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Wibowo DP, Chalid MT, Rasyak MR, El Khobar KE, Turyadi, Sjahril R, Wahyuni R, Setiady Y, Muljono DH. Characteristics of hepatitis B virus surface protein and occult hepatitis B infection in infants with immunoprophylaxis failure from Indonesia. Vaccine 2025; 56:127130. [PMID: 40305978 DOI: 10.1016/j.vaccine.2025.127130] [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: 07/15/2024] [Revised: 03/21/2025] [Accepted: 04/09/2025] [Indexed: 05/02/2025]
Abstract
Perinatal hepatitis B virus (HBV) infection carries a significant risk of chronicity and complications while making infected people reservoirs for further transmission. Hepatitis B immunization in infants, with or without hepatitis B immune globulin (HBIG), has proven effective in preventing mother-to-child transmission. Nevertheless, some newborns of mothers with high viremia testing positive for hepatitis B e antigen (HBeAg) may not benefit from HBV immunoprophylaxis. Nineteen (10.2 %) of 186 infants born to HBV-infected mothers were HBV DNA-positive. HBV genotypes, serotypes, and hepatitis B surface antigen (HBsAg) sequences were comparable in most mother-cord blood-infant sample pairings, indicating that the infants' HBV strains originated from their mothers. Three (15.3 %) infants had overt HBV infection, whereas 16 (84.2 %) had occult HBV infection (OBI). The HBV isolates from infants exhibited 26 mutations: 38.5 % in the 'a' determinant and 61.5 % in the rest of HBsAg. Mutations were identified in B-cell and T-cell epitopes, impairing humoral and cellular responses to detect or neutralize the virus. This rendered immunoprophylaxis and diagnostics ineffective while inducing tolerance to the infection. HBV strains with these mutations can persist and cause complications, but they can be transmitted undetected by HBsAg tests commonly used in community healthcare. This study reveals the risk of HBV transmission from HBsAg mutant-infected mothers to newborns despite having received the birth dose with HBIG and complete hepatitis B vaccination.
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Affiliation(s)
- Dhita Prabasari Wibowo
- Post Graduate School, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia; Eijkman Research Centre for Molecular Biology, National Research and Innovation Agency, Bogor, West Java, Indonesia
| | - Maisuri T Chalid
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | - Muhammad Rezki Rasyak
- Post Graduate School, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia; Eijkman Research Centre for Molecular Biology, National Research and Innovation Agency, Bogor, West Java, Indonesia
| | - Korri E El Khobar
- Eijkman Research Centre for Molecular Biology, National Research and Innovation Agency, Bogor, West Java, Indonesia
| | - Turyadi
- Eijkman Research Centre for Molecular Biology, National Research and Innovation Agency, Bogor, West Java, Indonesia
| | - Rizalinda Sjahril
- Department of Microbiology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | - Ridha Wahyuni
- Department of Microbiology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | | | - David H Muljono
- Department of Internal Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, South Sulawesi, Indonesia; Indonesian Academy of Sciences (AIPI), Jakarta, Indonesia; Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.
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Chen Q, Huang S, Peng J, Wang P, Shi X, Luo R, Xu H, Zhang W, Shi L, Peng Y, Yuan F, Tang X. The Burden of Hepatitis B and C in Asia, 1990-2019: An Update Analysis From the Global Burden of Disease Study 2019. Liver Int 2025; 45:e70004. [PMID: 39840788 DOI: 10.1111/liv.70004] [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: 04/13/2024] [Revised: 12/11/2024] [Accepted: 01/10/2025] [Indexed: 01/23/2025]
Abstract
AIM This research was aimed to uncover the hepatitis B virus (HBV) and hepatitis C virus (HCV) related diseases burden in Asia over the past 3 decades, estimating from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS Age-standardised rates, case numbers of prevalence, disability-adjusted life-years (DALYs), incidence and deaths with 95% uncertainty intervals (UI) for HBV/HCV-related diseases from 1990 to 2019 were derived from GBD 2019 database, with the estimated annual percentage changes (EAPCs) calculated. Our analysis also encompassed the association between the Sociodemographic Index (SDI) and the burden of HBV/HCV-related diseases, future disease burden predictions in six selected countries and various risk factors. RESULT A general downward trend in the age-standardised rates of death, disability-adjusted life years (DALYs), prevalence and incidence for both HBV and HCV-related diseases was observed in Asia during the past 30 years. Despite overall declining trends, some analysed diseases experienced an increase. Compared with females, the disease burden was greater in the male population and peaked in the age of 50-54 for both sexes. It is significant for the HBV-related and HCV-related diseases burden in Afghanistan, Cambodia, Mongolia and Pakistan. Drug use and smoking were prominent contributors to HCV and HBV-related diseases. There was a negative relationship between the burden of HCV and HBV-related diseases and SDI. CONCLUSION Although decreases were observed in Asia, the HBV- and HCV-associated diseases burden remained high, highlighting that imperative measures for prevention and treatment should be taken by governments in Asia.
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Affiliation(s)
- Qi Chen
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Shu Huang
- Department of Gastroenterology, Lianshui County People' Hospital, Huaian, China
- Department of Gastroenterology, Lianshui People' Hospital of Kangda College Affiliated to Nanjing Medical University, Huaian, China
| | - Jieyu Peng
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Ping Wang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Xiaomin Shi
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Rui Luo
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Huan Xu
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Wei Zhang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Lei Shi
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Yan Peng
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Fangfang Yuan
- Department of Intensive Care Unit, The 3rd Xiangya Hospital, Central South University, Changsha, China
| | - Xiaowei Tang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
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Kaewdech A, Charatcharoenwitthaya P, Piratvisuth T. Asian Perspective on Hepatitis B Virus and Hepatitis C Virus Elimination. Viruses 2024; 17:34. [PMID: 39861823 PMCID: PMC11768638 DOI: 10.3390/v17010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Revised: 12/27/2024] [Accepted: 12/27/2024] [Indexed: 01/27/2025] Open
Abstract
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain significant public health challenges in Asia, affecting millions and contributing to substantial morbidity and mortality. The prevalence of these infections varies across the region, with factors such as vaccination coverage, healthcare infrastructure, and sociocultural barriers influencing the epidemiology of both viruses. The persistent burden of chronic HBV, particularly in older populations, and the evolving HCV genotype landscape highlight the need for targeted, region-specific strategies. Universal screening programs have emerged as essential tools for detecting undiagnosed cases and optimizing healthcare resource allocation. Given the overlapping epidemiology of HBV and HCV, comprehensive public health interventions tailored to the unique contexts of different Asian countries are crucial for achieving global elimination goals. This review examines the epidemiological trends, challenges, and opportunities for addressing HBV and HCV in Asia, emphasizing the importance of overcoming sociocultural barriers to improve prevention, diagnosis, and treatment efforts across diverse populations.
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Affiliation(s)
- Apichat Kaewdech
- Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand;
| | - Phunchai Charatcharoenwitthaya
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Teerha Piratvisuth
- NKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
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Fang K, Shi Y, zhao Z, Zhao Y, Guo Y, Abudunaibi B, Qu H, Liu Q, Kang G, Wang Z, Hu J, Chen T. Trends in disease burden of hepatitis B infection in Jiangsu Province, China, 1990-2021. Infect Dis Model 2023; 8:832-841. [PMID: 37520113 PMCID: PMC10371820 DOI: 10.1016/j.idm.2023.07.007] [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] [Received: 04/06/2023] [Revised: 07/03/2023] [Accepted: 07/09/2023] [Indexed: 08/01/2023] Open
Abstract
Background The incidence of hepatitis B virus (HBV) has decreased year by year in China after the expansion of vaccination, but there is still a high disease burden in Jiangsu Province of China. Methods The year-by-year incidence data of HBV in Jiangsu Province from 1990 to 2021 were collected. The incidence rates of males and females age groups were clustered by systematic clustering, and the incidence rates of each age group were analyzed and studied by using Joinpoint regression model and age-period-cohort effect model (APC). Results Joinpoint regression model and APC model showed a general decrease in HBV prevalence in both males and females. In addition, the results of the APC model showed that the age, period, and cohort effects of patients all affected the incidence of HBV, and the incidence was higher in males than in females. The incidence is highest in the population between the ages of 15 and 30 years (mean: 21.76/100,000), especially in males (mean: 31.53/100,000) than in females (mean:11.67/100,000). Another high-risk group is those over 60 years of age (mean: 21.40/100,000), especially males (mean: 31.17/100,000) than females (mean: 11.63/100,000). The period effect of the APC model suggests that HBV vaccination is effective in reducing the incidence of HBV in the population. Conclusions The incidence of HBV in Jiangsu Province showed a gradual downward trend, but the disease burden in males was higher than that in females. The incidence is higher and increasing rapidly in the population between the ages of 15 and 30 years and people over 60 years of age. More targeted prevention and control measures should be implemented for males and the elderly.
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Affiliation(s)
- Kang Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, 361102, Fujian Province, People's Republic of China
| | - Yingying Shi
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing City, People's Republic of China
| | - Zeyu zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, 361102, Fujian Province, People's Republic of China
| | - Yunkang Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, 361102, Fujian Province, People's Republic of China
| | - Yichao Guo
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, 361102, Fujian Province, People's Republic of China
| | - Buasivamu Abudunaibi
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, 361102, Fujian Province, People's Republic of China
| | - Huimin Qu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, 361102, Fujian Province, People's Republic of China
| | - Qiao Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, 361102, Fujian Province, People's Republic of China
| | - Guodong Kang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing City, People's Republic of China
| | - Zhiguo Wang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing City, People's Republic of China
| | - Jianli Hu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing City, People's Republic of China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, 361102, Fujian Province, People's Republic of China
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Lestari CSW, Dewi RM, Sunarno S, Hasugian AR, Handayani S, Maha MS, Panjaitan NSD, Ningrum N, Sari M, Fairuza F. The effectiveness of hepatitis B vaccine in toddlers based on the five-year period national basic health research (Riskesdas 2007, 2013 and 2018) in Indonesia. PeerJ 2023; 11:e15199. [PMID: 37214093 PMCID: PMC10194077 DOI: 10.7717/peerj.15199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/16/2023] [Indexed: 05/24/2023] Open
Abstract
Background Hepatitis B is a viral infection that has a high prevalence in Indonesia. The Ministry of Health of Indonesia has conducted a national vaccination program for hepatitis B. In order to evaluate the success of the hepatitis B vaccination in Indonesia, a community study based on basic health research (Riskesdas) was performed nationwide since 2007 for five year period in 2007, 2013, and 2018. Methods Further statistical analysis was performed specifically for the children under 59 months old (toddlers) immunized in both urban and rural areas in 2007, 2013, and 2018 based on certain characteristics by examining antibodies against HBsAg (anti-HBs), IgG antibodies against the core antigen (HBcAb), surface antigen (HBsAg) of hepatitis B virus (HBV). The data obtained from the data management laboratory of Ministry of Health, Indonesia, was analyzed with Bivariate analysis with continuity correction chi-square or Pearson chi-square using Stata software version 16. Results This study showed an increase in hepatitis B coverage of complete immunization (30% in 2007, 60.3% in 2013, and 57% in 2018), which was also influenced by mothers' level of education (Pearson chi-square , p ¡ 0.05) and access to health service points within 30 minutes (OR = 1.3-2.8, p ¡ 0.05). The trend of the percentage of immune status (anti-HBs) was increased (41.8% in 2007; 56.1% in 2013; and 79.1% in 2018). The higher anti-HBs was found in complete hepatitis B immunization status (OR = 1.5-2, p ¡ 0.05) and in good nutritional status (p ¡ 0.05). However, the anti-HBs was found decreased with increasing age (p ¡ 0.05). The trend of positive HBcAb (exposure to HBV infection) showed a decrease gradually of almost ten times from 2007 (8.6%-13.5%) compared to 2013 (2.6%-11.1%) and 2018 (1.1%-2%). Urban areas were at higher risk of hepatitis B exposure (OR = 1.4-2.2) than rural areas (OR = 0.37-0.80). The HBsAg data were only available in 2013 and 2018. Riskesdas data analysis showed the prevalence of hepatitis B (HBsAg) was lower in complete immunization status than that in incomplete one (p ¡ 0.05), but with an increase from 3.9% (2013) to 9.3% (2018), possibly due to inappropriate implementation of birth dose immunization or a vaccine-escape mutant from the HBV variants. Conclusions The effectiveness of hepatitis B vaccine obtained from the three Riskesdas periods in Indonesia showed an improvement, with an increase in immune status, reduced exposure to HBV and a lower prevalence of hepatitis B in children with complete vaccination. However, there is still an increase in hepatitis B infection, especially in urban areas. Therefore, a long-term evaluation of immunization coverage especially ensuring that the initial dose of immunization was given within the first 24 h of birth, HBsAg and HBcAb, nutritional status, genomic surveillance of HBV, and other aspects of program quality evaluation are needed to ensure that elimination efforts have been implemented properly.
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Affiliation(s)
- Christina Safira Whinie Lestari
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Rita Marleta Dewi
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Sunarno Sunarno
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Armedy Ronny Hasugian
- Research Center for Preclinical and Clinical Medicine, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Sarwo Handayani
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Masri Sembiring Maha
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Novaria Sari Dewi Panjaitan
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Bogor, West Java, Indonesia
| | - Nathalia Ningrum
- Department of Paediatrics, Faculty of Medicine, Universitas Trisakti, West Jakarta, Jakarta, Indonesia
| | - Meiriani Sari
- Department of Paediatrics, Faculty of Medicine, Universitas Trisakti, West Jakarta, Jakarta, Indonesia
| | - Firda Fairuza
- Department of Paediatrics, Faculty of Medicine, Universitas Trisakti, West Jakarta, Jakarta, Indonesia
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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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de Almeida NAA, de Paula VS. Occult Hepatitis B virus (HBV) infection and challenges for hepatitis elimination: A literature review. J Appl Microbiol 2021; 132:1616-1635. [PMID: 34724308 DOI: 10.1111/jam.15351] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/08/2021] [Accepted: 10/11/2021] [Indexed: 12/15/2022]
Abstract
Occult hepatitis B infection (OBI) is characterized by the detection of hepatitis B virus (HBV) DNA in serum or liver but negativity for hepatitis B surface antigen. OBI, which is thought to be maintained by host, immunological, viral and/or epigenetic factors, is one of the most challenging clinical features in the study of viral hepatitis. Currently, there is no validated detection test for OBI. It is believed that OBI is widely distributed throughout the world, with a higher prevalence in populations at high-risk HBV, but the detailed worldwide prevalence patterns are unknown. We conducted a survey of recently published studies on OBI rates across all continents. High prevalence rates of OBI are observed in some specific groups, including patients with hepatitis C virus, human immunodeficiency virus co-infection or hepatocellular carcinoma. In 2016, the World Health Organization adopted strategies to eliminate viral hepatitis by 2030, but the difficulties in detecting and treating OBI currently challenge this goal. Subjects with OBI can transmit HBV, and episodes of reactivation can occur. Further studies to understanding the mechanisms that drive the development of OBI are needed and can contribute to efforts at eliminating viral hepatitis.
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Kambuno NT, Octrysdey K, Nurdin KE, Novicadlitha Y, Barung EN, Hafid F. Sharing of Personal Sanitary Kits as One Risk Factor of Horizontal Transmission of Hepatitis B among Children Resident at Orphanage. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Hepatitis B is a disease that infects the liver and is caused by the infection of a hepatitis B virus (HBV), and is becoming a global health issue, especially in developing countries including Indonesia. Hepatitis B can be transmitted through several ways such as infected bodily fluids. Indeed, children who live together in an orphanage are prone to having a high chance of transmitting Hepatitis B to each other.
AIM: The purpose of this study was to analyze the factors associated with the prevalence of infected Hepatitis B.
METHODS: This research used casecontrol study methodology by taking 15 positive case samples and 33 controlled uninfected patients and was conducted in six orphanages in Kupang Municipality in NTT between July 2019 and November 2019. There were 310 orphanage residents participating in this research.
RESULTS: The research denotes that variables of using a shared toothbrush, nail clipper, and shaver show a significant connection with their Hepatitis B status (p < 0.05). A further analysis also indicates that using a shared shaver and toothbrush for 12.6 times has a high risk of being infected by Hepatitis B compared to those who do not share their personal items.
CONCLUSION: Vaccinations and meeting the basic needs of every child in orphanages are essential in order to minimize the risk of Hepatitis B transmission.
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No evidence of occult HBV infection in population born after mass vaccination. Wien Med Wochenschr 2020; 170:218-223. [PMID: 32274600 DOI: 10.1007/s10354-020-00748-z] [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: 09/28/2019] [Accepted: 03/16/2020] [Indexed: 12/13/2022]
Abstract
Despite access to efficient hepatitis B virus (HBV) vaccine and universal immunization schedules, HBV infection remains a global health concern. HBV infection has decreased by this program. Nevertheless, breakthrough infections occur due to generation of occult HBV infection (OBI) and surface gene mutants in the immunized population. We aimed to determine the presence of OBI in a population born after initiation of nationwide HBV vaccination in Tehran, Iran. A HBV mass vaccination schedule was launched in Iran in 1993. For this study, we enrolled 1120 cases younger than 24 years. ELISA was applied to evaluate the presence of HBsAg, anti-HBs and anti-HBc. HBV-DNA presence was determined in all HBsAg-negative cases using nested polymerase chain reaction. The prevalence of HBsAg, anti-HBc and anti-HBs was 0.1, 0.54 and 39.9% respectively. Out of 6 anti-HBc-positive individuals, 4 cases also had anti-HBs. One case revealed HBsAg co-existence and the other one showed isolated anti-HBc. HBV-DNA was not detected in HBsAg-negative specimens. A very low prevalence of HBsAg and isolated anti-HBc was observed and no occult HBV infection was detected. It seems that evasion mutants are not a potential threat for HBV universal immunization efficacy in the vaccinated population.
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Komatsu H, Inui A, Suzuki Y, Sugiyama M, Fujisawa T. Deep sequencing of hepatitis B surface antigen gene in the preserved umbilical cords in immunoprophylaxis failure against mother-to-child HBV transmission. BMC Infect Dis 2019; 19:985. [PMID: 31752732 PMCID: PMC6873716 DOI: 10.1186/s12879-019-4624-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 11/08/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Vaccine escape mutants (VEMs) are one of the causes of breakthrough infections in the mother-to-child transmission of hepatitis B virus (HBV). We hypothesized that VEMs existing as minor populations in the maternal blood are associated with breakthrough infections in children. We sought to determine whether VEMs exist as minor populations in the preserved umbilical cords of children with breakthrough infections. CASE PRESENTATION Two families (Family 1: three children, Family 2: two children) were enrolled. Despite immunoprophylaxis, a breakthrough infection occurred in two Family 1 children and two Family 2 children. Preserved umbilical cords, serum, and nails were used for the HBV DNA analysis. To detect VEMs, we performed direct and deep sequencing of hepatitis B surface antigen gene. The direct sequencing showed that there were no VEMs in the serum of the children or mother of Family 1 and family 2, but it identified a G145A mutant in the nails of the mother of Family 2. In Family 1, deep sequencing detected a T143S mutant as a minor population (1.7-2.0%) in the umbilical cords and serum of all three children and in the serum of the mother. A T126A mutant was also detected in the umbilical cord (9.2%) and serum (7.0%) of the first-born child of Family 1. In Family 2, the deep sequencing showed no VEMs in the umbilical cords, but it detected D144A (2.5%) and G145A (11.2%) mutants in the serum of the 2nd-born child. CONCLUSIONS VEMs were present as minor populations in the preserved umbilical cords of children with breakthrough infections. The VEMs did not become major populations after the breakthrough infections. The evolution of VEMs from a minor form to a major form might not be a prerequisite for breakthrough infections in mother-to-child transmission.
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Affiliation(s)
- Haruki Komatsu
- Department of Pediatrics, Toho University, Sakura Medical Center, 564-1 Shimoshizu Sakura, Chiba, 285-8741, Japan.
| | - Ayano Inui
- Department of Pediatric Hepatology and Gastroenterology, Eastern Yokohama Hospital, Kanagawa, Japan
| | - Yasuto Suzuki
- Department of Pediatrics, Kushiro Red Cross Hospital, Hokkaido, Japan
| | - Masaya Sugiyama
- Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan
| | - Tomoo Fujisawa
- Department of Pediatric Hepatology and Gastroenterology, Eastern Yokohama Hospital, Kanagawa, Japan
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Deep Sequencing Reveals the Characteristics of Hepatitis B Virus (HBV) S Region in Vertical Transmission and the Influence of Mutations on Vaccination Failure. HEPATITIS MONTHLY 2019. [DOI: 10.5812/hepatmon.90964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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12
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Wahyuni RM, Utsumi T, Juniastuti, Yano Y, Murti IS, Amin M, Yamani LN, Istimagfiroh A, Purwono PB, Soetjipto, Lusida MI, Hayashi Y. Analysis of hepatitis B virus genotype and gene mutation in patients with advanced liver disease in East Kalimantan, Indonesia. Biomed Rep 2019; 10:303-310. [PMID: 31086664 PMCID: PMC6489537 DOI: 10.3892/br.2019.1202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/12/2019] [Indexed: 12/18/2022] Open
Abstract
Liver cirrhosis (LC) and hepatocellular carcinoma (HCC) are life-threatening conditions frequently associated with chronic hepatitis B virus (HBV) infection in Asian countries, including Indonesia. HBV genotypes and several specific mutations are associated with disease progression. To clarify the geographical variation in viral characteristics, HBV genotypes and gene mutations were investigated in patients with advanced liver disease (ALD) in Samarinda, East Kalimantan, Indonesia. Sera were collected from 41 patients with ALD at Abdul Wahab Sjahranie Hospital and HBV carriers from Red Cross Center blood bank in Samarinda, and screened for hepatitis B surface antigen and hepatitis B e-antigen. Liver function data were obtained from the medical records from each patient. HBV genotype and gene mutations were determined by polymerase chain reaction sequencing. Analysis of HBV isolates indicated that genotype B was the most frequent genotype, at 85.4 and 97.8%, followed by C, at 14.6 and 2.2%, in patients with ALD and in HBV carriers, respectively. The C1505A mutation in X region, T1753V and A1762T/G1764A mutations in the basal core promoter region and C1858T in precore (PC) region were frequent and only detected in patients with ALD (28.9, 40, 73.5 and 17.6%, respectively), whereas the G1896A mutation in the PC region was frequently detected in HBV carriers. The presence of HBV genotype B and certain HBV gene mutations were characteristic of patients with ALD in East Kalimantan.
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Affiliation(s)
- Rury Mega Wahyuni
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
| | - Takako Utsumi
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Juniastuti
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
- Department of Microbiology, Faculty of Medicine, Airlangga University, Campus A, Surabaya 60131, Indonesia
| | - Yoshihiko Yano
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Ignatia Sinta Murti
- Department of Internal Medicine, Faculty of Medicine, Mulawarman University, Samarinda 75119, Indonesia
| | - Mochamad Amin
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
| | - Laura Navika Yamani
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
- Department of Epidemiology, Faculty of Public Health, Airlangga University, Campus C, Surabaya 60115, Indonesia
| | - Anittaqwa Istimagfiroh
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
| | - Priyo Budi Purwono
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
- Department of Microbiology, Faculty of Medicine, Airlangga University, Campus A, Surabaya 60131, Indonesia
| | - Soetjipto
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
- Department of Biochemistry, Faculty of Medicine, Airlangga University, Campus A, Surabaya 60131, Indonesia
| | - Maria Inge Lusida
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Campus C, Surabaya 60115, Indonesia
- Department of Microbiology, Faculty of Medicine, Airlangga University, Campus A, Surabaya 60131, Indonesia
| | - Yoshitake Hayashi
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
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Childs L, Roesel S, Tohme RA. Status and progress of hepatitis B control through vaccination in the South-East Asia Region, 1992-2015. Vaccine 2018; 36:6-14. [PMID: 29174317 PMCID: PMC5774012 DOI: 10.1016/j.vaccine.2017.11.027] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/09/2017] [Accepted: 11/13/2017] [Indexed: 01/05/2023]
Abstract
In 2016, the Immunization Technical Advisory Group of the South-East Asia Region (SEAR) endorsed a regional goal to achieve ≤1% prevalence of hepatitis B surface antigen (HBsAg) among 5-year-old children by 2020. Chronic hepatitis B virus (HBV) infection is largely preventable with a birth dose of hepatitis B vaccine (HepB-BD) followed by two to three additional doses. We reviewed the progress towards hepatitis B control through vaccination in SEAR during 1992-2015. We summarized hepatitis B vaccination data and reviewed the literature to determine the prevalence of chronic HBV infection pre- and post-vaccine introduction. We used a mathematical model to determine post-vaccine prevalence of HBsAg among 5 year olds in countries lacking national serosurvey data and estimated the impact of vaccination on disease burden. Regional coverage with three doses of hepatitis B vaccine (HepB3) increased from 56% in 2011 to 87% in 2015. By 2016, 7 of 11 countries had introduced universal HepB-BD. Regional HepB-BD coverage increased from 9% in 2011 to 34% in 2015. In 2015, estimated HBsAg among 5 year olds was 1.1% with variability among countries. Myanmar (3.8%), Timor-Leste (2.7%), Indonesia (1.8%), and India (1%) had the highest prevalence of HBsAg. During 1992-2015, vaccination prevented approximately 16 million chronic HBV infections and 2.6 million related deaths. In 2015, around 197,640 perinatal HBV infections occurred in SEAR with majority occurring in India (62%), Bangladesh (24%), and Myanmar (8%). Myanmar had the highest rate of perinatal chronic HBV infections at 16 per 1000 live births. Despite significant progress in the control of HBV, SEAR needs to secure political commitment for elimination and consider additional strategies, such as promoting health facility births, universal birth dose administration, developing strong coordination between health sectors, and using alternative vaccine delivery methods, to improve HepB-BD coverage and subsequently achieve HBV control and elimination.
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Affiliation(s)
- Lana Childs
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA; Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sigrun Roesel
- World Health Organization Regional Office for South-East Asia, New Delhi, India
| | - Rania A Tohme
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
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14
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Prevalence of Hepatitis B Surface Antigen Among People Attending Medical Diagnostic Laboratories in Neyshabur, Northeast of Iran, During Years 2011 to 2015. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2017. [DOI: 10.5812/pedinfect.61633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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Eschlimann M, Malvé B, Velay A, Fenaux H, Berger S, Frippiat JP, Zoulim F, Bensenane M, Bronowicki JP, Goehringer F, May T, Jeulin H, Schvoerer E. The variability of hepatitis B envelope is associated with HBs antigen persistence in either chronic or acute HBV genotype A infection. J Clin Virol 2017; 94:115-122. [PMID: 28822954 DOI: 10.1016/j.jcv.2017.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 08/02/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND More than 240 million people are chronically infected by hepatitis B virus (HBV) worldwide. Envelope proteins play a crucial role in viral cellular entry and immune recognition. The loss of HBs antigen (HBsAg) correlated with a good clinical prognosis is rarely achieved with or without treatment (3-16%). OBJECTIVES HBV envelope variability was investigated according to HBsAg persistence. STUDY DESIGN The cohort consisted of 15 HBV genotype A-infected patients divided into "resolvers", with HBsAg clearance, and "non-resolvers", with HBsAg persistence and in subgroups: acute (n=5, AHBV) or chronic infection (n=4, CHBV) and HBV/HIV coinfection (n=6, CHBV/HIV). HBV S and preS sequences were studied by direct and ultra-deep sequencing. Amino acid sequences were analyzed with bioinformatics for predicted antigenicity. RESULTS In S gene, the complexity was lower in AHBV than in chronic-infected patients (p=0.046). Major mutations, detected using direct sequencing, were more frequent in AHBV developing chronicity (p=0.01) than in AHBV resolvers. In the Major Hydrophilic Region, more frequent mutations were observed in non-resolvers versus resolvers (p=0.047) and non-resolvers tended to have more haplotypes with a reduced predicted antigenicity (p=0.07). Most of the mutations in preS/S region were found rather in epitopic than in non-epitopic areas (p=0.025). Interestingly, the mutation sY161F found in 3/8 non-resolvers was associated with a decrease in predicted antigenicity (28%; AnTheProt). CONCLUSIONS HBsAg persistence was correlated with mutations and deletions in areas playing a key role in immune recognition. These data suggest that variability in HBV envelope could favor immune escape in various clinical settings of HBV genotype A-infected patients.
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Affiliation(s)
- Marine Eschlimann
- Université de Lorraine, EA 7300 Stress, Immunité, Pathogènes, Vandoeuvre-les-Nancy, F-54505, France.
| | - Brice Malvé
- Centre Hospitalier Universitaire de Nancy, Laboratoire de Virologie, Vandoeuvre-les-Nancy, F-54511, France.
| | - Aurélie Velay
- Université de Lorraine, EA 7300 Stress, Immunité, Pathogènes, Vandoeuvre-les-Nancy, F-54505, France; Centre Hospitalier Universitaire de Nancy, Laboratoire de Virologie, Vandoeuvre-les-Nancy, F-54511, France.
| | - Honorine Fenaux
- Centre Hospitalier Universitaire de Nancy, Laboratoire de Virologie, Vandoeuvre-les-Nancy, F-54511, France.
| | - Sibel Berger
- Centre Hospitalier Universitaire de Nancy, Laboratoire de Virologie, Vandoeuvre-les-Nancy, F-54511, France.
| | - Jean-Pol Frippiat
- Université de Lorraine, EA 7300 Stress, Immunité, Pathogènes, Vandoeuvre-les-Nancy, F-54505, France.
| | - Fabien Zoulim
- Université de Lyon, Unité Inserm UI1052, Lyon, F-69424, France.
| | - Mouni Bensenane
- Centre Hospitalier Universitaire de Nancy, Service d'Hépato-gastroentérologie, Vandoeuvre-les-Nancy, F-54511, France.
| | - Jean-Pierre Bronowicki
- Centre Hospitalier Universitaire de Nancy, Service d'Hépato-gastroentérologie, Vandoeuvre-les-Nancy, F-54511, France.
| | - François Goehringer
- Centre Hospitalier Universitaire de Nancy, Service des Maladies Infectieuses et Tropicales, Vandoeuvre-les-Nancy, F-54511, France.
| | - Thierry May
- Centre Hospitalier Universitaire de Nancy, Service des Maladies Infectieuses et Tropicales, Vandoeuvre-les-Nancy, F-54511, France.
| | - Hélène Jeulin
- Université de Lorraine, EA 7300 Stress, Immunité, Pathogènes, Vandoeuvre-les-Nancy, F-54505, France; Centre Hospitalier Universitaire de Nancy, Laboratoire de Virologie, Vandoeuvre-les-Nancy, F-54511, France.
| | - Evelyne Schvoerer
- Université de Lorraine, EA 7300 Stress, Immunité, Pathogènes, Vandoeuvre-les-Nancy, F-54505, France; Centre Hospitalier Universitaire de Nancy, Laboratoire de Virologie, Vandoeuvre-les-Nancy, F-54511, France.
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16
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H Muljono D. Epidemiology of Hepatitis B and C in Republic of Indonesia. Euroasian J Hepatogastroenterol 2017; 7:55-59. [PMID: 29201773 PMCID: PMC5663775 DOI: 10.5005/jp-journals-l0018-1212] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 10/29/2016] [Indexed: 12/19/2022] Open
Abstract
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections pose serious problems in terms of public health and clinical intervention in a country with approximately 250 million people, who live in more than 17,000 islands. Efforts to combat HBV and HCV have been made through the implementation of universal infant hepatitis B immunization, blood screening, and other health promotion actions, and building epidemiological data to develop intervention strategies. A nationwide study in 2013 revealed hepatitis B surface antigen (HBsAg) prevalence of 7.1%, which indicates that Indonesia has moved from high to moderate endemicity of hepatitis B, leaving the prevalence of 9.4% in 2007. The occurrences of new hepatitis B cases still continue in early childhood period, which may root from low coverage of birth-dose hepatitis B immunization in remote islands, and the potential mother-to-child transmission of HBV from HBsAg-positive pregnant mothers. Other problems still exist including the high HBV infection rates among young adults in remote islands, the presence of occult hepatitis B, as well as the substantial prevalence of HCV infection in general population, who do not have access to diagnosis and treatment. Effective preventive and control strategies are being developed tailored to the local capacity, infrastructures, socioeconomics, and culture, as well as geographical aspects of the country. How to cite this article: Muljono DH. Epidemiology of Hepatitis B and C in Republic of Indonesia. Euroasian J Hepato-Gastroenterol 2017;7(1):55-59.
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Affiliation(s)
- David H Muljono
- Eijkman Institute for Molecular Biology, Jakarta, Republic of Indonesia; Faculty of Medicine, Universitas Hasanuddin, Makassar, Republic of Indonesia; Sydney Medical School, University of Sydney, Australia
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17
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Elkady A, Iijima S, Aboulfotuh S, Mostafa Ali E, Sayed D, Abdel-Aziz NM, Ali AM, Murakami S, Isogawa M, Tanaka Y. Characteristics of escape mutations from occult hepatitis B virus infected patients with hematological malignancies in South Egypt. World J Hepatol 2017; 9:477-486. [PMID: 28396718 PMCID: PMC5368625 DOI: 10.4254/wjh.v9.i9.477] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 09/19/2016] [Accepted: 12/13/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the prevalence and virological characteristics of occult hepatitis B virus (HBV) infections in patients with hematological malignancies in South Egypt. METHODS Serum samples were collected from 165 patients with hematological malignancies to monitor titers of HBV DNA, hepatitis B surface antigen (HBsAg), and antibodies to HBV core (anti-HBc) and surface antigens. Serum samples negative for HBsAg and positive for anti-HBc were subjected to nucleic acid extraction and HBV DNA detection by real-time polymerase chain reaction. DNA sequences spanning the S region were analyzed in cases with occult HBV infection. In vitro comparative study of constructed 1.24-fold wild type and S protein mutant HBV genotype D clones was further performed. RESULTS HBV DNA was detected in 23 (42.6%) of 54 patients with hematological malignancies who were HBsAg negative, but anti-HBc positive, suggesting the presence of occult HBV infection. The complete HBV genome was retrieved from 6 occult HBV patients, and P120T and S143L were detected in 3 and 2 cases, respectively. Site directed mutagenesis was done to produce 1.24-fold genotype D clones with amino acid mutations T120 and L143. The in vitro analyses revealed that a lower level of extracellular HBsAg was detected by chemiluminescence enzyme immunoassay (CLEIA) with the clone containing T120 mutation, compared with the wild type or the clone with S143L mutation despite the similar levels of extracellular and intracellular HBsAg detected by Western blot. Southern blot experiments showed that the levels of intracellular HBV DNA were not different between these clones. CONCLUSION Occult HBV infection is common in patients with hematological malignancies and associated with P120T and S143L mutations. 120T mutation impairs the detection of HBsAg by CLEIA.
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Affiliation(s)
- Abeer Elkady
- Abeer Elkady, Department of Clinical and Chemical Pathology, Medical School of South Valley University, Qena 83523, Egypt
| | - Sayuki Iijima
- Abeer Elkady, Department of Clinical and Chemical Pathology, Medical School of South Valley University, Qena 83523, Egypt
| | - Sahar Aboulfotuh
- Abeer Elkady, Department of Clinical and Chemical Pathology, Medical School of South Valley University, Qena 83523, Egypt
| | - Elsayed Mostafa Ali
- Abeer Elkady, Department of Clinical and Chemical Pathology, Medical School of South Valley University, Qena 83523, Egypt
| | - Douaa Sayed
- Abeer Elkady, Department of Clinical and Chemical Pathology, Medical School of South Valley University, Qena 83523, Egypt
| | - Nashwa M Abdel-Aziz
- Abeer Elkady, Department of Clinical and Chemical Pathology, Medical School of South Valley University, Qena 83523, Egypt
| | - Amany M Ali
- Abeer Elkady, Department of Clinical and Chemical Pathology, Medical School of South Valley University, Qena 83523, Egypt
| | - Shuko Murakami
- Abeer Elkady, Department of Clinical and Chemical Pathology, Medical School of South Valley University, Qena 83523, Egypt
| | - Masanori Isogawa
- Abeer Elkady, Department of Clinical and Chemical Pathology, Medical School of South Valley University, Qena 83523, Egypt
| | - Yasuhito Tanaka
- Abeer Elkady, Department of Clinical and Chemical Pathology, Medical School of South Valley University, Qena 83523, Egypt
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18
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Wang M, Xi D, Ning Q. Virus-induced hepatocellular carcinoma with special emphasis on HBV. Hepatol Int 2017; 11:171-180. [PMID: 28097530 DOI: 10.1007/s12072-016-9779-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 12/22/2016] [Indexed: 12/12/2022]
Abstract
Hepatocellular carcinoma (HCC) is a common malignant tumor with high lethality, and the hepatitis B virus (HBV) is a chief cause. HBV can accelerate HCC via multiple mechanisms. First, HBV induces immune reactions that lead to repeated hepatic inflammation, fibrosis and a deficient immune microenvironment. Subsequently, HBV can modify host genes near the insertion point through DNA integration to cause host cell genome instability and to generate carcinogenic fusion proteins. Additionally, HBV expresses diverse active proteins, especially HBx and HBs, which have a range of transactivation functions such as regulation of apoptosis, interference with intracellular signaling pathways, and alteration of epigenetics. Currently, primary prevention measures for HBV-induced HCC focus on vaccination and antiviral treatment. Here, we report the epidemiology, the molecular mechanism and the progress in therapeutic strategies for controlling HBV-induced HCC.
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Affiliation(s)
- Ming Wang
- Department of Infectious Disease, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, No 1095, Jiefang Avenue, Wuhan, 430030, China
| | - Dong Xi
- Department of Infectious Disease, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, No 1095, Jiefang Avenue, Wuhan, 430030, China
| | - Qin Ning
- Department of Infectious Disease, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, No 1095, Jiefang Avenue, Wuhan, 430030, China.
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19
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Abstract
ABSTRACT
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections pose serious problems in terms of public health and clinical intervention in a country with approximately 250 million people, who live in more than 17,000 islands. Efforts to combat HBV and HCV have been made through the implementation of universal infant hepatitis B immunization, blood screening, and other health promotion actions, and building epidemiological data to develop intervention strategies. A nationwide study in 2013 revealed hepatitis B surface antigen (HBsAg) prevalence of 7.1%, which indicates that Indonesia has moved from high to moderate endemicity of hepatitis B, leaving the prevalence of 9.4% in 2007. The occurrences of new hepatitis B cases still continue in early childhood period, which may root from low coverage of birth-dose hepatitis B immunization in remote islands, and the potential mother-to-child transmission of HBV from HBsAg-positive pregnant mothers. Other problems still exist including the high HBV infection rates among young adults in remote islands, the presence of occult hepatitis B, as well as the substantial prevalence of HCV infection in general population, who do not have access to diagnosis and treatment. Effective preventive and control strategies are being developed tailored to the local capacity, infrastructures, socioeconomics, and culture, as well as geographical aspects of the country.
How to cite this article:
Muljono DH. Epidemiology of Hepatitis B and C in Republic of Indonesia. Euroasian J Hepato-Gastroenterol 2017;7(1):55-59.
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20
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Wait S, Kell E, Hamid S, Muljono DH, Sollano J, Mohamed R, Shah S, Mamun-Al-Mahtab, Abbas Z, Johnston J, Tanwandee T, Wallace J. Hepatitis B and hepatitis C in southeast and southern Asia: challenges for governments. Lancet Gastroenterol Hepatol 2016; 1:248-255. [PMID: 28404097 DOI: 10.1016/s2468-1253(16)30031-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 07/15/2016] [Accepted: 07/15/2016] [Indexed: 12/19/2022]
Abstract
In 2015, the Coalition to Eradicate Viral Hepatitis in Asia Pacific gathered leading hepatitis experts from Bangladesh, India, Indonesia, Malaysia, Pakistan, the Philippines, and Thailand to discuss common challenges to the burden posed by hepatitis B virus (HBV) and hepatitis C virus (HCV), to learn from each other's experience, and identify sustainable approaches. In this report, we summarise these discussions. Countries differ in their policy responses to HBV and HCV; however, substantial systemic, cultural, and financial barriers to achievement of elimination of these infections persist in all countries. Common challenges to elimination include limited availability of reliable epidemiological data; insufficient public awareness of risk factors and modes of transmission, leading to underdiagnosis; high rates of transmission through infected blood products, including in medical settings; limited access to care for people who inject drugs; prevailing stigma and discrimination against people infected with viral hepatitis; and financial barriers to treatment and care. Despite these challenges, promising examples of effective programmes, public-private initiatives, and other innovative approaches are evident in all countries we studied in Asia Pacific. The draft WHO Global Health Sector Strategy on Viral Hepatitis 2016-21 provides a solid framework upon which governments can build their local strategies towards viral hepatitis. However, greater recognition by national governments and the international community of the urgency to comprehensively tackle both HBV and HCV are still needed. In all countries, strategic plans and policy goals need to be translated into resources and concrete actions, with national governments at the helm, to enable a sustainable response to the rising burden of hepatitis B and C in all countries.
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Affiliation(s)
| | - Emily Kell
- The Health Policy Partnership, London, UK
| | - Saeed Hamid
- Department of Medicine, The Aga Khan University & Hospital, Karachi, Pakistan
| | - David H Muljono
- Hepatitis Laboratory, Eijkman Institute for Molecular Biology, Jakarta, Indonesia; Hasanuddin University, Makassar, Indonesia
| | - Jose Sollano
- University of Santo Tomas, España Boulevard, Manila, Philippines
| | - Rosmawati Mohamed
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Samir Shah
- Department of Hepatology, Institute of Liver Diseases, HPB Surgery and Transplant, Global Hospitals, Mumbai, India
| | - Mamun-Al-Mahtab
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Zaigham Abbas
- Department of Gastroenterology, Ziauddin University Hospital, Karachi, Pakistan
| | - Jennifer Johnston
- The Coalition for the Eradication of Viral Hepatitis in Asia Pacific, Singapore
| | - Tawesak Tanwandee
- Division of Gastroenterology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jack Wallace
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
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21
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Gunardi H, Iskandar MY, Turyadi, Ie SI, Dwipoerwantoro PG, Gani RA, Muljono DH. Hepatitis B virus infection in children of HBV-related chronic liver disease patients: a study of intra-familial HBV transmission. Hepatol Int 2016; 11:96-104. [PMID: 27624502 DOI: 10.1007/s12072-016-9764-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 08/25/2016] [Indexed: 01/17/2023]
Abstract
BACKGROUND HBV-infected patients are potential sources of intra-familial transmission. We studied HBV transmission and molecular characteristics within families of HBV-related chronic liver disease (CLD) patients. METHODS Family members [index cases (ICs), spouses, and 1-18-year-old children] of HBV-related CLD patients were tested for HBsAg, anti-HBc, and anti-HBs. HBsAg-positive subjects were tested for HBeAg/anti-HBe. Anti-HBc-positive children together with their family members were further investigated for HBV DNA. Sequences of positive isolates were analyzed over surface, precore (PC) and basal core promoter (BCP) regions. RESULTS Among 94 children of 46 ICs, the prevalence of HBsAg, anti-HBc, and anti-HBs was 10 (10.6 %), 19 (20.2 %), and 46 (48.9 %), respectively. Thirty-eight (40.4 %) children were seronegative, indicating susceptibility to HBV infection. HBV DNA was identified in all ICs, 4 spouses, and 16 children. Having both parents with HBsAg positive and at least two HBV carriers in the households were significant risk factors of intra-familial transmission. HBV genotype/subtype distributions were comparable between children and ICs/spouses, with predominance of genotype B. The majority of HBV DNA sequences found in children were identical to their corresponding ICs-particularly mothers-including mutation patterns in the surface, PC, and BCP regions. Recognized mutations associated with HBsAg detection and/or vaccination failure, T140I, T143S/M, G145R, and Y161F, were identified in 20 subjects; while mutations linked to HBeAg-defective variants, PC G1896A and BCP A1762T/G1764A, were found in 7 and 11 subjects, respectively. CONCLUSIONS Children of HBV-related CLD patients were at increased risk of HBV infection through multi-modal transmission routes despite negative parental HBsAg and HBeAg status.
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Affiliation(s)
- Hartono Gunardi
- Department of Child Health, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Melanie Y Iskandar
- Department of Child Health, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Turyadi
- Eijkman Institute for Molecular Biology, Jalan Diponegoro 69, Jakarta, 10430, Indonesia
| | - Susan I Ie
- Eijkman Institute for Molecular Biology, Jalan Diponegoro 69, Jakarta, 10430, Indonesia
| | | | - Rino A Gani
- Department of Internal Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - David H Muljono
- Eijkman Institute for Molecular Biology, Jalan Diponegoro 69, Jakarta, 10430, Indonesia. .,Faculty of Medicine, Hasanuddin University, Makassar, Indonesia. .,Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
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22
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Lusida MI, Juniastuti, Yano Y. Current hepatitis B virus infection situation in Indonesia and its genetic diversity. World J Gastroenterol 2016; 22:7264-7274. [PMID: 27621573 PMCID: PMC4997646 DOI: 10.3748/wjg.v22.i32.7264] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/27/2016] [Accepted: 08/01/2016] [Indexed: 02/06/2023] Open
Abstract
Indonesia has a moderate to high endemicity of hepatitis B virus (HBV) infection. The risk for chronic HBV infection is highest among those infected during infancy. Since 1997, hepatitis B (HepB) vaccination of newborns has been fully integrated into the National Immunization Program. Although HBV infection has been reduced by the universal newborn HepB immunization program, it continues to occur in Indonesia. The low birth dose coverage and the presence of vaccine escape mutants might contribute to this endemicity among children. Although limited information is available for an analysis of occult HBV infection (OBI), several variations and substitutions in the pre-S/S region have been detected in Indonesian HBV strains. Additionally, persistent infection and disease progression of chronic hepatitis B are related to not only viral factors but also the host genome. Indonesia is one of the most ethnically heterogeneous nations, with Javanese and Sundanese as the two highest ethnic groups. This multi-ethnicity makes genomic research in Indonesia difficult. In this article, we focused on and reviewed the following aspects: the current hepatitis B immunization program and its efficacy, OBI, HBV infection among high-risk patients, such as hemodialysis patients, and research regarding the host genome in Indonesia.
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Zhang Z, Zhang L, Dai Y, Zhang Y, Li J, Li X. Occult hepatitis B virus infection: influence of S protein variants. Virol J 2016; 13:10. [PMID: 26786229 PMCID: PMC4717550 DOI: 10.1186/s12985-016-0464-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 01/07/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND In occult hepatitis B viral infection (OBI), the persistence of hepatitis B virus (HBV) DNA is associated with a lack of hepatitis B surface antigen (HBsAg). To assess the possible role of HBsAg immune escape variants in OBI patients, variability in the HBV S gene was evaluated for OBI patients as well as chronic HBV infection patients from the same families. METHODS We selected 17 HBV DNA-positive/HBsAg-negative patients (OBI group) and 15 HBV DNA- and HBsAg-positive patients from OBI families (control group). The S gene was amplified and cloned, and at least 15 clones per patient were sequenced and analyzed. RESULTS Although the incidence of stop codon mutations within the S region was higher in the OBI group (13.6 %) than in the control group (1.5 %, P < 0.001), this type of mutation, together with insertion and deletion mutations, was prevalent in only three OBI patients. In the major hydrophilic region (MHR), a median of 0.75 residues were altered in every 100 residues for the OBI patients, whereas 0.95 out of 100 residues were changed in the control group (P = 0.428). Furthermore, some variants that are generally considered immune escape variants, such as mutations at positions s145, s147, and s123, were only observed in less than 5 % of all the clones sequenced, in either OBI or control group. CONCLUSIONS Our data suggest that HBsAg variants may not play a major role in OBI pathogenesis.
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Affiliation(s)
- Zhenhua Zhang
- Department of Infectious Diseases, the First Affiliated Hospital, Anhui Medical University, Hefei, 230022, China.
- School of Pharmacy, Anhui Medical University, Hefei, China.
| | - Ling Zhang
- Department of Infectious Diseases, the First Affiliated Hospital, Anhui Medical University, Hefei, 230022, China.
| | - Yu Dai
- Department of Infectious Diseases, the First Affiliated Hospital, Anhui Medical University, Hefei, 230022, China.
| | - Yafei Zhang
- Department of Infectious Diseases, the First Affiliated Hospital, Anhui Medical University, Hefei, 230022, China.
| | - Jun Li
- School of Pharmacy, Anhui Medical University, Hefei, China.
| | - Xu Li
- Department of Infectious Diseases, the First Affiliated Hospital, Anhui Medical University, Hefei, 230022, China.
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Oliveira MP, Lemes PS, Matos MAD, Del-Rios NHA, Santos Carneiro MA, Costa Silva ÁM, Lopes CLR, Teles SA, Aires RS, Lago BV, Araujo NM, Martins RMB. Overt and occult hepatitis B virus infection among treatment-naïve HIV-infected patients in Brazil. J Med Virol 2016; 88:1222-9. [DOI: 10.1002/jmv.24462] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2015] [Indexed: 12/18/2022]
Affiliation(s)
- Marina Pedroso Oliveira
- Institute of Tropical Pathology and Public Health; Federal University of Goiás (UFG); Goiás Brazil
| | - Pollyanne Sousa Lemes
- Institute of Tropical Pathology and Public Health; Federal University of Goiás (UFG); Goiás Brazil
| | - Márcia Alves Dias Matos
- Institute of Tropical Pathology and Public Health; Federal University of Goiás (UFG); Goiás Brazil
| | | | | | - Ágabo Macedo Costa Silva
- Institute of Tropical Pathology and Public Health; Federal University of Goiás (UFG); Goiás Brazil
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Coppola N, Onorato L, Minichini C, Di Caprio G, Starace M, Sagnelli C, Sagnelli E. Clinical significance of hepatitis B surface antigen mutants. World J Hepatol 2015; 7:2729-2739. [PMID: 26644816 PMCID: PMC4663392 DOI: 10.4254/wjh.v7.i27.2729] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/27/2015] [Accepted: 11/13/2015] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B virus (HBV) infection is a major public health problem in many countries, with nearly 300 million people worldwide carrying HBV chronic infection and over 1 million deaths per year due to cirrhosis and liver cancer. Several hepatitis B surface antigen (HBsAg) mutations have been described, most frequently due to a single amino acid substitution and seldom to a nucleotide deletion. The majority of mutations are located in the S region, but they have also been found in the pre-S1 and pre-S2 regions. Single amino acid substitutions in the major hydrophilic region of HBsAg, called the "a" determinant, have been associated with immune escape and the consequent failure of HBV vaccination and HBsAg detection, whereas deletions in the pre-S1 or pre-S2 regions have been associated with the development of hepatocellular carcinoma. This review article will focus on the HBsAg mutants and their biological and clinical implications.
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Affiliation(s)
- Nicola Coppola
- Nicola Coppola, Lorenzo Onorato, Carmine Minichini, Giovanni Di Caprio, Mario Starace, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy
| | - Lorenzo Onorato
- Nicola Coppola, Lorenzo Onorato, Carmine Minichini, Giovanni Di Caprio, Mario Starace, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy
| | - Carmine Minichini
- Nicola Coppola, Lorenzo Onorato, Carmine Minichini, Giovanni Di Caprio, Mario Starace, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy
| | - Giovanni Di Caprio
- Nicola Coppola, Lorenzo Onorato, Carmine Minichini, Giovanni Di Caprio, Mario Starace, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy
| | - Mario Starace
- Nicola Coppola, Lorenzo Onorato, Carmine Minichini, Giovanni Di Caprio, Mario Starace, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy
| | - Caterina Sagnelli
- Nicola Coppola, Lorenzo Onorato, Carmine Minichini, Giovanni Di Caprio, Mario Starace, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy
| | - Evangelista Sagnelli
- Nicola Coppola, Lorenzo Onorato, Carmine Minichini, Giovanni Di Caprio, Mario Starace, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy
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26
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Yano Y, Utsumi T, Lusida MI, Hayashi Y. Hepatitis B virus infection in Indonesia. World J Gastroenterol 2015; 21:10714-20. [PMID: 26478663 PMCID: PMC4600573 DOI: 10.3748/wjg.v21.i38.10714] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/14/2015] [Accepted: 09/15/2015] [Indexed: 02/06/2023] Open
Abstract
Approximately 240 million people are chronically infected with hepatitis B virus (HBV), 75% of whom reside in Asia. Approximately 600000 of infected patients die each year due to HBV-related diseases or hepatocellular carcinoma (HCC). The endemicity of hepatitis surface antigen in Indonesia is intermediate to high with a geographical difference. The risk of HBV infection is high in hemodialysis (HD) patients, men having sex with men, and health care workers. Occult HBV infection has been detected in various groups such as blood donors, HD patients, and HIV-infected individuals and children. The most common HBV subgenotype in Indonesia is B3 followed by C1. Various novel subgenotypes of HBV have been identified throughout Indonesia, with the novel HBV subgenotypes C6-C16 and D6 being successfully isolated. Although a number of HBV subgenotypes have been discovered in Indonesia, genotype-related pathogenicity has not yet been elucidated in detail. Therefore, genotype-related differences in the prognosis of liver disease and their effects on treatments need to be determined. A previous study conducted in Indonesia revealed that hepatic steatosis was associated with disease progression. Pre-S2 mutations and mutations at C1638T and T1753V in HBV/B3 have been associated with advanced liver diseases including HCC. However, drug resistance to lamivudine, which is prominent in Indonesia, remains obscure. Although the number of studies on HBV in Indonesia has been increasing, adequate databases on HBV infection are limited. We herein provided an overview of the epidemiology and clinical characteristics of HBV infection in Indonesia.
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27
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Ie SI, Turyadi, Sidarta E, Sadhewa A, Purnomo GA, Soedarmono YSM, Pattiiha MZ, Thedja MD, Harahap AR, Muljono DH. High Prevalence of Hepatitis B Virus Infection in Young Adults in Ternate, Eastern Indonesia. Am J Trop Med Hyg 2015; 93:1349-55. [PMID: 26392157 DOI: 10.4269/ajtmh.15-0331] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 08/05/2015] [Indexed: 12/29/2022] Open
Abstract
The incidence of hepatitis B virus (HBV) infection has been declining thanks to the universal hepatitis B infant immunization program. Nevertheless, young adults born before the program implementation might have acquired HBV in early childhood or remain susceptible to infection. This study aimed to evaluate hepatitis B epidemiology in asymptomatic young adult population in Ternate, eastern Indonesia. Serum samples of 376 subjects (aged 17-25, mean 19.82 ± 1.69 years; male/female 138/238) were screened for HBV parameters serologically (HBV surface antigen [HBsAg]; its antibody [anti-HBs]; anti-core antigen [anti-HBc]), and molecularly (HBV DNA). HBsAg, anti-HBc, anti-HBs, and HBV DNA prevalence were 15.7%, 36.2%, 24.2%, and 27.9%, respectively, with male predominance. Of all subjects, 13.0% were HBsAg negative with detectable HBV DNA (occult hepatitis B [OHB]), and 56.4% showed negativity for all seromarkers. This population showed high hepatitis B prevalence with substantial occurrence of OHB. However, a high percentage of the population were still susceptible and at risk of HBV infection. This study emphasizes the necessity to improve prevention strategies to screen and manage HBV carriers, including the adoption of catch-up or booster vaccination targeted to young adult populations. Investigations on the roles of host-virus interactions associated with OHB and its implications are warranted.
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Affiliation(s)
- Susan Irawati Ie
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia; School of Life Sciences and Technology, Bandung Institute of Technology, Bandung, Indonesia; Central Blood Center, Indonesian Red Cross, Jakarta, Indonesia; Department of Internal Medicine, Ternate General Hospital, Ternate, Maluku, Indonesia; Department of Clinical Pathology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia; Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; Sydney Medical School, University of Sydney, New South Wales, Australia
| | - Turyadi
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia; School of Life Sciences and Technology, Bandung Institute of Technology, Bandung, Indonesia; Central Blood Center, Indonesian Red Cross, Jakarta, Indonesia; Department of Internal Medicine, Ternate General Hospital, Ternate, Maluku, Indonesia; Department of Clinical Pathology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia; Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; Sydney Medical School, University of Sydney, New South Wales, Australia
| | - Erick Sidarta
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia; School of Life Sciences and Technology, Bandung Institute of Technology, Bandung, Indonesia; Central Blood Center, Indonesian Red Cross, Jakarta, Indonesia; Department of Internal Medicine, Ternate General Hospital, Ternate, Maluku, Indonesia; Department of Clinical Pathology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia; Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; Sydney Medical School, University of Sydney, New South Wales, Australia
| | - Arkasha Sadhewa
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia; School of Life Sciences and Technology, Bandung Institute of Technology, Bandung, Indonesia; Central Blood Center, Indonesian Red Cross, Jakarta, Indonesia; Department of Internal Medicine, Ternate General Hospital, Ternate, Maluku, Indonesia; Department of Clinical Pathology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia; Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; Sydney Medical School, University of Sydney, New South Wales, Australia
| | - Gludhug Ariyo Purnomo
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia; School of Life Sciences and Technology, Bandung Institute of Technology, Bandung, Indonesia; Central Blood Center, Indonesian Red Cross, Jakarta, Indonesia; Department of Internal Medicine, Ternate General Hospital, Ternate, Maluku, Indonesia; Department of Clinical Pathology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia; Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; Sydney Medical School, University of Sydney, New South Wales, Australia
| | - Yuyun S M Soedarmono
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia; School of Life Sciences and Technology, Bandung Institute of Technology, Bandung, Indonesia; Central Blood Center, Indonesian Red Cross, Jakarta, Indonesia; Department of Internal Medicine, Ternate General Hospital, Ternate, Maluku, Indonesia; Department of Clinical Pathology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia; Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; Sydney Medical School, University of Sydney, New South Wales, Australia
| | - Mochtar Zein Pattiiha
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia; School of Life Sciences and Technology, Bandung Institute of Technology, Bandung, Indonesia; Central Blood Center, Indonesian Red Cross, Jakarta, Indonesia; Department of Internal Medicine, Ternate General Hospital, Ternate, Maluku, Indonesia; Department of Clinical Pathology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia; Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; Sydney Medical School, University of Sydney, New South Wales, Australia
| | - Meta Dewi Thedja
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia; School of Life Sciences and Technology, Bandung Institute of Technology, Bandung, Indonesia; Central Blood Center, Indonesian Red Cross, Jakarta, Indonesia; Department of Internal Medicine, Ternate General Hospital, Ternate, Maluku, Indonesia; Department of Clinical Pathology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia; Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; Sydney Medical School, University of Sydney, New South Wales, Australia
| | - Alida R Harahap
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia; School of Life Sciences and Technology, Bandung Institute of Technology, Bandung, Indonesia; Central Blood Center, Indonesian Red Cross, Jakarta, Indonesia; Department of Internal Medicine, Ternate General Hospital, Ternate, Maluku, Indonesia; Department of Clinical Pathology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia; Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; Sydney Medical School, University of Sydney, New South Wales, Australia
| | - David H Muljono
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia; School of Life Sciences and Technology, Bandung Institute of Technology, Bandung, Indonesia; Central Blood Center, Indonesian Red Cross, Jakarta, Indonesia; Department of Internal Medicine, Ternate General Hospital, Ternate, Maluku, Indonesia; Department of Clinical Pathology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia; Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; Sydney Medical School, University of Sydney, New South Wales, Australia
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