Serological and molecular characterization of HBV infection with HBsAg reactive and HBV DNA non-reactive / 中国输血杂志

【Objective】 To investigate the serological and molecular characteristics of HBsAg+ /HBV DNA non-reactive (NR) infections. 【Methods】 Samples tested as HBsAg+ and HBV DNA NR were confirmed by individual NAT repeat testing, viral particle concentration by PEG precipitation combined with in-house nested PCR and real-time quantitative PCR, anti-HBc testing, and HBsAg quantification. HBV sequences were compared with those from donors with chronic and occult infection as controls. 【Results】 A total of 792 195 samples were screened between January 2011 and December 2020, of which 53 (1: 14 947) were confirmed HBsAg+ /HBV DNA NR. HBV DNA was detected further in five (9.4%) samples; three S sequences and four Pre Core/Core sequences were obtained. Unique amino acid substitutions (P130T, P135Q/S, R151Q, G153S and S155F) were found in the Core protein that may affect virus packaging and replication. 【Conclusion】 Extremely low HBV DNA level was detected in plasmas of HBsAg+ /HBV DNA NR donors. Barely detectable HBV DNA might be associated with unusual mutations in the Pre Core/Core protein affecting viral replication. More sensitive HBV DNA and/or HBsAg assays may be considered to further reduce the potential HBV transfusion-transmission residual risk.

A prospective cohort study on the risk of HBV infection in preschool children without immune response to hepatitis B vaccine / 中华疾病控制杂志

@# Objective To evaluate the risk of hepatitis B virus(HBV) infection among preschool children who were the non-responders to hepatitis B vaccine in future. Methods A prospective cohort study was conducted. Children aged 2 to 5 years were selected from 64 kindergartens.These children were inoculated three doses of hepatitis b vaccine at 0, 1 and 6 months after birth. Hepatitis B surface antigen (HBsAg)and Hepatitis B surface antibody (anti-HBs)were detected during the period from March to May 2015. The children who were HBsAg negative were enrolled in the study. The subjects were divided into exposure group (anti-HBs negative) and control group (anti-HBs positive) . The follow-up began on June 1, 2015 and ended on June 1, 2016. Serum HBsAg of children in the cohort was then collected and detected from June 1 to 30, 2016. At the end of the study, the HBsAg positive rates between two groups were compared. Results 83 children who received hepatitis B vaccine again during the follow-up period were excluded from 1 907 non-responders. The actual number in non-responders group was 1 824. 151 children were lost at the end of the study. The actual number of follow-up was 1 673 and 5 children were found to be positive for HBsAg and the infection rate was 0.30% (5/1673). In the respondent goup, 2 054 were enrolled and followed. Finally, 140 children were lost and none of the remaining 1 914 people were HBsAg positive at the end of the study. HBsAg positive rate was higher in the non-responder group than in the responder group (P=0.023). Conclusion There is a risk of HBV infection in the children who are non-responders to hepatitis B vaccine in future.

Relationship between the HBsAg-positive infection status of mothers and the non/low-response to hepatitis B vaccine of their infants / 中华流行病学杂志

Objective To explore the relationship between the status of HBsAg-positive infection of mothers and the non/low-response to hepatitis B vaccine of their infants.Methods A total of 225 pairs of mothers and their infants were recruited in our cohort from June 2011 to July 2013.Infants were given three doses of hepatitis B vaccine at hour 24,first month and month 6th respectively and were followed up for one year after birth.HBV serological markers and HBV DNA in the peripheral blood of both mothers and infants were detected by Electro-chemiluminescence immunoassay and fluorescence quantitative Polymerase Chain Reaction.Results Six HBV infection models were detected in HBsAg-positive mothers,and "HBsAg (+),HBeAg (+),anti-HBc (+)" (model one) and "HBsAg (+),anti-HBe (+),anti-HBc (+)" (model two) accounted for 92.5％ (208/225) of all the models.Rate of non/low-response to hepatitis B vaccine in infants born to mothers in model one was lower than those in model two,the differences are statistically significant (x2=4.80,P=0.029).The rate of non/low-response to hepatitis B vaccine in infants showed a downward trend with the rising of HBeAg level in their mothers (x2=4.86,P=0.028).Results from the unconditional logistic regression analysis showed that the HBeAg of the HBsAg-positive mothers was significantly correlated with the low risk of non/low-response to hepatitis B vaccine in infants (OR=0.598,95％CI:0.378-0.947).The positive rate of serum HBV DNA in HBsAg-positive mothers was 54.2％,while the rate of non/low-response to hepatitis B vaccine in infants born to HBV DNA positive mothers was similar to those infants born to HBV DNA negative mothers (X2=0.22,P=0.640).Conclusions "HBsAg (+),HBeAg (+),anti-HBc (+)" and "HBsAg (+),anti-HBe(+),anti-HBc (+)" were the common models seen in HBsAg-positive mothers,and the rate of non/low-response to hepatitis B vaccine was different between the two models.HBeAg of HBsAg-positive mothers might have positive effects on the immune response to hepatitis B vaccine in infants but the mechanisms remained not clear.HBV DNA of the HBsAg-positive mothers did not seem to be correlated with the immune response to hepatitis B vaccine in infants.

Relationship between the HBsAg-positive infection status of mothers and the non/low-response to hepatitis B vaccine of their infants / 中华流行病学杂志

Objective To explore the relationship between the status of HBsAg-positive infection of mothers and the non/low-response to hepatitis B vaccine of their infants.Methods A total of 225 pairs of mothers and their infants were recruited in our cohort from June 2011 to July 2013.Infants were given three doses of hepatitis B vaccine at hour 24,first month and month 6th respectively and were followed up for one year after birth.HBV serological markers and HBV DNA in the peripheral blood of both mothers and infants were detected by Electro-chemiluminescence immunoassay and fluorescence quantitative Polymerase Chain Reaction.Results Six HBV infection models were detected in HBsAg-positive mothers,and "HBsAg (+),HBeAg (+),anti-HBc (+)" (model one) and "HBsAg (+),anti-HBe (+),anti-HBc (+)" (model two) accounted for 92.5％ (208/225) of all the models.Rate of non/low-response to hepatitis B vaccine in infants born to mothers in model one was lower than those in model two,the differences are statistically significant (x2=4.80,P=0.029).The rate of non/low-response to hepatitis B vaccine in infants showed a downward trend with the rising of HBeAg level in their mothers (x2=4.86,P=0.028).Results from the unconditional logistic regression analysis showed that the HBeAg of the HBsAg-positive mothers was significantly correlated with the low risk of non/low-response to hepatitis B vaccine in infants (OR=0.598,95％CI:0.378-0.947).The positive rate of serum HBV DNA in HBsAg-positive mothers was 54.2％,while the rate of non/low-response to hepatitis B vaccine in infants born to HBV DNA positive mothers was similar to those infants born to HBV DNA negative mothers (X2=0.22,P=0.640).Conclusions "HBsAg (+),HBeAg (+),anti-HBc (+)" and "HBsAg (+),anti-HBe(+),anti-HBc (+)" were the common models seen in HBsAg-positive mothers,and the rate of non/low-response to hepatitis B vaccine was different between the two models.HBeAg of HBsAg-positive mothers might have positive effects on the immune response to hepatitis B vaccine in infants but the mechanisms remained not clear.HBV DNA of the HBsAg-positive mothers did not seem to be correlated with the immune response to hepatitis B vaccine in infants.

Evaluation of prevention program for neonatal vertical transmission from HBsAg positive mother in Korea / 대한산부인과학회지

OBJECTIVE: For evaluation of prevention program for neonatal vertical transmission from HBsAg positive mother in Korea METHODS: From January 15th to February 15th 2003, the status of neonatal vaccination, immunoglobuline injection and breast feeding of HBsAg positive mother was evaluated by using mailed questionnaire in 848 hostpitals with more than 100 deliveries in the year of 2001. 341 out of 848 (40.2%) hospitals returned questionnaires. RESULTS: 91.9% of total hospital reported that the vaccination of hepatitis B and immunoglobulin injection was done within 12 hours after birth in more than 90% of neonate. The most commonly used vaccine type was 0-1-6 method. In case of unknown result of HBsAg/ HBsAb in mother, 84.4% of hospitals delayed immunoglobulin injection until complete report, however 63% of hospitals gave hepatitis vaccine without delay before complete result. The breast feeding of HBsAg positive mother was recommended according to the result of HBeAg in 66.3% of hospitals while 24.9% of hospitals recommend breast feeding. CONCLUSION: Most hospitals in Korea reported that vaccination of Hepatitis B and immunoglobulin injection was done within 12 hours after in over 90% of neonate whose mother was HBsAg Positive. But continuous education and careful monitoring are required for injection method and vaccination policy in neonates of mothers with unknown result of HBsAg/HBsAb of mother.

The prevalence of HBsAg positive parturients in Korea / 대한산부인과학회지

OBJECTIVE: To study prevalence rate of HBsAg positive parturient women in Korea and compare different rates according to the locations of delivery. METHODS: Total 848 institutions which reported more than 100 deliveries during 2001, were included for this study. Designed questionnaire were used to study the numbers of HBsAg positive parturients and total deliveries. The survey was conducted by mail, telephone and visit. Total 279,734 deliveries (55.2% of estimated total deliveries) were obtained to complete the study. RESULTS: Prevalence rates of HBsAg positive parturient women in Korea were 3.23% and 3.3% in 2001 and 2002 respectively. Cheju area showed highest prevalence rates. Women delivering in urban area showed higher prevlance rate than those in rural area. CONCLUSION: Prevalence rates of HBsAg positive parturient women were 3.3% in 2001-2002 and the rates sustained around 3.5% since 1992 in Korea.

The Effects of Enflurane, Isoflurane and Regional Anesthesia on the Liver Function in HBsAg Positive Patients / 대한마취과학회지

It is already well known that there are relatively many patients in Korea who have hepatitis B surface antigen. Anesthesiologists are often put into such a dilemma that they can't decide definitely whether going on procedures or not for HBsAg positive patients with or without mildly impaired liver function. The effects of enflurane, isoflurane and regional anesthesia on the liver function were compared in 85 patients with hepatitis B surface antigen. All the patients were randomly divided into 3 groups of enflurane(n=8), isoflurane(n=60) and regional anesthesia(n=17), and subdivided into 4 groups according to the preoperative value of liver functuion test and the presence of hepatitis B e antigen. Liver function tests were performed preoperatively, and on the 1st, 3rd and 7th, days postoperatively. Postoperative values of liver function tests were compared to preoperative ones within each group, and were also compared between groups. The results showed no significant differences between groups of hepatitis B eantigen positive and hepatitis B e antigen negative, but showed slight differences between anesthetics or anesthetic methads. In conclusion, anesthetic management of hepatitis B surface antigen positive patients could be performed without regard to the presence of hepatitis B e antigen. However, regional anesthesia seemed to be better than inhalation anesthesia in patients with hepatitis B surface antigen.

The Effect of Enflurane Anesthesia on HBsAg Positive Patient / 대한마취과학회지

It is well known that halogenated anesthetics have been mainly used for inhalation anesthesia these days. However many controversies still exist concerning hepatic cellular damage after halothane anesthesia. Although several articles have been issued concerning the effects of halogenated anesthetics for hepatitis B surface antigen positive patients, a study of frequent research and strict case collections is meaningful. The authors observed the effects of enflurane anesthesia on 15 HBsAg positive patients who had not recognized themselves whether they had hepatitis symptoms or were carriers. During the period of study, all groups(enflurane study group and enflurane and halothane control groups) did not experience any difficulty with the anesthesia, blood transfusion, and jaundice, etc. The comparative data of liver function tests did not show great differences during the convalescent period. According to this and other recent studies, we can positively conclude that halogenated anesthetics, especially enflurane, may favorably be used to administer HBsAg positive patients, unless any undesirable problems related to anesthesia exist.

The Incidence of HBs Antigenemia in Glomerular Desease and Control Group in Children

HBsAg, HBcAb and HBsAb were examined with radio-immunoassay in 265 patients with glomerular disease, who were admitted to wards or visited to outpatient clinics of department of pediatrics, Seoul National University Hospital, from Jan., 78 to Oct. 80, and in 576 control group, with other than liver disease and without history of transfusion. The incidence in glomerular disease was 10.2%(27 of 265 patients)-nephrotic syndrome 9.2%(12 of 130); acute glomerulonephritis 7.3%(5 of 68), recurrent hematuria 7.7%(2 of 26), H-S nephritis 25%(3 of 12), chronic renal failure 21%(3 of 14), and the others 13.3%(2 of 15), while the incidence of HBs antigenemia in control group was 5.03%(29 of 576 patients)-male 5.5%(21 of 362), female 4.2%(8 of 214). The overall incidence of HBs antigenemia in renal disease was statistically higher than that of control group(p<0.05), though the respective incidences of the above each renal disease group were somewhat higher than that of control group, however they were not statistically significant, The incidence of positive rate of HBsAb and/or HBcAb in control group was 26.7%(56 of 209), and that in renal disease was 23%(18 of 578).