Planning Unit, Institute for Medical Research, National Institute of Health, Persiaran Setia Murni, Setia Alam, 40170, Shah Alam, Selangor Darul Ehsan, Malaysia
| | - Mohd Redzwan Sabran
- Department of Nutrition, Faculty of Medicine and Health Sciences, 43400 UPM, Serdang, Selangor Darul Ehsan, Malaysia
| | - Ab Hamid Hasiah
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, 43400 UPM, Serdang, Selangor Darul Ehsan, Malaysia
| | - Rozaini Abdullah
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, 43400 UPM, Serdang, Selangor Darul Ehsan, Malaysia.
- Natural Medicines and Products Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.
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Tang X, Yang L, Zhang P, Wang C, Luo S, Liu B, Fu Y, Candotti D, Allain JP, Zhang L, Li C, Li T. Occult Hepatitis B Virus Infection and Liver Fibrosis in Chinese Patients. J Infect Dis 2023; 228:1375-1384. [PMID: 37170968 DOI: 10.1093/infdis/jiad140] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/20/2023] [Accepted: 05/11/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND The impact of hepatitis B surface antigen (HBsAg)-negative/hepatitis B virus (HBV) DNA-positive occult HBV infection (OBI) on the severity of liver fibrosis remains unclear. METHODS A total of 1772 patients negative for HBsAg but positive for antibody to hepatitis B core antigen (HBcAg), stratified by the presence or absence of OBI, were selected for long-term carriage leading to elevation of ≥2 of 4 liver fibrosis indexes-hyaluronic acid (HA), laminin, type III procollagen peptide (PCIII), and type IV collagen (CIV)-at testing in a Chinese hospital. Patients were tested for serum viral load, HBV markers, and histopathological changes in liver biopsy specimens. RESULTS OBI was identified in 148 patients with liver fibrosis (8.4%), who had significantly higher levels of HA, laminin, PCIII, and CIV than 1624 fibrotic patients without OBI (P < .05). In 36 patients with OBI who underwent liver biopsy, significant correlations were observed between OBI viral load and serum HA levels (P = .01), PCIII levels (P = .01), and pathological histological activity index (HAI) scores (P < .001), respectively; HAI scores and PCIII levels (P = .04); HBcAg immunohistochemical scores and HA levels (P < .001); and HBcAg immunohistochemical scores and PCIII levels (P = .03). Positive fluorescent in situ hybridization results were significantly more frequent in patients with OBIs (80.6% vs 37.5% in those without OBIs). Among patients with OBIs, HBcAg was detected in the liver tissue in 52.8% and HBsAg in 5.6%. CONCLUSIONS OBI status appears to be associated with liver fibrosis severity.
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Affiliation(s)
- Xi Tang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
- Department of Infectious Diseases, The First Foshan People's Hospital, Foshan, China
| | - Liu Yang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Panli Zhang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Cong Wang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Shengxue Luo
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Bochao Liu
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Yongshui Fu
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
- Institute of Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
| | - Daniel Candotti
- Department of Virology, Henri Mondor Hospital, AP-HP and University of Paris-Est, INSERM U955, IMRB, Créteil, France
| | - Jean-Pierre Allain
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
- Depratment of Haematology, University of Cambridge, Cambridge, United Kingdom
| | - Ling Zhang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Chengyao Li
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Tingting Li
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
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Xu MR, Jin CH, Lu JX, Li MF, Li LX. High-normal unconjugated bilirubin is associated with decreased risk of chronic kidney disease in type 2 diabetes: A real-world study. Diabetes Metab Res Rev 2023; 39:e3672. [PMID: 37309279 DOI: 10.1002/dmrr.3672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 04/01/2023] [Accepted: 05/26/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the association between serum unconjugated bilirubin (UCB) within normal limits and chronic kidney disease (CKD) in T2DM patients. METHOD This cross-sectional, real-world study was performed in 8661 hospitalised T2DM patients. The subjects were stratified into quintiles based on serum UCB levels. The clinical characteristics and CKD prevalence were compared among the UCB quantile groups. The associations of serum UCB levels and quintiles with CKD were also analysed by binary logistic regression. RESULTS After controlling for age, sex, and diabetes duration (DD), the CKD prevalence (20.4%, 12.2%, 10.6%, 8.3%, and 6.4% for the first, second, third, fourth, and fifth quintiles, respectively, p < 0.001 for trend) was significantly decreased across the serum UCB quintiles. The fully adjusted regression model showed negative associations of serum UCB levels (OR: 0.660, 95% CI: 0.585-0.744; p < 0.001 for trend) and quintiles (p < 0.001) with the presence of CKD. Compared with the subjects in the lowest UCB quintile, the risk of CKD decreased by 36.2%, 54.3%, 53.8%, and 62.1%, respectively, in those from the second to the highest UCB quintile. Additionally, C-reactive protein (CRP) levels were significantly higher in the subjects with CKD than in those without CKD (p < 0.001), and significantly decreased across the UCB quintiles (p < 0.001 for trend). CONCLUSIONS Serum UCB levels within the normal range were significantly and negatively linked to CKD in T2DM patients. High-normal UCB may be an independent protective factor for CKD by its antioxidant and the following anti-inflammatory activities through its signalling activity, which was indicated by clearly decreased CRP levels across the UCB quintiles.
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Affiliation(s)
- Man-Rong Xu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Chun-Hua Jin
- Department of Endocrinology and Metabolism, Shanghai Songjiang District Central Hospital, Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine (Preparatory Stage), Shanghai, China
| | - Jun-Xi Lu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Mei-Fang Li
- Department of Emergency, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lian-Xi Li
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
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13
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Jun YK, Koh SJ, Myung DS, Park SH, Ooi CJ, Sood A, Im JP. Infectious complications in patients with inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 8th Asian Organization for Crohn's and Colitis meeting. Intest Res 2023; 21:353-362. [PMID: 37533266 PMCID: PMC10397552 DOI: 10.5217/ir.2023.00013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/24/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND/AIMS Infectious complications are major concerns when treating patients with inflammatory bowel disease (IBD). This study evaluated clinical differences across countries/regions in the management of infectious diseases in patients with IBD. METHODS A multinational online questionnaire survey was administered to participants at the 8th meeting of the Asian Organization for Crohn's and Colitis. The questionnaire included questions regarding surveillance, diagnosis, management, and prevention of infection in patients with IBD. RESULTS A total of 384 physicians responded to the questionnaire. The majority of Korean (n=70, 63.6%) and Chinese (n=51, 51.5%) physicians preferred vancomycin to metronidazole in the treatment of Clostridium difficile infection, whereas more than half of the Japanese physicians (n=62, 66.7%) preferred metronidazole. Physicians in Korea (n=88, 80.0%) and China (n=46, 46.5%) preferred a 3-month course of isoniazid and rifampin to treat latent tuberculosis infection, whereas most physicians in Japan (n=71, 76.3%) favored a 9-month course of isoniazid. Most Korean physicians (n=89, 80.9%) recommended hepatitis B virus (HBV) vaccination in patients lacking HBV surface antigen, whereas more than half of Japanese physicians (n=53, 57.0%) did not consider vaccination. CONCLUSIONS Differences in the diagnosis, prevention, and management of infections in patients with IBD across countries/regions reflect different prevalence rates of infectious diseases. This survey may broaden understanding of the real-world clinical settings across Asian countries/regions and provide information for establishing practical guidelines to manage patients with IBD.
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Affiliation(s)
- Yu Kyung Jun
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seong-Joon Koh
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Dae Seong Myung
- Department of Gastroenterology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Sang Hyoung Park
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Choon Jin Ooi
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Ajit Sood
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Jong Pil Im
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
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Baek JE, Hwang SW. Diagnosis, management, and prevention of infectious complications in inflammatory bowel disease: variations among Asian countries. Intest Res 2023; 21:277-279. [PMID: 37533262 PMCID: PMC10397542 DOI: 10.5217/ir.2023.00076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/13/2023] [Indexed: 08/04/2023] Open
Affiliation(s)
- Ji Eun Baek
- Department of Gastroenterology and Inflammatory Bowel Disease Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Wook Hwang
- Department of Gastroenterology and Inflammatory Bowel Disease Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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15
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Wanlapakorn N, Pruetarat N, Sarawanangkoor N, Phanphanit K, Srimuan D, Thatsanathorn T, Thongmee T, Posuwan N, Poovorawan Y. Immunogenicity of the pentavalent DTwP-HB-Hib vaccine (Shan-5) used in the Thai Expanded Program on Immunization compared to the hexavalent DTaP-HB-Hib-IPV and DTwP-HB-Hib (Quinvaxem) vaccines administered to infants at 2, 4, 6 months of age. Vaccine 2023; 41:3855-3861. [PMID: 37202270 DOI: 10.1016/j.vaccine.2023.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND The pentavalent DTwP-HB-Hib (Shan-5) vaccine was first introduced into the Thailand Expanded Program on Immunization (EPI) in 2019. The Shan-5 vaccine is administered to infants at 2, 4, and 6 months of age, after initial vaccination with monovalent hepatitis B (HepB) and Bacillus Calmette-Guérin (BCG) vaccines at birth. This study compared the immunogenicity of the HepB, diphtheria, tetanus, and Bordetella pertussis antigens incorporated in the EPI Shan-5 vaccine versus the optional pentavalent (DTwP-HB-Hib) Quinvaxem and hexavalent (DTaP-HB-Hib-IPV) Infanrix-hexa vaccine. METHODS Three-dose Shan-5-vaccinated children were prospectively enrolled at the Regional Health Promotion Centre 5, Ratchaburi province, Thailand, between May 2020 and May 2021. Blood sampling was performed at months 7 and 18. The levels of HepB surface antibody (anti-HBs), anti-diphtheria toxoid (DT) IgG, anti-tetanus toxoid (TT) IgG, and anti-pertussis toxin (PT) IgG were evaluated using commercially available enzyme-linked immunoassays. RESULTS Anti-HBs levels of ≥10 mIU/mL were achieved in 100 %, 99.2 %, and 99.2 % of infants in the Shan-5 EPI group, hexavalent group and Quinvaxem group one month after four dose immunization (at 0, 2, 4, 6 months of age), respectively. The geometric mean concentrations of the EPI Shan-5 and hexavalent groups were comparable but were higher than those of the Quinvaxem group. At one month after primary vaccination (month 7), infants in the Shan-5 EPI group had significantly higher levels of anti-DT IgG, anti-TT IgG, and anti-PT IgG than infants in the hexavalent and Quinvaxem groups. CONCLUSIONS The immunogenicity of the HepB surface antigen in the EPI Shan-5 vaccine was similar to that achieved by the hexavalent vaccine, but was higher than that achieved by the Quinvaxem vaccine. The Shan-5 vaccine is highly immunogenic and generates robust antibody responses after primary immunization.
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Affiliation(s)
- Nasamon Wanlapakorn
- Center of (a)Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Division of Academic Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Napa Pruetarat
- Regional Health Promotion Center 5, Na Mueang, Mueang Ratchaburi, Ratchaburi 70000, Thailand
| | - Nasiri Sarawanangkoor
- Center of (a)Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kanchana Phanphanit
- Regional Health Promotion Center 5, Na Mueang, Mueang Ratchaburi, Ratchaburi 70000, Thailand
| | - Donchida Srimuan
- Center of (a)Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thaksaporn Thatsanathorn
- Center of (a)Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thanunrat Thongmee
- Center of (a)Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nawarat Posuwan
- Center of (a)Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yong Poovorawan
- The Academy of Science, The Royal Society of Thailand, Dusit, Bangkok 10300, Thailand.
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Corredoira J, Miguez E, Mateo LM, Fernández-Rodríguez R, García-Rodríguez JF, Pérez-González A, Sanjurjo A, Pulian MV, Ayuso-García B. The interaction between liver cirrhosis, infection by Streptococcus bovis, and colon cancer. Eur J Clin Microbiol Infect Dis 2023:10.1007/s10096-023-04618-5. [PMID: 37145237 DOI: 10.1007/s10096-023-04618-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/28/2023] [Indexed: 05/06/2023]
Abstract
Whether cirrhotic patients with Streptococcus bovis bacteremia have an increased risk of colorectal neoplasm is uncertain. A multicentric retrospective cohort study was conducted investigating associations between S. bovis biotype and species, cirrhosis, and colorectal neoplasm. Out of 779 patients with S. bovis bacteremia, 69 (8.7%) had cirrhosis. No differences were found in the prevalence of colorectal neoplasm between cirrhotic and non-cirrhotic patients undergoing colonoscopy. Among cirrhotic patients, prevalence of colorectal neoplasms was higher in S. bovis biotype I (S. gallolyticus) bacteremia (80%) than in S. bovis biotype II (33.3%; p < 0.007). In conclusion, risk of colorectal neoplasm is high among cirrhotic patients with S. gallolyticus bacteremia.
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Affiliation(s)
- Juan Corredoira
- Infectious Diseases Unit, University Hospital Lucus Augusti, Lugo, Spain
| | - Enrique Miguez
- Infectious Diseases Unit, A Coruña University Hospital Complex, A Coruña, Spain
| | - Lara María Mateo
- Internal Medicine Department, Santiago de Compostela University Hospital Complex, Santiago de Compostela, Spain
| | | | | | | | - Ana Sanjurjo
- Internal Medicine Department, POVISA Hospital, Vigo, Spain
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Umemura T, Wattanakamolkul K, Nakayama Y, Takahashi Y, Sbarigia U, KyungHwa L, Villasis-Keever A, Furegato M, Gautier L, Nowacki G, Azzi J, Wu DBC. Real-World Epidemiology, Clinical and Economic Burden of Chronic Hepatitis B in Japan: A Retrospective Study Using JMDC Claims Database. Infect Dis Ther 2023; 12:1337-1349. [PMID: 37067724 DOI: 10.1007/s40121-023-00795-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/24/2023] [Indexed: 04/18/2023] Open
Abstract
INTRODUCTION Chronic hepatitis B (CHB) is one of the world's major healthcare problems, especially in the Western Pacific regions. This study describes the prevalence, incidence, treatment profiles and clinical and economic burden of chronic hepatitis B patients in Japan using the Japan Medical Data Center (JMDC) Claims Database. METHODS This is a retrospective observational study. Prevalence cases were identified as patients with ≥ 1 inpatient or ≥ 2 outpatient CHB diagnoses and ≥ 2 records for hepatitis B tests or ≥ 1 prescription for CHB treatment between January 2010 and December 2019. Newly diagnosed CHB patients were defined as patients diagnosed from 2010 to 2018 with no history of the disease up to 2 years prior to the diagnosis. The index date is defined as the first CHB diagnosis day. We only used patients' data with ≥ 1-year post-index date. RESULTS We identified 13,061 CHB prevalent cases (2010-2019), yielding a crude period prevalence of 0.32%. Newly diagnosed CHB patients (n = 1973; median age 52 years) were followed for a median period of 3.1 years, during which 15% received a CHB treatment. Entecavir was the most common first treatment (66%). During this period, 3.4% of the patients developed compensated cirrhosis (CC), 1.5% decompensated cirrhosis (DC) and 3.0% hepatocellular carcinoma (HCC). Around 43.3% of CHB patients were hospitalized at least once. Hospitalizations, treatment rates, serologic testing and screening for liver diseases increased as the severity of the disease progressed. The average total healthcare cost was 870,568 JPY (7779 USD) per person per year. DC and HCC resulted in the highest management costs. CONCLUSIONS Chronic hepatitis B represents a high clinical and economic burden for patients and caregivers, given its morbidity and associated costs.
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Affiliation(s)
- Takeji Umemura
- Division of Gastroenterology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | | | | | | | | | | | | | | | | | | | | | - David Bin-Chia Wu
- Janssen Asia Pacific, Singapore, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
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Chen Y, Zhang G, Yang Y, Zhang S, Jiang H, Tian K, Arenbaoligao, Chen D. The treatment of inflammatory bowel disease with monoclonal antibodies in Asia. Biomed Pharmacother 2023; 157:114081. [PMID: 36481399 DOI: 10.1016/j.biopha.2022.114081] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/27/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Crohn's disease (CD) and ulcerative colitis (UC), the two main forms of inflammatory bowel disease (IBD), are chronic, systemic autoimmune diseases. As the incidence of IBD rapidly increases in Asia, increasing attention has been paid to developing additional treatment strategies. Presently, the end point of therapy is achieving clinical and endoscopic remission through the blockade of inflammatory cascades. Recent studies have shown that monoclonal antibodies (mAbs) use for precise molecular targeting of inflammatory pathways has a promising effect on IBD, especially moderate-to-severe CD and UC. Since the 1997 report on the use of infliximab (a monoclonal antibody against tumor necrosis factor alpha [TNF-α]) in patients with CD, mAbs have expanded therapeutic options and have also complicated initial management options and subsequent treatment. This review comprehensively summarizes the clinical reports and studies related to the use of mAbs for the treatment of IBD in Asian countries and regions in recent years thus demonstrating the current status of mAbs use in Asia. In addition, the differences in the use of mAbs for the treatment of IBD between the Asia and the West are expounded. Ultimately, it is hoped that this review will provide new insights and a scientific basis for the clinical application of mAbs.
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Affiliation(s)
- Yu Chen
- Dalian Medical University, Dalian, China
| | | | | | | | - Haozheng Jiang
- Department of Joint and Sports Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Kang Tian
- Department of Joint and Sports Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China
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Peng S, Wang H, Wang Z, Wang Q. Progression of Antiviral Agents Targeting Viral Polymerases. Molecules 2022; 27:7370. [PMID: 36364196 PMCID: PMC9654062 DOI: 10.3390/molecules27217370] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 08/08/2023] Open
Abstract
Viral DNA and RNA polymerases are two kinds of very important enzymes that synthesize the genetic materials of the virus itself, and they have become extremely favorable targets for the development of antiviral drugs because of their relatively conserved characteristics. There are many similarities in the structure and function of different viral polymerases, so inhibitors designed for a certain viral polymerase have acted as effective universal inhibitors on other types of viruses. The present review describes the development of classical antiviral drugs targeting polymerases, summarizes a variety of viral polymerase inhibitors from the perspective of chemically synthesized drugs and natural product drugs, describes novel approaches, and proposes promising development strategies for antiviral drugs.
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Affiliation(s)
| | | | - Zhengtao Wang
- Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Qingzhong Wang
- Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
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20
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Knowledge about Hepatitis B Virus and Relevant Safety Precautions among Dental Students in Kurdistan Region, Iraq. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:8516944. [PMID: 36172400 PMCID: PMC9510674 DOI: 10.1155/2022/8516944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/10/2022] [Indexed: 12/04/2022]
Abstract
Background Hepatitis B virus (HBV) is still a major health problem worldwide, placing healthcare workers, medical and dental students, and professionals at higher occupational risk. The present study aimed to evaluate the level of knowledge about this virus and relevant safety precautions among dental students in the Kurdistan region of Iraq. Materials and methods. This cross-sectional study was conducted among the third, fourth, and fifth stage dental students of Hawler Medical, Sulaimani, and Duhok universities. Data on the students' demographic characteristics and their knowledge about HBV (16 close-ended questions) and safety precaution measures (10 close-ended questions) were collected by means of a questionnaire. Analysis of variance was used to compare the mean of knowledge and safety precaution scores. Results In total, 372 students (mean age 21.77 ± 1.31 years) completed the questionnaires. The mean scores for knowledge and safety precautions were 13.17 ± 2.09 and 8.05 ± 1.61, respectively. Respondents from Hawler Medical University showed statistically significantly higher knowledge levels than their counterparts in Sulaimani and Duhok universities (p = 0.012). Conclusions The majority of surveyed dental students are aware of HBV, its mode of transmission, infection, complications, vaccination, and safety precautions required to prevent the spreading of the virus. While the levels of knowledge about HBV and safety precautions among the dental students in the Kurdistan region of Iraq were generally acceptable, differences in knowledge level were identified between the universities, and these may be related to their educational and training programs.
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21
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Xie WY, Sun C, He H, Deng C, Sheng Y. Estimates of the prevalence of occult HBV infection in Asia: a systematic review and meta-analysis. Infect Dis (Lond) 2022; 54:881-896. [PMID: 36047593 DOI: 10.1080/23744235.2022.2115126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
PURPOSE Occult Hepatitis B virus infection (OBI) is of great significance to the transmission of Hepatitis B virus (HBV) and the evolution of the patient's clinical outcome. We conducted a systematic review and meta-analysis to estimate the prevalence of OBI in Asia. METHODS Literature search was conducted in PubMed, Cochrane Library database, Web of Science and Embase with the keywords of 'Hepatitis B virus', 'occult infection', 'prevalence'. 70 studies were included in the meta-analysis. Meta-analysis was performed using random-effects models to calculate the pooled prevalence of OBI and 95% confidence interval (CI). The data were analyzed in R 4.1.2. RESULTS The overall prevalence of OBI was 4% (95%CI: 0.03-0.06) in Asia. Subgroup analysis based on geographic region showed a prevalence of 3% (95%CI 0.02-0.06) in East Asia, 9% (95%CI 0.05-0.15) in West Asia, 3% (95%CI 0.01-0.11) in Southern Asia and 9% (95%CI 0.05-0.15) in Southeast Asia. Subgroup analysis demonstrated a prevalence of 1% (95%CI 0.00-0.02) in general population, 5% (95%CI: 0.03-0.08) in high-risk population, 9% (95%CI: 0.03-0.22) in the human immunodeficiency virus (HIV)-infected patient, 18% (95%CI: 0.09-0.32) in the hepatopathy patients. CONCLUSION Based on the meta-analysis of the prevalence of OBI in different populations, we concluded that the prevalence of OBI in the high-risk population, hepatopathy patients, and HIV-infected patients was higher than that in the general population. A systematic review showed that OBI was associated with disease progression and prognosis. Therefore, these populations should be routinely screened for OBI and promptly intervened to avoid promoting disease progression.
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Affiliation(s)
- Wen Yangyang Xie
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Changfeng Sun
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Infection & Immunity Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hongyan He
- Experimental Teaching Center, School of Public Health of Southwest Medical University, Luzhou, China
| | - Cunliang Deng
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yunjian Sheng
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Infection & Immunity Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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22
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Dettori S, Russo C, Mora S, Giacomini M, Taramasso L, Dentone C, Vena A, Bassetti M, Di Biagio A. Prevalence of Viral Hepatitis in Unselected, Consecutively Enrolled Patients Hospitalised for SARS-CoV-2. J Community Health 2022; 47:800-805. [PMID: 35729474 PMCID: PMC9211782 DOI: 10.1007/s10900-022-01111-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 02/07/2023]
Abstract
Diagnosing people living with chronic viral hepatitis is challenging due to the absence of symptoms as long as liver decompensated cirrhosis come out. The aim of this retrospective study was to evaluate the prevalence of HBV and/or HCV infections in a non-selected population, hospitalised for SARS-CoV-2 infection in a tertiary care hospital in Northern Italy. During the study period 1,429 patients were admitted to hospital for SARS-CoV-2 infection, serologic tests for HBV and/or HCV were available for 382 (27%) patients and 3 were excluded due to their previous known serologic status. Among 379 patients, 235 (62%) were male, median age was 70 years (range 21–103), 360 (95%) were Caucasian. Among them, 372/379 (98%) were screened for HBsAg, 320/379 (84%) for HBcAb. HBsAg was positive in 2/372 (0.5%, 95% CI 0.0006–0.02) patients (only in one HBV-DNA was performed that was negative), while HBcAb was found positive in 55/320 (17%, 95% CI 0.13–0.22). Among 370/379 (98%) patients screened for HCV, 11/370 (3%, 95% CI 0.02–0.05) had positive HCV-Ab. Five out of 11 (45%) were tested for HCV-RNA that resulted positive in two patients (0.5%, 95% CI 0.0006–0.02). Considering this data, even though the screening was performed in only 27% of study population, a tailored screening in people with known risk factors for hepatitis might be preferable to universal screening in low prevalence areas. Also a prompt diagnostic workout should begin in case of clinical or laboratory suspicion of hepatitis and in those starting immunosuppressive treatments.
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Affiliation(s)
- Silvia Dettori
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Infectious Diseases Unit, Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Chiara Russo
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy. .,Infectious Diseases Unit, Ospedale Policlinico San Martino IRCCS, Genoa, Italy. .,Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy. .,IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy.
| | - Sara Mora
- Department of Informatics Bioengineering, Robotics, and Systems Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Mauro Giacomini
- Department of Informatics Bioengineering, Robotics, and Systems Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Lucia Taramasso
- Infectious Diseases Unit, Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Chiara Dentone
- Infectious Diseases Unit, Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Antonio Vena
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Infectious Diseases Unit, Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Matteo Bassetti
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Infectious Diseases Unit, Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Antonio Di Biagio
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Infectious Diseases Unit, Ospedale Policlinico San Martino IRCCS, Genoa, Italy
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23
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Shirmast P, Shahri MA, Pashangzadeh S, Mirshahabi H, Samadi E, Motamed N. Detection of occult hepatitis B virus in patients undergoing chemotherapy in Iran. Future Virol 2022. [DOI: 10.2217/fvl-2020-0386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: Occult hepatitis B infection (OBI) is life threatening and has a high mortality rate despite applying antiviral treatments in cancer patients. This study aimed to investigate the prevalence of OBI in patients undergoing chemotherapy in Iran. Materials & methods: A total of 342 patients undergoing chemotherapy were enrolled. OBI detection in anti-HBc positive individuals was conducted using nested PCR. Results: Among 342 subjects, 103 (30.1%) were positive for anti-HBc. Fifteen (14.6%) cases of 103 anti-HBc positive samples were also positive for HBsAg. Overall, HBV DNA was positive in three (3.4%) of 88 anti-HBc subjects. Conclusion: Our results indicated that OBI might occur in almost one in 25 anti-HBc-positive patients undergoing chemotherapy.
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Affiliation(s)
- Paniz Shirmast
- Department of Microbiology & Virology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahdi Abedinzade Shahri
- Department of Biology, Faculty of Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Salar Pashangzadeh
- Iranian Research Center of HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hessam Mirshahabi
- Department of Microbiology & Virology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Elham Samadi
- Department of Microbiology & Virology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Nima Motamed
- Department of Community Medicine, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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24
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Wang W, Yang T, Li D, Huang Y, Bai G, Li Q. LINC00491 promotes cell growth and metastasis through miR-324-5p/ROCK1 in liver cancer. J Transl Med 2021; 19:504. [PMID: 34876144 PMCID: PMC8650505 DOI: 10.1186/s12967-021-03139-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/07/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND LINC00491 was involved in some tumors development, but its function in liver cancer has not been reported. This study aimed to investigate LINC00491 expression and function in liver cancer progression. METHODS Sixty liver cancer cases were enrolled. LINC00491, miR-324-5p and rho-associated kinase 1 (ROCK1) expression in liver cancer patients and cells were detected by quantitative reverse transcription-polymerase chain reaction and Western blot. HUH-7 and SK-Hep-1 cells were transfected to modulate LINC00491, miR-324-5p and ROCK1 expression. Cell counting kit-8 assay, colony formation assay, wound healing assay, Transwell experiment, Tunel assay and flow cytometry were performed to detected HUH-7 and SK-Hep-1 cells proliferation, migration, invasion, apoptosis and cell cycle. Biotin-RNA pull-down assay and Dual-Luciferase Reporter Assay was performed to detect the binding among LINC00491, miR-324-5p and ROCK1. Xenograft tumor and lung metastasis was performed using nude mice. Xenograft tumor and lung tissues of mice were experienced immunohistochemistry and hematoxylin-eosin staining. RESULTS LINC00491 was highly expressed in liver cancer cases, associating with poor prognosis. si-LINC00491 inhibited proliferation, colony formation, invasion, migration, and induced cell cycle G1 arrest and apoptosis in HUH-7 and SK-Hep-1 cells. LINC00491 overexpression showed opposite effects. LINC00491 promoted ROCK1 expression by reducing miR-324-5p. miR-324-5p up-regulation or ROCK1 knockdown reversed LINC00491 promotion on liver SK-Hep-1 cells malignant phenotype. LINC00491 facilitated xenograft tumor growth and lung metastasis in mice. CONCLUSION LINC00491 was highly expressed in liver cancer patients, associating with poor prognosis. LINC00491 facilitated liver cancer progression by sponging miR-324-5p/ROCK1. LINC00491 might be a potential treatment target of liver cancer.
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Affiliation(s)
- Wei Wang
- Department of General Surgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121000, China
| | - Tao Yang
- Department of General Surgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121000, China
| | - Dongsheng Li
- Department of General Surgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121000, China
| | - Yinpeng Huang
- Department of General Surgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121000, China
| | - Guang Bai
- Department of General Surgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121000, China
| | - Qing Li
- Department of Nephrology, The Third Affiliated Hospital of Jinzhou Medical University, No. 2 Section 5 Heping Road, Jinzhou, 121000, China.
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25
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Wang HH, Sun SL, Jau RC, Tantoh DM, Hsu SY, Nfor ON, Chen PH, Liu WH, Ko JL, Liaw YP. Risk of HBV infection among male and female first-time blood donors born before and after the July 1986 HBV vaccination program in Taiwan. BMC Public Health 2021; 21:1831. [PMID: 34627173 PMCID: PMC8502303 DOI: 10.1186/s12889-021-11846-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 09/21/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In July 1984, Taiwan officially began a nationwide hepatitis B virus (HBV) vaccination program where only infants born to HBsAg-positive mothers were vaccinated free of charge until June 1986. However, from July 1986, all infants were vaccinated against HBV. The impact of the July 1986 HBV vaccination program on first-time blood donors has not been exhaustively studied. We, therefore, determined the risk of HBV among male and female first-time blood donors born before and after the July 1986 HBV vaccination program in Taiwan. METHODS Initially, we recruited 857,310 first-time blood donors whose data were collected between 2013 and 2018 from 5 blood donation centers in Taiwan. However, we excluded donors with incomplete and outlying data (n = 12,213) and those born between July 1984 and June 1986 (n = 21,054). The final study participants comprised 9118 HBV positive and 814,925 HBV negative individuals. We divided the participants into two birth cohorts (born before and after July 1986) and assumed that those born before July 1986 were not vaccinated at birth while those born after July 1986 were vaccinated. RESULTS The prevalence of HBV among those born before and after July 1986 was 4.53 and 0.25%, respectively. Individuals born after July 1986 had a lower risk of HBV than those born before July 1986. The adjusted odds ratio (OR), 95% confidence interval (CI) was 0.16, 0.13-0.19. Men had a higher risk of HBV than women (OR = 1.40, 95% CI = 1.34-1.47). The interaction between sex and birth date was significant (p-value = 0.0067). Stratification of participants by birth date revealed a higher risk of HBV in men compared to women in both birth cohorts. The OR, 95% CI was 1.47, 1.40-1.55 for those born before July 1986 but declined to 1.15, 1.02-1.29 for those born after July 1986. CONCLUSIONS The risk of HBV was lower among those born after than those born before the July 1986 vaccination program. In both cohorts, the risk was high in men relative to women. The seemingly protective effect among those born after July 1986 was higher in women than men.
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Affiliation(s)
- Hsuan-Hui Wang
- Taichung Blood Center, Taiwan Blood Services Foundation, Taichung, Taiwan
| | - Shu-Lung Sun
- Taiwan Blood Services Foundation, Taipei, Taiwan
| | - Rong-Chiou Jau
- Taichung Blood Center, Taiwan Blood Services Foundation, Taichung, Taiwan
| | - Disline Manli Tantoh
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd, Taichung, 40201, Taiwan
| | - Shu-Yi Hsu
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd, Taichung, 40201, Taiwan
| | - Oswald Ndi Nfor
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd, Taichung, 40201, Taiwan
| | - Pei-Hsin Chen
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd, Taichung, 40201, Taiwan
| | - Wen-Hsiu Liu
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd, Taichung, 40201, Taiwan
| | - Jiunn-Liang Ko
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd, Taichung, 40201, Taiwan.
- Department of Medical Oncology and Chest Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Yung-Po Liaw
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd, Taichung, 40201, Taiwan.
- Medical Imaging and Big Data Center, Chung Shan Medical University Hospital, Taichung, Taiwan.
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26
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Lee JM, Wei SC, Lee KM, Ye BD, Mao R, Kim HS, Park SJ, Park SH, Oh EH, Im JP, Jang BI, Kim DB, Takeuchi K. Clinical Course of Hepatitis B Viral Infection in Patients Undergoing Anti-Tumor Necrosis Factor α Therapy for Inflammatory Bowel Disease. Gut Liver 2021; 16:396-403. [PMID: 34593670 PMCID: PMC9099383 DOI: 10.5009/gnl210081] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/17/2021] [Accepted: 06/29/2021] [Indexed: 11/17/2022] Open
Abstract
Background/Aims Little is known about the clinical course of hepatitis B virus (HBV)-infected patients undergoing anti-tumor necrosis factor α (TNF-α) therapy for inflammatory bowel disease (IBD). We aimed to investigate the clinical course of HBV infection and IBD and to analyze liver dysfunction risks in patients undergoing anti-TNF-α therapy. Methods This retrospective multinational study involved multiple centers in Korea, China, Taiwan, and Japan. We enrolled IBD patients with chronic or resolved HBV infection, who received anti-TNF-α therapy. The patients’ medical records were reviewed, and data were collected using a web-based case report form. Results Overall, 191 patients (77 ulcerative colitis and 114 Crohn’s disease) were included, 28.3% of whom received prophylactic antivirals. During a median follow-up duration of 32.4 months, 7.3% of patients experienced liver dysfunction due to HBV reactivation. Among patients with chronic HBV infection, the proportion experiencing liver dysfunction was significantly higher in the non-prophylaxis group (26% vs 8%, p=0.02). Liver dysfunction occurred in one patient with resolved HBV infection. Antiviral prophylaxis was independently associated with an 84% reduction in liver dysfunction risk in patients with chronic HBV infection (odds ratio, 0.16; 95% confidence interval, 0.04 to 0.66; p=0.01). The clinical course of IBD was not associated with liver dysfunction or the administration of antiviral prophylaxis. Conclusions Liver dysfunction due to HBV reactivation can occur in HBV-infected IBD patients treated with anti-TNF-α agents. Careful monitoring is needed in these patients, and antivirals should be administered, especially to those with chronic HBV infection.
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Affiliation(s)
- Ji Min Lee
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Shu-Chen Wei
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Kang-Moon Lee
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byong Duk Ye
- Department of Gastroenterology and Inflammatory Bowel Disease Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ren Mao
- Department of Internal Medicine, First Affiliated Hospital, Sun Yat-sen University, Shanghai, China, Korea
| | - Hyun-Soo Kim
- Department of Internal Medicine and Institute of Lifelong Health, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Soo Jung Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hyoung Park
- Department of Gastroenterology and Inflammatory Bowel Disease Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Hye Oh
- Department of Gastroenterology and Inflammatory Bowel Disease Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Gastroenterology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jong Pil Im
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Byung Ik Jang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Dae Bum Kim
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ken Takeuchi
- Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
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Mamo FT, Abate BA, Zheng Y, Nie C, He M, Liu Y. Distribution of Aspergillus Fungi and Recent Aflatoxin Reports, Health Risks, and Advances in Developments of Biological Mitigation Strategies in China. Toxins (Basel) 2021; 13:678. [PMID: 34678973 PMCID: PMC8541519 DOI: 10.3390/toxins13100678] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/15/2021] [Accepted: 09/20/2021] [Indexed: 12/24/2022] Open
Abstract
Aflatoxins (AFs) are secondary metabolites that represent serious threats to human and animal health. They are mainly produced by strains of the saprophytic fungus Aspergillus flavus, which are abundantly distributed across agricultural commodities. AF contamination is receiving increasing attention by researchers, food producers, and policy makers in China, and several interesting review papers have been published, that mainly focused on occurrences of AFs in agricultural commodities in China. The goal of this review is to provide a wider scale and up-to-date overview of AF occurrences in different agricultural products and of the distribution of A. flavus across different food and feed categories and in Chinese traditional herbal medicines in China, for the period 2000-2020. We also highlight the health impacts of chronic dietary AF exposure, the recent advances in biological AF mitigation strategies in China, and recent Chinese AF standards.
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Affiliation(s)
- Firew Tafesse Mamo
- School of Food Science and Engineering, Food Safety Research Centre, Foshan University, Foshan 528231, China; (C.N.); (M.H.)
- Ethiopian Biotechnology Institute, Addis Ababa 5954, Ethiopia;
| | | | - Yougquan Zheng
- State Key Laboratory for Biology of Plant Diseases and Insect Pests, Institute of Plant Protection, Chinese Academy of Agricultural Sciences, Beijing 100193, China;
| | - Chengrong Nie
- School of Food Science and Engineering, Food Safety Research Centre, Foshan University, Foshan 528231, China; (C.N.); (M.H.)
| | - Mingjun He
- School of Food Science and Engineering, Food Safety Research Centre, Foshan University, Foshan 528231, China; (C.N.); (M.H.)
| | - Yang Liu
- School of Food Science and Engineering, Food Safety Research Centre, Foshan University, Foshan 528231, China; (C.N.); (M.H.)
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28
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Chen MH, Wu CS, Chen MH, Tsai CY, Lee FY, Huang YH. High Risk of Viral Reactivation in Hepatitis B Patients with Systemic Lupus Erythematosus. Int J Mol Sci 2021; 22:9116. [PMID: 34502025 PMCID: PMC8430791 DOI: 10.3390/ijms22179116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/13/2021] [Accepted: 08/23/2021] [Indexed: 12/12/2022] Open
Abstract
HBV reactivation (HBVr) can occur in hepatitis B surface antigen (HBsAg)-positive and negative patients. Here, we determined the incidence of HBVr and its related hepatitis in patients with systemic lupus erythematosus (SLE). From 2000 to 2017, 3307 SLE cases were retrospectively reviewed for episodes of hepatitis. The incidence, long-term outcomes and risk factors associated with HBVr, including HBsAg reverse seroconversion (RS) were analyzed. Among them, 607 had available HBsAg status. Fifty-five (9.1%) patients were positive for HBsAg and 63 (11.4%) were HBsAg-negative/antibody to hepatitis B core antigen (anti-HBc)-positive (resolved hepatitis B infection, RHB). None of them received antiviral prophylaxis before immunosuppressive treatment. During a mean 15.4 years of follow-up, 30 (54.5%) HBsAg-positive patients developed HBVr and seven (23.3%) died of liver failure, whereas only two (3.2%) RHB cases experienced HBsAg reverse seroconversion (RS). Multivariate logistic regression analysis showed that age ≥ 40 years at diagnosis of SLE (HR 5.30, p < 0.001), receiving glucocorticoid-containing immunosuppressive therapy (HR 4.78, p = 0.003), and receiving glucocorticoid ≥ 10 mg prednisolone equivalents (HR 3.68, p = 0.003) were independent risk factors for HBVr in HBsAg-positive patients. Peak level of total bilirubin ≥ 5 mg/dL during HBVr was an independent factor of mortality (p = 0.002). In conclusion, the risk of HBVr was associated with glucocorticoid daily dose. Antiviral prophylaxis is mandatory for SLE patients diagnosed at age of ≥40 years who receive ≥ 10 mg daily dose of oral prednisone or equivalent.
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Affiliation(s)
- Ming-Han Chen
- Division of Allergy-Immunology-Rheumatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan;
| | - Chien-Sheng Wu
- Division of Allergy-Immunology-Rheumatology, Department of Medicine, Far Eastern Memorial Hospital, Taipei 220216, Taiwan;
| | - Ming-Huang Chen
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan;
| | - Chang-Youh Tsai
- Division of Allergy-Immunology-Rheumatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan;
| | - Fa-Yauh Lee
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (F.-Y.L.); (Y.-H.H.)
| | - Yi-Hsiang Huang
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (F.-Y.L.); (Y.-H.H.)
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
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Froeschl G, Hoelscher M, Maganga LH, Kroidl I, Clowes P, Geis S, Saathoff E, Hoffmann D, Protzer U, Kroidl A. Hepatitis B, C and D virus prevalence in children and adults in Mbeya Region, Tanzania: results from a cohort study 2002 - 2009. Pan Afr Med J 2021; 39:174. [PMID: 34584600 PMCID: PMC8449578 DOI: 10.11604/pamj.2021.39.174.26553] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 04/08/2021] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION sub-Saharan Africa bears a high prevalence for hepatitis B virus (HBV) infection. This analysis aims at elucidating the exposure to HBV across different age groups in Mbeya Region in Tanzania and determines prevalences of hepatitis C (HCV) and hepatitis delta antigen (HDV) infections. METHODS plasma samples from children and adults with defined HIV status were analysed for HBV, HCV and HDV markers.\. RESULTS hepatitis B (HBs)-antigen positivity was 8.3% (3/36) in the 0 to 5 years age group, 13.3% (8/60) in the 6 to 7 years, 17.2% (10/58) in the 8 to 14 years and 13.3% (8/60) in the 15 to 18 years age groups. In adults 5.0% of samples were HBs-antigen positive. Overall, 17.1% were HIV-1 positive. Adults infected with HIV-1 were significantly more often HBs-antigen positive (7.5%) than HIV-1 negative adults (4.5%; p<0.05). A serological sub-study including 174 adults showed that both total anti-HBs and total anti-HBc positivity increased with age in HBs-antigen negative participants. Across all age groups, HCV antibodies were found in 9 individuals, HDV antibodies in 3 individuals. CONCLUSION children presented a high prevalence of HBs-antigen carriers, with lower levels in the younger children. Among adults, the overall prevalence of HBs-antigen was lower than in children, either corresponding to clearance of HBV over time or due to a die-off effect. HBs-antigen positive adults had higher frequencies of anti-HBc- and anti-HBe-antibodies, indicating better immunological control of HBV infection than children. This supports claims that HBV infections in Africa are mostly acquired in childhood and to a large extent cleared again by adulthood. One in 20 adults remains chronically infected, emphasising the importance of HBV vaccination strategies.
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Affiliation(s)
- Guenter Froeschl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität of Munich, Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität of Munich, Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Lucas Henze Maganga
- National Institute for Medical Research, Mbeya Medical Research Center, Mbeya, Tanzania
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität of Munich, Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Petra Clowes
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität of Munich, Munich, Germany
- National Institute for Medical Research, Mbeya Medical Research Center, Mbeya, Tanzania
| | - Steffen Geis
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität of Munich, Munich, Germany
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität of Munich, Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Dieter Hoffmann
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- Helmholtz Zentrum München/Technische Universität München, Institute of Virology, Munich, Germany
| | - Ulrike Protzer
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- Helmholtz Zentrum München/Technische Universität München, Institute of Virology, Munich, Germany
| | - Arne Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität of Munich, Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
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Kamalapirat T, Yingcharoen K, Ungtrakul T, Soonklang K, Dechma J, Chunnuan P, Kusuman P, Pothijaroen C, Tawpa J, Cheirsilpa K, Auewarakul C. Assessing risk scores for predicting hepatocellular carcinoma in Thai patients with chronic hepatitis B. J Viral Hepat 2021; 28:1034-1041. [PMID: 33880807 DOI: 10.1111/jvh.13517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 03/16/2021] [Accepted: 04/04/2021] [Indexed: 12/12/2022]
Abstract
Chronic hepatitis B (CHB) infection-associated hepatocellular carcinoma (HCC) is a major health problem in Asian countries. Several HCC risk prediction models have been developed using either treated or untreated CHB patients. However, there is limited validation of these risk scores in a treated and untreated mixed CHB patient cohort. This study analysed and validated HCC risk scores among 2208 CHB patients who enrolled in the HCC surveillance programme in Thailand during July 2010. The baseline clinical and radiologic data of these CHB patients were applied to calculate various HCC risk scores. There were 20 patients (0.9%) with HCC development at the 5.9-year follow-up. The areas under the receiver operating characteristic curves (AUROCs) predicting HCC risk at 5 years were 0.80 (0.68-0.91), 0.73 (0.60-0.85), 0.79 (0.67-0.91), 0.70 (0.58-0.82), 0.72 (0.59-0.85), 0.76 (0.63-0.87) and 0.77 (0.64-0.89) for the GAG-HCC, CU-HCC, REACH-B, PAGE-B, mPAGE-B, CAMD and AASL scores, respectively. The overall HCC risk scores were accurate and comparable. However, the subgroup analysis revealed better HCC-risk-predictive performance in the treated patients, while performance was less helpful in those not fulfilling criteria for antiviral therapy. Clinicians should be aware of these data when using the HCC risk score in untreated CHB patients.
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Affiliation(s)
- Thanachote Kamalapirat
- Faculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Kesinee Yingcharoen
- Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Teerapat Ungtrakul
- Faculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Kamonwan Soonklang
- Data Management Unit, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Jiraporn Dechma
- Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Pitchayachuda Chunnuan
- Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Pattama Kusuman
- Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Charinthip Pothijaroen
- Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Jantarika Tawpa
- Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Kunsuda Cheirsilpa
- Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Chirayu Auewarakul
- Faculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
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Geta M, Yizengaw E, Getaneh Z, Getahun T. Seroprevalence of Hepatitis B Virus Infection Among Patients Attending at Addis Alem Primary Hospital, Bahir Dar, Northwest Ethiopia. Int J Gen Med 2021; 14:405-411. [PMID: 33603446 PMCID: PMC7883309 DOI: 10.2147/ijgm.s298586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 01/27/2021] [Indexed: 01/05/2023] Open
Abstract
Background Hepatitis B virus (HBV) causes severe liver disease, such as hepatocellular carcinoma (HCC) and life-threatening liver disease. Hepatitis B virus infection is one of the most dominant public health problems these days. Therefore, this study aimed to determine the seroprevalence of HBV infection among patients attending Addis Alem Hospital, Bahir Dar, Northwest Ethiopia. Methods A retrospective study was conducted from January to February 2019 on HBV registered from January 2016 to December 2018 for three years period. The presence of HBsAg in serum was detected using the One Step Cassette Style HBsAg test kit. Data were analyzed using SPSS version 20. Descriptive statistics were used to describe the characteristics of participants with HBV infection. Statistical association of the determinants with HBV infection was determined by the X2 test. Results In this study, a total of 2010 participants of HBsAg rapid test records in the laboratory logbook were included. The median age of women was 25 years. The overall seroprevalence of HBsAg was 78 (3.9%). There was a general increment of HBV infection from 2016 to 2018, X2 =7.52; P=0.023. Age (X2 =8.19; P= 0.042) and sex (X2 =37.77; P <0.001) were associated with HBsAg positivity. Conclusion and Recommendations An intermediate seroprevalence of HBV infection was detected among participants in our study area. This figure raises significant public health concerns. Therefore, implementing strategies for routine screening of women for HBV and hospital attendants would be critical.
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Affiliation(s)
- Mekuanint Geta
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Endalew Yizengaw
- Departments of Microbiology, Immunology and Parasitology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Zegeye Getaneh
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tseng TC, Liu CJ. Occult Hepatitis B Infection. HEPATITIS B VIRUS AND LIVER DISEASE 2021:411-425. [DOI: 10.1007/978-981-16-3615-8_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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Muhamad NA, Ab Ghani RM, Abdul Mutalip MH, Muhammad EN, Mohamad Haris H, Mohd Zain R, Abdullah N, Muhammad Azami NA, Abd Jalal N, Ismail N, Mhd Yusuf NA, Othman R, Kamalul Arifin AS, Abdullah MS, Kamaruddin MA, Abu Hassan MR, Aris T, Jamal R. Seroprevalence of hepatitis B virus and hepatitis C virus infection among Malaysian population. Sci Rep 2020; 10:21009. [PMID: 33273475 PMCID: PMC7713078 DOI: 10.1038/s41598-020-77813-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/21/2020] [Indexed: 11/25/2022] Open
Abstract
Malaysia is a country with an intermediate endemicity for hepatitis B. As the country moves toward hepatitis B and C elimination, population-based estimates are necessary to understand the burden of hepatitis B and C for evidence-based policy-making. Hence, this study aims to estimate the prevalence of hepatitis B and C in Malaysia. A total of 1458 participants were randomly selected from The Malaysian Cohort (TMC) aged 35 to 70 years between 2006 and 2012. All blood samples were tested for hepatitis B and C markers including hepatitis B surface antigen (HBsAg), anti-hepatitis B core antibody (anti-HBc), antibodies against hepatitis C virus (anti-HCV). Those reactive for hepatitis C were further tested for HCV RNA genotyping. The sociodemographic characteristics and comorbidities were used to evaluate their associated risk factors. Descriptive analysis and multivariable analysis were done using Stata 14. From the samples tested, 4% were positive for HBsAg (95% CI 2.7-4.7), 20% were positive for anti-HBc (95% CI 17.6-21.9) and 0.3% were positive for anti-HCV (95% CI 0.1-0.7). Two of the five participants who were reactive for anti-HCV had the HCV genotype 1a and 3a. The seroprevalence of HBV and HCV infection in Malaysia is low and intermediate, respectively. This population-based study could facilitate the planning and evaluation of the hepatitis B and C control program in Malaysia.
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Affiliation(s)
- Nor Asiah Muhamad
- Evidence-Based Healthcare Sector, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Rimah Melati Ab Ghani
- Evidence-Based Healthcare Sector, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Mohd Hatta Abdul Mutalip
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Eida Nurhadzira Muhammad
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Hasmah Mohamad Haris
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Rozainanee Mohd Zain
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Noraidatulakma Abdullah
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Azila Muhammad Azami
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nazihah Abd Jalal
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norliza Ismail
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Ain Mhd Yusuf
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Raihannah Othman
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Mohd Shaharom Abdullah
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Arman Kamaruddin
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Tahir Aris
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Rahman Jamal
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
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POURI AA, GHOJAZADEH M, SHIRMOHAMMADI M, EFTEKHAR-SADAT AT, SOMI MH. Seroepidemiology and Risk Factors of Hepatitis B Virus Infection: A Population-Based Azar Cohort Study. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:2152-2160. [PMID: 33708736 PMCID: PMC7917508 DOI: 10.18502/ijph.v49i11.4733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 05/19/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hepatitis B is a major global health problem. It can cause chronic infections and put people at high risk of death from cirrhosis and hepatocellular carcinoma. The aim of this study was to report the epidemiological features of hepatitis B virus (HBV) infection and risk factors based on the data from Azar Cohort. METHODS The population of this study comprised the people in the age range of 35-70 yr from Azar cohort, East Azerbaijan Province, Iran between 2015 and 2016. Based on cluster sampling, 4,949 people were selected and invited to complete the questionnaire and perform the tests. Blood samples were analyzed for serum HBV markers (HBsAg, HBsAb and HBcAb) by ELFA method. The data were analyzed using SPSS statistical software. RESULTS The mean (SD) age of the participants was 49.15 ± 9.02 years. The frequency rates of HBsAg, HBsAb and HBcAb were estimated as 1.03%, 16.9% and 24.95%, respectively. There was statistically significant association between family history of hepatitis (P<0.001) and jaundice history (P<0.001) with the presence of HBsAg. There was also a positive correlation between marital status (P=0.002), history of hospitalization (P<0.001), smoking (P=0.001), dental procedures (P<0.001), foreign travels (P=0.005), occupation status (P=0.002) and the presence of HBcAb. CONCLUSION The frequency of hepatitis B in Azar Cohort was 1.03% which is a lower rate compared with other reports from Iran. The association of the population studied and the increase of public awareness in this area can probably prevent this disease.
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Affiliation(s)
- Ali Asghar POURI
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza GHOJAZADEH
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud SHIRMOHAMMADI
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mohammad Hossein SOMI
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Guo Y, Yang Y, Bai Q, Huang Z, Wang Z, Cai D, Li S, Man X, Shi X. Cost-utility analysis of newborn hepatitis B immunization in Beijing. Hum Vaccin Immunother 2020; 17:1196-1204. [PMID: 33016814 PMCID: PMC8018439 DOI: 10.1080/21645515.2020.1807812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objectives To evaluate cost-utility of universal Hepatitis B vaccination program in the Beijing city (Beijing). Methods A decision-Markov model was constructed to determine the cost-utility of the universal immunization program for infants (universal vaccination program) by comparing with a hypothetic nonvaccination strategy in Beijing. Parameters in models were extracted from Beijing Center for Disease Control and Prevention (CDC) annual work report, Beijing health statistical yearbook, National Health Survey report, Beijing 1% population sample survey report, Beijing Health and Medical Price Monitoring Data Platform, and public literatures. The incremental cost‑utility ratio (ICUR) was used to compare alternative scenarios. One-way sensitivity analysis and probabilistic sensitivity analysis were used to assess parameter uncertainties. Results The universal vaccination program had increased the utility and reduced cost among infants born in 2016 in Beijing. The ICUR was CNY −24,576.61 (US$ −3779.16) per QALY for universal vaccination program comparing with non-vaccination scenario from healthcare perspective. It was estimated that the universal vaccination would save direct medical treatment cost of CNY 2,262,869,173.50 (US$ 347,962,414.43) and prevent loss of 18322.25 QALYs within lifetime of target cohort. Discount rate accounted for the most remarkable influence on ICUR in one-way sensitivity analysis. The result of probabilistic sensitivity analysis illustrated that all of the ICURs were located in the fourth quadrant of the cost-utility incremental plot undergone 5000 times of Monte Carlo simulation. Conclusions Current universal hepatitis B vaccination program in Beijing was highly cost utility. The investment was reasonable for current universal vaccination program in Beijing.
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Affiliation(s)
- Yiwei Guo
- Dong Fureng Economic & Social Development School, Wuhan University, Wuhan, Hubei, China.,Beijing University of Chinese Medicine (BUCM), Beijing, China
| | - Yong Yang
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Qian Bai
- Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, China
| | - Zhengwei Huang
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Zongwu Wang
- General Administration Department, Health News Co.,Ltd., Beijing, China
| | - Dongxia Cai
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Shuo Li
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaowei Man
- School of Management, National Institute of Chinese Medicine Development and Strategy, Beijing University of Chinese Medicine, Beijing, China
| | - Xuefeng Shi
- School of Management, National Institute of Chinese Medicine Development and Strategy, Beijing University of Chinese Medicine, Beijing, China
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Posuwan N, Wanlapakorn N, Sintusek P, Wasitthankasem R, Poovorawan K, Vongpunsawad S, Poovorawan Y. Towards the elimination of viral hepatitis in Thailand by the year 2030. J Virus Erad 2020; 6:100003. [PMID: 33251021 PMCID: PMC7646674 DOI: 10.1016/j.jve.2020.100003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 01/12/2020] [Accepted: 06/23/2020] [Indexed: 12/19/2022] Open
Abstract
Viral hepatitis is a global problem with mortality comparable to HIV, tuberculosis and malaria. The WHO aims to eliminate hepatitis B (HBV) and hepatitis C (HCV) by 2030. Improved socioeconomic status of developing countries such as Thailand has reduced the incidence and morbidity associated with hepatitis A. Since the beginning of hepatitis B vaccination in all Thai newborns in 1992, at least 95% of one-year-olds are currently receiving 3-4 hepatitis B doses. The second vaccination of newborns of carrier mothers at 1 month of age has contributed to an effective reduction in mother-to-child transmission. Universal vaccination, blood donation screening, and decreasing needle sharing have reduced hepatitis B infection. Under the test and treat model, cost-effective screening at the point-of-care (health center or village hospital) is recommended for adults >30 years-old. Following referral to a tertiary healthcare center for a treatment plan in developing disease management plan, its implementation by trained healthcare professionals is preferably administered at the point-of-care. Hepatitis C prevalence is also decreasing as a result of blood-borne pathogen awareness. Current hepatitis C infection is highest for adults >35 years who were born prior to 1983, with screening is recommend once in their lifetime. Treatment strategy recommendation follows that of hepatitis B. The availability of direct antiviral agents with high cure rates is expected to contribute to the reduction in hepatitis C transmission and mortality as set forth by the WHO policy. Thus, ensuring the successful planning of hepatitis elimination in Thailand requires pilot regional assessment prior to national implementation.
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Affiliation(s)
- Nawarat Posuwan
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University Bangkok, Thailand
| | - Nasamon Wanlapakorn
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University Bangkok, Thailand
- Division of Academic Affairs, Faculty of Medicine, Chulalongkorn University Bangkok, Thailand
| | - Palittiya Sintusek
- STAR (Special Task Force for Activating Research), Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University Bangkok, Thailand
| | - Rujipat Wasitthankasem
- National Biobank of Thailand, National Science and Technology Development Agency, Thailand Science Park, Pathum Thani, Thailand
| | - Kittiyod Poovorawan
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Sompong Vongpunsawad
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University Bangkok, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University Bangkok, Thailand
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Tuberculosis and viral hepatitis in patients treated with certolizumab pegol in Asia-Pacific countries and worldwide: real-world and clinical trial data. Clin Rheumatol 2020; 40:867-875. [PMID: 32740672 PMCID: PMC7895783 DOI: 10.1007/s10067-020-05248-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/13/2020] [Accepted: 06/18/2020] [Indexed: 11/25/2022]
Abstract
Introduction/objectives To evaluate the incidence rate (IR) of tuberculosis (TB) and viral hepatitis B and C (HBV/HCV) during certolizumab pegol (CZP) treatment, worldwide and in Asia-Pacific countries, across clinical trials and post-marketing reports (non-interventional studies and real-world practice). Method CZP safety data were pooled across 49 clinical trials from 1998 to June 2017. Post-marketing reports were from initial commercialization until March 2015 (TB)/February 2017 (HBV/HCV). All suspected TB and HBV/HCV cases underwent centralized retrospective review by external experts. Incidence rates (IRs) were calculated per 100 patient-years (PY) of CZP exposure. Results Among 11,317 clinical trial patients (21,695 PY), 62 TB cases were confirmed (IR 0.29/100 PY) including 2 in Japan (0.10/100 PY) and 3 in other Asia-Pacific countries (0.58/100 PY). From > 238,000 PY estimated post-marketing CZP exposure, there were 31 confirmed TB cases (0.01/100 PY): 5 in Japan (0.05/100 PY), 1 in other Asia-Pacific countries (0.03/100 PY). Reported regional TB IRs were highest in eastern Europe (0.17/100 PY), central Europe (0.09/100 PY), and Mexico (0.16/100 PY). Across clinical trials, there was 1 confirmed HBV reactivation and no HCV cases. From > 420,000 PY estimated post-marketing CZP exposure, 5 HBV/HCV cases were confirmed (0.001/100 PY): 2 HCV reactivations; 1 new HCV; plus 2 HBV reactivations in Japan (0.008/100 PY). Conclusions CZP TB risk is aligned with nationwide TB rates, being slightly higher in Asia-Pacific countries excluding Japan. Overall, TB and HBV/HCV risk with CZP treatment is currently relatively low, as risk can be minimized with patient/physician education, screening, and vigilant treatment, according to international guidelines. Key Points: • TB rates were highest in eastern/central Europe, Mexico, and Asia-Pacific regions. • With the implementation of stricter TB screening and risk evaluations in 2007, especially in high TB incidence countries, there was a notable reduction TB occurrence. • Safety profile of biologics in real-world settings complements controlled studies. • TB and hepatitis (HBV/HCV) risk with certolizumab pegol (CZP) treatment is low. |
Electronic supplementary material The online version of this article (10.1007/s10067-020-05248-4) contains supplementary material, which is available to authorized users.
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Mak JSM, Lao TT. Assisted reproduction in hepatitis carrier couples. Best Pract Res Clin Obstet Gynaecol 2020; 68:103-108. [PMID: 32278628 DOI: 10.1016/j.bpobgyn.2020.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 02/27/2020] [Accepted: 02/27/2020] [Indexed: 01/04/2023]
Abstract
Chronic Hepatitis B virus (HBV) infection is endemic worldwide, and the prevalence is especially high in the Asia-Pacific regions. Despite its high prevalence, the literature regarding the impact of HBV infection on subfertility and fertility treatment remains limited and conflicting. Latest studies do not suggest any detrimental effect of HBV infection on the outcome of IVF/ICSI treatment in women having chronic HBV infection. There is evidence that HBV exists in ovarian tissue including oocyte and follicular fluid, and therefore has the potential risk of transmission to the embryo, which can explain the finding of vertical transmission despite immunoprophylaxis. Most recently, we have observed the evidence of HBV viral replication in female HBV carriers undergoing IVF/ICSI treatment. This raises the question of whether antiviral medication should be administered during ovarian stimulation in IVF/ICSI treatment cycles for women with chronic HBV infection to help reduce the chance of vertical transmission.
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Affiliation(s)
- Jennifer S M Mak
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Terence T Lao
- Department of Obstetrics & Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
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Tung W, Yang C, Tseng P, Hung C, Wang J, Chen C, Hu T, Lu S, Xu H. Revisiting the accuracy of splenomegaly by sonography in patients with chronic hepatitis B. ADVANCES IN DIGESTIVE MEDICINE 2020. [DOI: 10.1002/aid2.13143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Wei‐Ling Tung
- Division of Hepatogastroenterology, Department of Internal MedicineChiayi Chang Gung Memorial Hospital Chiayi Taiwan
| | - Chun‐Hsun Yang
- Division of Hepatogastroenterology, Department of Internal MedicineKaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine Kaohsiung Taiwan
| | - Po‐Lin Tseng
- Division of Hepatogastroenterology, Department of Internal MedicineKaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine Kaohsiung Taiwan
| | - Chao‐Hung Hung
- Division of Hepatogastroenterology, Department of Internal MedicineChiayi Chang Gung Memorial Hospital Chiayi Taiwan
| | - Jing‐Houng Wang
- Division of Hepatogastroenterology, Department of Internal MedicineKaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine Kaohsiung Taiwan
| | - Chien‐Hung Chen
- Division of Hepatogastroenterology, Department of Internal MedicineKaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine Kaohsiung Taiwan
| | - Tsung‐Hui Hu
- Division of Hepatogastroenterology, Department of Internal MedicineKaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine Kaohsiung Taiwan
| | - Sheng‐Nan Lu
- Division of Hepatogastroenterology, Department of Internal MedicineChiayi Chang Gung Memorial Hospital Chiayi Taiwan
| | - Huang‐Wei Xu
- Division of Hepatogastroenterology, Department of Internal MedicineChiayi Chang Gung Memorial Hospital Chiayi Taiwan
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Posuwan N, Wanlapakorn N, Vongpunsawad S, Sintusek P, Leuridan E, Van Damme P, Poovorawan Y. Comparison of hepatitis B surface antibody levels induced by the pentavalent DTwP-HB-Hib versus the hexavalent DTaP-HB-Hib-IPV vaccine, administered to infants at 2, 4, 6, and 18 months of age, following monovalent hepatitis B vaccination at birth. Vaccine 2020; 38:1643-1651. [PMID: 31948817 DOI: 10.1016/j.vaccine.2019.12.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/24/2019] [Accepted: 12/28/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND In Thailand, the hepatitis B (HB) vaccine is administered as a tetravalent vaccine (DTwP-HB) to all infants at 2, 4, and 6 months of age, following an initial vaccination with a monovalent HB vaccine at birth. As part of ongoing vaccine evaluation, we aimed to compare the hepatitis B immunogenicity profiles of children who had received either the pentavalent (DTwP-HB-Hib) or the hexavalent (DTaP-HB-Hib-IPV) vaccine. METHODS Two groups of infants, whose mothers previously received the tetanus-diphtheria-acellular pertussis vaccine (Tdap), were randomly vaccinated with either pentavalent or hexavalent vaccine at 2, 4, 6, and 18 months of age, following monovalent HB vaccine at birth. Blood samples were obtained at birth, one-month post-primary series immunization (mo 7), pre-booster (mo 18), one-month post-booster (mo 19), and six months post-booster (mo 24). The third group of infants, whose mothers did not receive Tdap, was vaccinated with DTwP-HB-Hib (EPI pentavalent group). Levels of HBsAg, anti-HBc, and anti-HBs were evaluated by means of an automated Chemiluminescent Microparticle Immunoassay. RESULTS Anti-HBs levels of ≥10 mIU/ml were achieved in 99.2% (hexavalent group), 99.2% (pentavalent group), and 98.5% (EPI pentavalent group) of infants, after four-dose immunization (at 0, 2, 4, 6 months of age). One month after the additional dose given at 18 months of age, anti-HBs levels of ≥10 mIU/ml were observed in 100% (hexavalent group), 99.2% (pentavalent group), and 93.8% (EPI pentavalent group) of infants. At 24 months of age, higher percentages of infants achieving anti-HBs levels ≥10 mIU/ml were found in the hexavalent group (98.3%) compared to the pentavalent group (86.5%). CONCLUSIONS Both vaccines were effective in inducing anti-HBs levels of ≥10 mIU/ml, and therefore either can be used as a single formula booster at 18 months of age to simplify vaccine administration under the Expanded Program on Immunization in Thailand.
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Affiliation(s)
- Nawarat Posuwan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nasamon Wanlapakorn
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Division of Academic Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sompong Vongpunsawad
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Palittiya Sintusek
- Division of Gastroenterology and Hepatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Pediatric Liver Disease and Immunology STAR (Special Task Force for Activating Research), Department of Pediatrics, King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Elke Leuridan
- Center for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Pierre Van Damme
- Center for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; The Academy of Science, The Royal Society of Thailand, Dusit, Bangkok 10300, Thailand.
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Mak JSM, Lao TT, Leung MBW, Chung CHS, Chung JPW, Cheung LP, Li TC. Ovarian HBV replication following ovulation induction in female hepatitis B carriers undergoing IVF treatment: A prospective observational study. J Viral Hepat 2020; 27:110-117. [PMID: 31519044 DOI: 10.1111/jvh.13210] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/14/2019] [Accepted: 08/15/2019] [Indexed: 01/15/2023]
Abstract
Hepatitis B virus (HBV) can be found in ovarian tissues. This study compared HBV DNA levels in follicular fluid collected during oocyte retrieval with paired serum samples in HBV carriers after ovarian stimulation during IVF treatment for infertility. Sixty-four HBV carrier women referred to the Assisted Reproductive Units of two Hong Kong hospitals were recruited. At oocyte retrieval, the follicular fluid aspirated from the first follicle was collected for study. In 22 women, the first follicular fluid sample from both ovaries was similarly collected and studied. These women were also tested for liver function test and HBeAg. In 28 (43.8%) women, HBV DNA was detected in follicular fluid and the level correlated with serum levels (Spearman's correlation P < .001). There was concordant detection of HBV DNA in both ovaries, and the levels were significantly correlated (Spearman's correlation P = .029). In 40% of women with FF HBV DNA, the follicular fluid:serum ratio was >1.0, suggesting stimulation of HBV replication. These women also had significantly different liver function test results. Increased HBV replication exists in 40% of women with HBV DNA detected in follicular undergoing ovarian stimulation during IVF treatment.
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Affiliation(s)
- Jennifer Sze Man Mak
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Terence T Lao
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Maran Bo Wah Leung
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Cathy Hoi Sze Chung
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jacqueline Pui Wah Chung
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Lai Ping Cheung
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Tin-Chiu Li
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
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Rim CH, Yim HJ, Park S, Seong J. Recent clinical applications of external beam radiotherapy for hepatocellular carcinoma according to guidelines, major trials and meta-analyses. J Med Imaging Radiat Oncol 2019; 63:812-821. [PMID: 31482683 DOI: 10.1111/1754-9485.12948] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 08/11/2019] [Indexed: 12/12/2022]
Abstract
External beam radiotherapy (EBRT) for hepatocellular carcinoma (HCC) has not been widely used due to lack of high-level evidence, despite its potent local therapeutic effect. While clinical evidence has accumulated and meta-analyses of observational studies have provided integrated information to help in clinical decision-making, a recent randomized trial demonstrated the benefit of EBRT in cases of HCC with major vessel invasion. Based on these trends, the efficacy of EBRT has been better recognized, and EBRT has been more frequently recommended in several international treatment guidelines newly updated in 2018. This review examined the key issues of EBRT in the guidelines updated in 2018 as well as recently published noteworthy randomized trials and meta-analyses. Ongoing trials to identify the trends and direction of future research on EBRT for HCC were also reviewed.
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Affiliation(s)
- Chai Hong Rim
- Department of Radiation Oncology, Korea University Ansan Hospital, Gyeong-Gi Do, Korea
| | - Hyung Joon Yim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ansan Hospital, Gyeong-Gi Do, Korea
| | - Sunmin Park
- Department of Radiation Oncology, Korea University Ansan Hospital, Gyeong-Gi Do, Korea
| | - Jinsil Seong
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
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Chuon C, Takahashi K, Matsuo J, Katayama K, Yamamoto C, Ko K, Hok S, Nagashima S, Akbar SMF, Tanaka J. High possibility of hepatocarcinogenesis in HBV genotype C1 infected Cambodians is indicated by 340 HBV C1 full-genomes analysis from GenBank. Sci Rep 2019; 9:12186. [PMID: 31434918 PMCID: PMC6704254 DOI: 10.1038/s41598-019-48304-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 07/30/2019] [Indexed: 02/06/2023] Open
Abstract
Approximately 75% of hepatocellular carcinomas (HCC) occur in Asia; core promoter mutations are associated with HCC in HBV genotype C, the dominant genotype in Cambodia. We analyzed these mutations in Cambodian residents and compared them with HBV full genomes registered in GenBank. We investigated the characteristics of 26 full-length HBV genomes among 35 residents positive for hepatitis B surface antigen in Siem Reap province, Cambodia. Genotype C1 was dominant (92.3%, 24/26), with one case of B2 and B4 each. Multiple mutations were confirmed in 24 Cambodian C1 isolates, especially double mutation at A1762T/G1764A in 18 isolates (75.0%), and combination mutation at C1653T and/or T1753V and A1762T/G1764A in 14 isolates (58.3%). In phylogenetic analysis, 16 of 24 isolates were located in the cluster with Laos, Thailand, and Malaysia. In 340 GenBank-registered C1 strains, 113 (33.2%) had combination mutation amongst which 16.5%, 34.2%, and 95.2% were found in ASC, chronic hepatitis, and liver cirrhosis (LC)/HCC respectively (P < 0. 001). Mutations were abundantly found in 24 Cambodian C1 isolates, and 340 C1 strains from GenBank showed mutation in genotype C1 brings high possibility of LC/HCC occurrence. Therefore, we suggest that Cambodian people infected with HBV genotype C1 have high possibility of hepatocarcinogenesis.
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Affiliation(s)
- Channarena Chuon
- Department of Epidemiology, Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan
| | - Kazuaki Takahashi
- Department of Epidemiology, Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan
| | - Junko Matsuo
- Department of Epidemiology, Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan
| | - Keiko Katayama
- Department of Epidemiology, Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan
| | - Chikako Yamamoto
- Department of Epidemiology, Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan
| | - Ko Ko
- Department of Epidemiology, Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan
| | | | - Shintaro Nagashima
- Department of Epidemiology, Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan
| | | | - Junko Tanaka
- Department of Epidemiology, Infectious Diseases Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Japan.
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Mak JSM, Leung MBW, Chung CHS, Chung JPW, Cheung LP, Lao TT, Li TC. Presence of Hepatitis B virus DNA in follicular fluid in female Hepatitis B carriers and outcome of IVF/ICSI treatment: A prospective observational study. Eur J Obstet Gynecol Reprod Biol 2019; 239:11-15. [PMID: 31158788 DOI: 10.1016/j.ejogrb.2019.05.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/20/2019] [Accepted: 05/23/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To determine the relationship between the presence of detectable HBV DNA in the follicular fluid in HBV carriers with IVF/ICSI treatment outcome. STUDY DESIGN A prospective observational study conducted in the Assisted Reproductive Unit, a tertiary referral centre affiliated with the Department of Obstetrics and Gynecology, The Chinese University of Hong Kong; and the Union Reproductive Medicine Centre at Union Hospital, Hong Kong. The primary outcome measure was pregnancy rate. Secondary outcome measures were the prevalence of detectable HBV DNA in the follicular fluid, implantation rate, clinical pregnancy rate, ongoing pregnancy rate and live birth rate. RESULTS HBV DNA was detected in the follicular fluid of 28 (43.8%) of the 64 women, and the mean level in this group in log10 copies/mL (±SD) was 4.36 ± 1.85. Women with detectable follicular fluid HBV DNA were younger, lighter, had longer duration of infertility, higher incidence of detectable serum HBV DNA (OR 4.592, 95% C I 2.333-9.038), and significantly wider range in the number of total fertilized, viable embryos, and blastocyst rate, but no difference in cycle characteristics, stimulation and pregnancy outcomes, although the almost doubled ongoing pregnancy/live birth rate per cycle initiated (60.7% versus 38.9%) failed to reach statistical significance due to the small numbers. CONCLUSION Our results suggested HBV infection did not appear to be detrimental to the outcome of IVF/ICSI treatment.
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Affiliation(s)
- Jennifer S M Mak
- Assisted Reproduction Technology unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.
| | - Maran B W Leung
- Assisted Reproduction Technology unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Cathy H S Chung
- Assisted Reproduction Technology unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Jacqueline P W Chung
- Assisted Reproduction Technology unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - L P Cheung
- Assisted Reproduction Technology unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Terence T Lao
- Assisted Reproduction Technology unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - T C Li
- Assisted Reproduction Technology unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
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Rajamoorthy Y, Radam A, Taib NM, Rahim KA, Munusamy S, Wagner AL, Mudatsir M, Bazrbachi A, Harapan H. Willingness to pay for hepatitis B vaccination in Selangor, Malaysia: A cross-sectional household survey. PLoS One 2019; 14:e0215125. [PMID: 30964934 PMCID: PMC6456223 DOI: 10.1371/journal.pone.0215125] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 03/28/2019] [Indexed: 12/17/2022] Open
Abstract
Background In Malaysia, one million individuals are estimated to be infected with the hepatitis B virus. A vaccine for infants has been compulsory since 1989, whereas those born before 1989 need to spend their own money to be vaccinated in private clinics or hospitals. The aim of this study was to investigate and ascertain the determinants of willingness to pay (WTP) for adult hepatitis B vaccine in Selangor, Malaysia. Methods In 2016, 728 households were selected through a stratified, two stage cluster sample and interviewed. Willingness to pay for hepatitis B vaccine was estimated using the Contingent Valuation Method, and factors affecting WTP were modelled with logit regression. Results We found that 273 (37.5%) of the households were willing to pay for hepatitis B vaccination. The mean and median of WTP was estimated at Ringgit Malaysia (RM)303 (approximately US$73) for the three dose series. The estimated WTP was significantly greater in those with higher levels of education, among Malays and Chinese (compared to others, predominantly Indians), and for those with greater perceived susceptibility to hepatitis B virus infection. Other factors–perceived severity, barriers, benefits and cues to action–were not significantly associated with WTP for adult hepatitis B vaccination. Conclusion Additional resources are needed to cover the households that are not willing to pay for hepatitis B vaccination. More awareness (particularly in regards to hepatitis B virus susceptibility) could change the national perception towards self-paid hepatitis B virus vaccination and increase hepatitis B vaccine coverage.
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Affiliation(s)
- Yogambigai Rajamoorthy
- Department of Economics, Faculty of Accountancy and Management, Universiti Tunku Abdul Rahman, Selangor, Malaysia
- Department of Economics, Faculty of Economics and Management, Universiti Putra Malaysia, Selangor, Malaysia
- * E-mail: (YR); (MM); (HH)
| | - Alias Radam
- Department of Economics, Faculty of Economics and Management, Universiti Putra Malaysia, Selangor, Malaysia
| | - Niazlin Mohd Taib
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Khalid Ab Rahim
- Department of Economics, Faculty of Economics and Management, Universiti Putra Malaysia, Selangor, Malaysia
| | - Subramaniam Munusamy
- Department of Economics, Faculty of Economics and Management, Universiti Putra Malaysia, Selangor, Malaysia
- Centre for Language and Foundation Studies, Manipal International University, Negeri Sembilan, Malaysia
| | - Abram Luther Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Mudatsir Mudatsir
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- * E-mail: (YR); (MM); (HH)
| | - Abdullatif Bazrbachi
- Department of Economics, Faculty of Economics and Management, Universiti Putra Malaysia, Selangor, Malaysia
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- School of Biomedical Sciences, University of Western Australia, Nedlands, Western Australia, Australia
- * E-mail: (YR); (MM); (HH)
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Sui MH, Wang HG, Chen MY, Wan T, Hu BY, Pan YW, Li H, Cai HY, Cui C, Lu SC. Assessment of the effect of the Aquamantys® system on local recurrence after hepatectomy for hepatocellular carcinoma through propensity score matching. Clin Transl Oncol 2019; 21:1634-1643. [DOI: 10.1007/s12094-019-02092-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 03/13/2019] [Indexed: 12/13/2022]
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Wong MCS, Huang JLW, George J, Huang J, Leung C, Eslam M, Chan HLY, Ng SC. The changing epidemiology of liver diseases in the Asia-Pacific region. Nat Rev Gastroenterol Hepatol 2019; 16:57-73. [PMID: 30158570 DOI: 10.1038/s41575-018-0055-0] [Citation(s) in RCA: 233] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This Review presents current epidemiological trends of the most common liver diseases in Asia-Pacific countries. Hepatitis B virus (HBV) remains the primary cause of cirrhosis; despite declining prevalence in most Asian nations, this virus still poses a severe threat in some territories and regions. Mortality resulting from HBV infection is declining as a result of preventive measures and antiviral treatments. The epidemiological transition of hepatitis C virus (HCV) infection has varied in the region in the past few decades, but the medical burden of infection and the prevalence of its related cancers are increasing. The lack of licensed HCV vaccines highlights the need for novel treatment strategies. The prevalence of nonalcoholic fatty liver disease (NAFLD) has risen in the past decade, mostly owing to increasingly urbanized lifestyles and dietary changes. Alternative herbal medicine and dietary supplements are major causes of drug-induced liver injury (DILI) in some countries. Complications arising from these chronic liver diseases, including cirrhosis and liver cancer, are therefore emerging threats in the Asia-Pacific region. Key strategies to control these liver diseases include monitoring of at-risk populations, implementation of national guidelines and increasing public and physician awareness, in concert with improving access to health care.
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Affiliation(s)
- Martin C S Wong
- Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- State Key Laboratory for Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- J.C. School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Jason L W Huang
- J.C. School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Jacob George
- Storr Liver Centre, Westmead Millennium Institute and Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Junjie Huang
- J.C. School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Colette Leung
- J.C. School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Mohammed Eslam
- Storr Liver Centre, Westmead Millennium Institute and Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Henry L Y Chan
- Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- State Key Laboratory for Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Siew C Ng
- Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong.
- State Key Laboratory for Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong.
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong.
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Rajamoorthy Y, Radam A, Taib NM, Rahim KA, Wagner AL, Mudatsir M, Munusamy S, Harapan H. The relationship between perceptions and self-paid hepatitis B vaccination: A structural equation modeling approach. PLoS One 2018; 13:e0208402. [PMID: 30521602 PMCID: PMC6283584 DOI: 10.1371/journal.pone.0208402] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 11/15/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Malaysia has a comprehensive, publicly-funded immunization program for hepatitis B (HepB) among infants, but adults must pay for the vaccine. The number of HepB carriers among adults is expected to increase in the future; therefore, we examined the impact of five constructs (cues to action, perceived barriers, perceived benefit, perceived severity, and perceived susceptibility) on adults' willingness to pay (WTP) for HepB vaccine; secondarily, we examined the association between perceived barriers and perceived benefits. METHODS Adults were selected through a stratified, two-stage cluster community sample in Selangor, Malaysia. The reliability, convergent validity, and discriminant validity of the measurement model were assessed before implementing a partial least squares structural equation model (PLS-SEM) to evaluate the significance of the structural paths. RESULTS A total of 728 participants were enrolled. The five constructs all showed adequate internal reliability, convergent validity, and discriminant validity. There was a significant, positive relationship to WTP from constructs (perceived barriers [Path coefficient (β) = 0.082, P = 0.036], perceived susceptibility [β = 0.214, P<0.001], and cues to action [β = 0.166, P<0.001]), and the model all together accounted for 8.8% of the variation in WTP. There was a significant, negative relationship between perceived barriers and perceived benefit [β = -0.261, P<0.001], which accounted for 6.8% of variation in perceived benefit. CONCLUSIONS Policy and programs should be targeted that can modify individuals' thoughts about disease risk, their obstacles in obtaining the preventive action, and their readiness to obtain a vaccine. Such programs include educational materials about disease risk and clinic visits that can pair HepB screening and vaccination.
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Affiliation(s)
- Yogambigai Rajamoorthy
- Department of Economics, Faculty of Accountancy and Management, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
- Department of Economics, Faculty of Economics and Management, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Alias Radam
- Department of Economics, Faculty of Economics and Management, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Niazlin Mohd Taib
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Khalid Ab Rahim
- Department of Economics, Faculty of Economics and Management, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Abram Luther Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Mudatsir Mudatsir
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
- Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Subramaniam Munusamy
- Department of Economics, Faculty of Economics and Management, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- School of Management and Business, Manipal International University, Nilai, Negeri Sembilan, Malaysia
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
- Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
- School of Biomedical Sciences, University of Western Australia, Nedlands, Western Australia, Australia
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Kim BG, Park NH, Lee SB, Jeon S, Park JH, Jung SW, Jeong ID, Bang SJ, Shin JW. The risk of hepatocellular carcinoma within and beyond the first 5 years of entecavir in Korean patients with chronic hepatitis B. Liver Int 2018; 38:2269-2276. [PMID: 30052303 DOI: 10.1111/liv.13938] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 07/05/2018] [Accepted: 07/23/2018] [Indexed: 02/13/2023]
Abstract
BACKGROUND & AIMS The development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) has decreased due to potent antiviral agents. However, it remains uncertain whether the risk of HCC will diminish after long-term antiviral therapy in Asia, where CHB is endemic and vertical transmission is common. This study aimed to compare the incidence of HCC within and beyond the first 5 years of entecavir (ETV) in treatment-naïve Korean patients with CHB. METHODS We performed a retrospective observational analysis of data from 894 consecutive, adult patients with CHB undergoing ETV treatment at a tertiary referral hospital in Ulsan, Korea from January 1, 2007 through April 31, 2017. We compared the HCC incidence rates per 100 person-years within and beyond the first 5 years. Univariate and multivariate analyses for factors predictive of HCC were performed. RESULTS The incidence rate of HCC in patients with CHB did not differ statistically when we compared within and beyond the first 5 years of ETV therapy (2.29% vs 1.66% per person-year, P = 0.217). Failure to achieve maintained virological response (MVR) was a major independent risk factor for HCC in patients at a follow-up of <5 years. In contrast, in patients with a follow-up of ≥5 years, achieving MVR was not significantly associated with HCC development. CONCLUSIONS The incidence rate of HCC may not change significantly before and after 5 years of ETV therapy in Korean CHB patients. The risk of HCC in Asian CHB patients may remain in the long-term.
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Affiliation(s)
- Byung Gyu Kim
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Neung Hwa Park
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Seung Bum Lee
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Soyoung Jeon
- Statistical Consulting Laboratory, Department of Mathematical Sciences, University of Texas at El Paso, El Paso, Texas
| | - Jae Ho Park
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Seok Won Jung
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - In Du Jeong
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sung-Jo Bang
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jung Woo Shin
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
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Kwon JC, Chang HY, Kwon OY, Park JH, Oh IS, Kim HJ, Lee JH, Roh HJ, Lee HW. Seroepidemiology of Hepatitis Viruses and Hepatitis B Genotypes of Female Marriage Immigrants in Korea. Yonsei Med J 2018; 59:1072-1078. [PMID: 30328322 PMCID: PMC6192883 DOI: 10.3349/ymj.2018.59.9.1072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/11/2018] [Accepted: 08/23/2018] [Indexed: 01/21/2023] Open
Abstract
PURPOSE The Korean society has moved rapidly toward becoming a multicultural society. This study aimed to estimate the seroprevalence of hepatitis viruses and investigate hepatitis B virus (HBV) genotypic diversity in female marriage immigrants. MATERIALS AND METHODS Screening program was conducted at support centers for multicultural families in 21 administrative districts in Korea between July 2011 and January 2017. A total of 963 female marriage immigrants were included in this study. Blood samples were tested for hepatitis viral markers and HBV genotype. RESULTS Subjects' median age was 33 years (20-40 years), and they originated from nine countries including Vietnam (n=422, 43.8%), China (n=311, 32.3%), the Philippines (n=85, 8.8%), Cambodia (n=58, 6.0%), and Japan (n=39, 4.0%). About 30% (n=288) of subjects required hepatitis A vaccination. HBsAg positive rate was 5.4% (n=52). Positive HBsAg results were the highest in subjects from Southeast Asia (6.6%, n=38). Anti-HBs positive rate was 60.4% (n=582). About 34% (n=329) of subjects who were negative for anti-HBs and HBsAg required HBV vaccinations. Genotypes B and C were found in 54.6% (n=12) and 45.4% (n=10) of the 22 subjects with HBV, in whom genotypes were tested. Eight (0.8%) subjects were positive for anti-HCV. Positive anti-HCV results were the highest in subjects from Central Asia (7.9%, n=3). CONCLUSION Testing for hepatitis viral marker (hepatitis A virus IgG and HBsAg/anti-HBs) is needed for female marriage immigrants. Especially, HBV genotype B is different from genotype C of Koreans. Therefore, interest and attention to vaccination programs for female marriage immigrants are necessary for both clinicians and public health institutes.
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Affiliation(s)
- Jae Cheol Kwon
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hye Young Chang
- Department of Internal Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Oh Young Kwon
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ji Hoon Park
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - In Soo Oh
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hyung Joon Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jun Hyung Lee
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Ha Jung Roh
- Molecular Epidemiology and Bioinformatics Laboratory, Division of Viral Hepatitis, Center for Disease Control and Prevention, Atlanta, GA, USA
| | - Hyun Woong Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.
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