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1.
Zoonoses ; 2(19), 2022.
Article in English | CAB Abstracts | ID: covidwho-2025752

ABSTRACT

Since the International Health Regulations National Focal Point for the United Kingdom alerted the WHO of ten cases of acute severe hepatitis of unknown etiology in children on April 5, 2022, relevant cases have been reported worldwide. These patients had acute hepatitis (negative for hepatitis viruses A-E) and elevated aminotransferase (AST) or alanine aminase (ALT) exceeding 500 U/L. Furthermore, severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) and/or adenovirus type F41 have been detected in some cases. This unknown hepatitis has been hypothesized to be induced by a viral reservoir of novel coronavirus superantigen, which repeatedly stimulates the intestines and leads to a multisystem inflammatory syndrome in children (MIS-C), which causes immune abnormalities in the presence of human adenovirus. Although this hypothesis has not been confirmed by any in vivo experimental or clinical studies, it may provide ideas for possible intervention strategies.

2.
Basic and Clinical Andrology ; 32(1), 2022.
Article in English | Web of Science | ID: covidwho-2021237

ABSTRACT

Background: The seminal virome and its implications for fertility remain poorly understood. To date, there are no defined panels for the detection of viruses of clinical interest in seminal samples. Results: In this study, we characterized the human seminal virome based on more than 1,000 studies published over the last five years. Conclusions: The number of studies investigating viruses that occur in human semen has increased, and to date, these studies have been mostly prospective or related to specific clinical findings. Through the joint analysis of all these studies, we have listed the viruses related to the worsening of seminal parameters and propose a new panel with the main viruses already described that possibly affect male fertility and health. This panel can assist in evaluating semen quality and serve as a tool for investigation in cases of infertility.

3.
Dig Dis Sci ; : 1-17, 2022.
Article in English | PubMed | ID: covidwho-2014217

ABSTRACT

BACKGROUND: The COVID-19 pandemic has brought new problems to patients infected with hepatitis B virus (HBV). AIM: We aim to know the effects of HBV infection on patients with COVID-19. METHODS: We searched PubMed, Embase, and Web of Science for data and utilized Stata 14.0 software for this meta-analysis with a random-effects model. This paper was conducted in alignment with the preferred reporting items for systematic review and meta-analysis (PRISMA) guideline. RESULTS: In total, 37,696 patients were divided into two groups: 2591 COVID-19 patients infected with HBV in the experimental group and 35,105 COVID-19 patients not infected with HBV in the control group. Our study showed that the in-hospital mortality of the experimental group was significant higher than that of the control group (OR = 2.04, 95% CI 1.49-2.79). We also found that COVID-19 patients infected with HBV were more likely to develop severe disease (OR = 1.90, 95% CI 1.32-2.73) than COVID-19 patients not infected with HBV. Upon measuring alanine aminotransferase (SMD = 0.62, 95% CI 0.25-0.98), aspartate aminotransferase (SMD = 0.60, 95% CI 0.30-0.91), total bilirubin (SMD = 0.45, 95% CI 0.23-0.67), direct bilirubin (SMD = 0.36, 95% CI 0.24-0.47), lactate dehydrogenase (SMD = 0.32, 95% CI 0.18-0.47), we found that HBV infection led to significantly higher laboratory results in COVID-19 patients. CONCLUSION: COVID-19 patients infected with HBV should receive more attention, and special attention should be given to various liver function indices during treatment.

4.
Journal of Clinical Hepatology ; 38(5):1048-1052, 2022.
Article in Chinese | GIM | ID: covidwho-2012826

ABSTRACT

Objective: To investigate a reasonable threshold d total bilirubin for the diagnosis of hepatitis B virus - related acute - on -chronic liver failure (HBV - ACLF), and to realize accurate early diagnosis.

5.
Weekly Epidemiological Record ; 96(44):540-548, 2021.
Article in English, French | GIM | ID: covidwho-2012096

ABSTRACT

This report, which updates previous reports, presents estimates of global, regional, and national vaccination coverage and trends as of 2020. It describes the changes in vaccination coverage and the numbers of unvaccinated and undervaccinated children as measured by receipt of the first and third doses of diphtheria, tetanus, and pertussis-containing vaccine (DTP)in 2020, when the COVID-19 pandemic began, compared with 2019. Global coverage estimates with the third dose of DTP (DTP3) and a polio vaccine (Pol3) fell from 86% in 2019 to 83% in 2020. Similarly, MCV1 coverage fell from 86% in 2019 to 84% in 2020. The last year the coverage estimates were at 2020 levels was 2009 for DTP3 and 2014 for both MCV1 and the third dose of Pol (Pol3). Worldwide, 22.7 million children(17% of the target population) did not receive DTP in 2020, compared with 19.0 million (14%) in 2019. Children who did not receive the first DTP dose (DTP1) by age 12 months (zero-dose children) accounted for 95%of the increased number. Among those who did not receive DTP3 in 2020, approximately 17.1 million (75%)were zero-dose children. Global coverage decreased in 2020 compared with 2019 estimates for the completion of Haemophilus influenzae type b (Hib), hepatitis B vaccine (HepB), human papillomavirus vaccine (HPV),and rubella-containing vaccine (RCV). To reach full coverage with all recommended vaccines, tailored strategies will be needed, especially to reach communities with a lot of children who haven't had any or enough vaccines.

6.
Frontiers in Immunology ; 13, 2022.
Article in English | EMBASE | ID: covidwho-2009860

ABSTRACT

Allelic diversity of human leukocyte antigen (HLA) class II genes may help maintain humoral immunity against infectious diseases. In this study, we investigated germline genetic variation in classical HLA class II genes and employed a systematic, unbiased approach to explore the relative contribution of this genetic variation in the antibody repertoire to various common pathogens. We leveraged a well-defined cohort of 800 adults representing the general Arab population in which genetic material is shared because of the high frequency of consanguineous unions. By applying a high-throughput method for large-scale antibody profiling to this well-defined cohort, we were able to dissect the overall effect of zygosity for classical HLA class II genes, as well as the effects associated with specific HLA class II alleles, haplotypes and genotypes, on the antimicrobial antibody repertoire breadth and antibody specificity with unprecedented resolution. Our population genetic studies revealed that zygosity of the classical HLA class II genes is a strong predictor of antibody responses to common human pathogens, suggesting that classical HLA class II gene heterozygosity confers a selective advantage. Moreover, we demonstrated that multiple HLA class II alleles can have additive effects on the antibody repertoire to common pathogens. We also identified associations of HLA-DRB1 genotypes with specific antigens. Our findings suggest that HLA class II gene polymorphisms confer specific humoral immunity against common pathogens, which may have contributed to the genetic diversity of HLA class II loci during hominine evolution.

7.
Annals of the Rheumatic Diseases ; 81:1286, 2022.
Article in English | EMBASE | ID: covidwho-2009174

ABSTRACT

Background: Recent published data have emerged some concerns about safety of Janus kinase (JAK) inhibitors and FDA have established prescribing restrictions. Objectives: The aim of this study was to analyze the safety profile of current approved JAK inhibitors in Europe with data from a Real World cohort. Methods: A single center observational study was performed including patients who had initiated treatment with Tofacitinib, Baricitinib or Upadacitinib from September, 2017 to January, 2022. Demographic, clinical, laboratory and safety variables were collected from baseline and at months 1, 3, 6 and every six months. Safety data was collected including any adverse event (AE) due to any cause. An AE was considered serious if it was life-threatening or result in hospitaliza-tion, disability or in death. All AE and SAE were expressed adjusted by exposure (E/100 PY). Results: A total of 194 patients were included whom baseline demographic and disease characteristics are exposed in Table 1. Drug exposure was 265.5 patient-years. Overall, 214 AE were detected being mild upper tract respiratory infection the most frequently registered (15.82 E/100PY) followed by Urinary tract Infection accounting 7.16 E/100PY. 10 Serious Infections were detected in 10 patients of which 5 were pneumonia (1.88 E/100PY), 1 cellulitis (0.38 E/100PY) and 2 COVID-19 (0.76 E/100PY). 12 herpetic infection were detected in 9 patients (4.52 E/100PY) of which 7 were caused by herpes zoster (2.64 E/100PY) and 5 by herpes simplex (1.88 E/100PY) 3 cases were mono-metameric and 4 multi-metameric. Moreover, 2 patient developed postherpetic neuralgia. A patient with RA developed Miliary Tuberculosis (0.38 E/100PY) with a negative IGRA test prior to the JAKi. A patient with RA suffered a Myocardial Infarction (0.38 E/100PY). 7 RA patients developed malignancy (2.64 E/100PY), one with oral squamous cell carcinoma, two Bowen carcinoma, one breast cancer, 2 basal cell carcinoma and a colorectal metastatic cancer. Not a single case of thromboembolic event nor Hepatitis B Virus reactivation were registered. 2 patients died, one with cancer and the other suffered a severe COVID-19 (unvaccinated). Conclusion: In this updated analysis of 194 patients treated with JAKi, the three approved JAKi showed a safety profile consistent with data from RCT. The patients under JAK therapy should be carefully evaluated on their follow-up.

8.
Scientific reports ; 12(1):14476, 2022.
Article in English | MEDLINE | ID: covidwho-2008302

ABSTRACT

Drug resistance caused by mutations is a public health threat for existing and emerging viral diseases. A wealth of evidence about these mutations and their clinically associated phenotypes is scattered across the literature, but a comprehensive perspective is usually lacking. This work aimed to produce a clinically relevant view for the case of Hepatitis B virus (HBV) mutations by combining a chronic HBV clinical study with a compendium of genetic mutations systematically gathered from the scientific literature. We enriched clinical mutation data by systematically mining 2,472,725 scientific articles from PubMed Central in order to gather information about the HBV mutational landscape. By performing this analysis, we were able to identify mutational hotspots for each HBV genotype (A-E) and gene (C, X, P, S), as well as the location of disulfide bonds associated with these mutations. Through a modelling study, we also identified a mutation position common in both the clinical data and the literature that is located at the binding pocket for a known anti-HBV drug, namely entecavir. The results of this novel approach show the potential of integrated analyses to assist in the development of new drugs for viral diseases that are more robust to resistance. Such analyses should be of particular interest due to the increasing importance of viral resistance in established and emerging viruses, such as for newly developed drugs against SARS-CoV-2.

9.
Journal of Hepatology ; 77:S303, 2022.
Article in English | EMBASE | ID: covidwho-1996631

ABSTRACT

Background and aims: In low endemic countries, screening for hepatitis B surface antigen (HBsAg) in migrants is cost-effective to reduce the disease burden of hepatitis B virus (HBV) infections, but linkage to care (LTC) remains a challenge. We previously found outreach screenings for HBV using point of care tests (POCT) to result in a 2.5 times higher LTC compared to venepunctures in an Asian migrant population. In the current study we compared LTC between different ethnic groups screened for HBsAg with POCT in an outreach setting. A secondary objective, was to compare the estimated HBsAg seroprevalence for ethnic minorities to the established prevalence in the general population in order to guide future screening initiatives. Method: Opportunistic outreach screenings using finger prick Vikia HBsAg tests were performed at municipal integration classes between 11/2017 and 03/2021. If tested positive, an appointment was given immediately at the outpatient hepatology clinic for followup and confirmation of HBsAg positivity in blood. A dedicated nurse contacted identified patients via phone, social media or home visits to motivate them for further linkage to care. The latterwas defined as having received medical care from a hepatologist, a blood test and an abdominal ultrasound. Results: A total of 521 persons with different ethnicities (Asia, Middle-East and Africa)were serologically screened using POCT tests. The seroprevalence for HBsAg was 3.45% (18/521) and was significantly higher compared to that of the general population (i.e. 0.66% in 2003 (p < 0.0001)). All HBsAg-positive patients were linked to care and assessed by a hepatologist. LTC for all ethnicities combined (p < 0.0001), for Sub-Saharan African patients (p = 0.023) and Middle- Eastern patients (p < 0.0001) was significantly higher compared to the previously observed rate of 34.38% (11/32 patients) using venepunctures as a screening method, but without the commitment of dedicated nurse. Among the HBV infected patients, 22.22% (4/18), 83.33% (15/18) and 22.22% (4/18) met criteria for treatment indication, intrafamilial transmission risk and HCC surveillance respectively. Despite COVID-19 pandemic, linkage to care remains high using POCT and through the commitment of a dedicated nurse. However, the time frame between screening and the first hospital visit is significantly higher (p = 0.0049) during the COVID-19 pandemic than in the pre-pandemic period.(Figure Presented) Conclusion: HBsAg seroprevalence in ethnic minorities is higher than the general population andwarrants targeted screening. Most of the identified patients meet the indication for treatment, counseling to prevent intrafamilial transmission or HCC surveillance. In addition, the use of POCT and commitment of a dedicated nurse can overcome previously identified barriers for linkage to care.

10.
Hepatology International ; 16:S133-S134, 2022.
Article in English | EMBASE | ID: covidwho-1995886

ABSTRACT

Objectives: Elimination of Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) require continuous interventions. This study aimed to assess the response and impact of COVID-19 on Hepatitis prevention and treatment in Japan. This international joint research was conducted by three research groups of Ministry of Health, Labour and Welfare (MHLW) in Japan with The Task Force for Global Health and in cooperation with Japan Society of Hepatology (JSH). Materials and Methods: We have conducted this cross-sectional study by questionnaire survey both in Japanese and English language on online Microsoft forms platform from 24 August to 03 October 2021. The questionnaire was designed to address the impact of COVID-19 on hepatitis treatment, testing, screening;mitigation strategies;response to COVID-19;and perceived benefits of COVID-19. Results: Total 196 medical doctors have participated from 35 prefectures among them 49.5% are in administrative positions. 55.6% of participants responded about no interruption while 11.7% reported supply chain disruptions during the survey period. 1-25% decrease in HBV screening, testing was reported by 38.8% and 43.9% participants, respectively. Decease of 1-25% in HCV screening, testing and were reported by 39.8% and 43.4% participants, respectively. However, no decline to initiate HBV and HCV treatment was reported by 53.6% and 45.4%, respectively. But extend of hospital visits was reported by 65.3%. The survey response illustrated the decrease in patients' imaging (65.8%), lab testing (68.4%), HCC screening (55.1%), gastrointestinal endoscopy (87.2%), and liver biopsy (43.4%). Patient anxiety and fear (67.4%), loss of staff to COVID-19 response (49.0%), and limited availability of staff (46.4%) are responded as challenges to resume services to pre-COVID-19 level. Conclusion: A greater decrease has been noticed in HBV and HCV testing, screening, and other associated liver diseases than treatment initiation in Japan. However, anxiety and fear of patients, lack of staff and facilities are major challenges to overcome such situation.

11.
Hepatology International ; 16:S153-S154, 2022.
Article in English | EMBASE | ID: covidwho-1995883

ABSTRACT

Objectives: Reactivation of hepatitis B is defined as dramatic increase in hepatitis B virus (HBV) replication in a patient with inactive or resolved hepatitis B. Reactivation can occur spontaneously but typically is triggered by immunosuppressive therapy or discontinuation of antiviral treatment. Some cases with COVID-19 progress into severe or critical disease requiring immunosuppressive therapy. Materials and Methods: We report the case of hepatitis B virus reactivation in a young adult with COVID-19. Results: 40-year-old male presented on day 7 of disease with sustaining fever and weakness. Chest CT scan revealed ground glass opacity. Nasopharyngeal mucus sample showed positive for SARSCov-2 PCR. Oxygen saturation (SpO2) was over 93% on room air. 10 years ago patient was diagnosed with HBV infection HBeAg +and high viral concentration, thus tenofovir was initiated. After 3 year of AVT seroconversion of HBeAg was achieved, after 5 years of AVT HBV PCR was negative. As treatment for COVID-19 high doses of methylprednisolone was administered and titrated during a month. Patient refused AVT, and it was terminated. COVID-19 resolved but after 2 months blood analysis revealed following: ALT' 357 U/L, AST' 147 U/L, GGT' 110U/l, ALP' 67 U/L, PCR HBsAg' 11.000 U/L, HBeAg' positive, PCR HBV' positive. HBV reactivation was diagnosed and ATV was restarted. After 1 week of ATV HBsAg lowered to 9000, HBeAg became negative, ALT-1400 U/L, AST-375 U/L, GGT-191U/L, ALP-164U/L. 1 month later HBsAg was 76 U/L, HBeAg-negative and ALT-90 U/L, AST-46 U/L, GGT-116 U/L, ALP-72 U/L. After 2 months HBsAg became negative, without AntiHBsAg, ATV was continued. Conclusion: This case is a vivid example of the association of HBV reactivation and immunosuppressive treatment with discontinuation of AVT during COVID-19 and illustrates the importance of AVT maintenance and careful consideration of high doses of steroids in patients with HBV infection.

12.
World Journal of Hepatology ; 14(7):1333-1343, 2022.
Article in English | Scopus | ID: covidwho-1988243

ABSTRACT

The global burden of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and coinfection represents a major public health concern, particularly in resource-limited settings. Elimination of HCV by 2030 has become foreseeable, with effective direct-acting antiviral oral therapies and the availability of affordable generics in low-and-middle-income countries (LMICs). However, access to oral nucleos(t)ide therapy for HBV remains critical and is limited outside the existing global HIV program platforms despite affordable prices. Prevention of mother-to-child transmission of HBV through scaling up of birth dose implementation in LMICs is essential to achieve the 2030 elimination goal. Most individuals living with HBV and/or HCV in resource-limited settings are unaware of their infection, and with improved access to medications, the most significant barrier remains access to affordable diagnostics and preventive strategies. The coronavirus disease 2019 pandemic interrupted hepatitis elimination programs, albeit offered opportunities for improved diagnostic capacities and raised political awareness of the critical need for strengthening health care services and universal health coverage. This review underpins the HBV and HCV management challenges in resource-limited settings, highlighting the current status and suggested future elimination strategies in some of these countries. Global efforts should continue to improve awareness and political commitment. Financial resources should be secured to access and implement comprehensive strategies for diagnosis and linkage to care in resource-constrained settings to fulfill the 2030 elimination goal. © The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

13.
Matern Fetal Med ; 4(1): 72-86, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1985144

ABSTRACT

Viral infections during pregnancy are associated with adverse pregnancy outcomes, including maternal and fetal mortality, pregnancy loss, premature labor, and congenital anomalies. Mammalian gestation encounters an immunological paradox wherein the placenta balances the tolerance of an allogeneic fetus with protection against pathogens. Viruses cannot easily transmit from mother to fetus due to physical and immunological barriers at the maternal-fetal interface posing a restricted threat to the fetus and newborns. Despite this, the unknown strategies utilized by certain viruses could weaken the placental barrier to trigger severe maternal and fetal health issues especially through vertical transmission, which was not fully understood until now. In this review, we summarize diverse aspects of the major viral infections relevant to pregnancy, including the characteristics of pathogenesis, related maternal-fetal complications, and the underlying molecular and cellular mechanisms of vertical transmission. We highlight the fundamental signatures of complex placental defense mechanisms, which will prepare us to fight the next emerging and re-emerging infectious disease in the pregnancy population.

14.
International Journal of Toxicological and Pharmacological Research ; 12(7):159-165, 2022.
Article in English | EMBASE | ID: covidwho-1976209

ABSTRACT

Background: On March 11, 2020, the World Health Organization (WHO) proclaimed Corona-virus Infection 2019 (COVID-19) to be a pandemic. Older subjects and those with underlying medical disorders such hypertension, asthma, diabetes mellitus, chronic lung infection, cardiovascular infections, obesity, and chronic kidney infection have been shown to have a more serious infection course and a greater fatality risk. Aims and Objectives: A study on biochemical parameters of HBV positive individuals suffering from Covid 19 & its effect on their final outcome Material and Methods: The research was conducted in the Department of Biochemistry L.N. Medical College, Bhopal. 200 subjects who are Covid positive will be included in the research. Category-1-60 corona positive subjects who are Hepatitis B virus positive. Category-2-140 corona positive subjects. Results: Out of total 200 covid positive cases, 60 individuals were also HBV positive & rest were only having Covid positive status. When we compared for the pathological/ laboratory diagnostic parameters of all the covid cases, Mean White blood cell Count was more in HBV positive individuals. Lymphocyte count was grossly decreased in HBV positive individuals. Neutrophil count, Platelet count, Alanine aminotransferase, Aspartate aminotransferase, Total bilirubin, Gamma-glutamyltransferase, Alkaline phosphatase, Albumin all these were comparatively on higher side in HBV positive individuals. Conclusion: Cholangiocytes have a role in various immune response-related activities of the hepatic, and when their function is disturbed, it can cause hepatobiliary damage due to a cytopathic effect. The hypothesis that cholangiocytes express more ACE2 receptors than other cell types could help to explain why hepatic function is dysregulated.

15.
JHEP Rep ; : 100531, 2022 Jul 27.
Article in English | MEDLINE | ID: covidwho-1966845

ABSTRACT

Background & Aims: The World Health Organization (WHO) HBV and HCV elimination targets, set in 2016 and based on projections to 2030, were unable to consider the impact of intervening factors. To evaluate the impact of the COVID-19 pandemic on viral hepatitis elimination programs, the European Association for the Study of the Liver (EASL) conducted a survey in liver centers worldwide in 2021. Methods: A web-based questionnaire was distributed (May-July 2021) to all EASL members representing clinical units providing HBV and HCV hepatitis care. Results are expressed as absolute numbers and reduction rates for each care activity. Results: Data were collected from 32 European and 12 non-European clinical centers. Between January 2019 (pre-pandemic) and December 2020 (during the pandemic), chronic HBV consultations decreased by 32% and 26%, new referrals by 38% and 39%, HBV testing rates by 39% and 21% (for HBsAg detection) and 30% and 22% (for HBV DNA detection), and new HBV treatments by 20% and 44% (p = 0.328) in European and non-European centers, respectively. With regard to HCV during the same time frame, the overall reductions were 39% and 50% for consultations, 49% and 49% for new referrals, 11% and 38% for HCV RNA detection, and 51% and 54% for new HCV antiviral treatments for European and non-European Centers, respectively (p = 0.071). Conclusions: All steps in the viral hepatitis care cascade have been hampered by the COVID-19 pandemic, with a comparable impact across different centers. These data reaffirm the pandemic's major effect on global viral hepatitis elimination programs and suggest that actions to achieve the WHO 2030 targets should be reconsidered and revised to account for each country's progress relative to pre-pandemic values. Lay summary: The EASL multinational survey conclusively shows that viral hepatitis elimination programs, expected to provide control of hepatitis B and hepatitis C worldwide by 2030, have been held back by the COVID-19 pandemic in clinical centers from several European and non-European countries, with a comparable impact across centers. Limitations in the cascade of care for both HBV and HCV were linked to limited access to screening, consultations, specific testing, and actual treatment. As restrictions for COVID-19 begin to lift, efforts to diagnose and provide treatment for viral hepatitis should remain high on the list of priorities for public health officials to maintain the WHO elimination efforts. Measures that have been put in place to control the COVID-19 pandemic could be transferred to increasing the diagnosis and linkage to care of people with hepatitis.

16.
Journal of Hepatology ; 77:S233-S234, 2022.
Article in English | EMBASE | ID: covidwho-1967501

ABSTRACT

Background and aims: Georgia introduced routine infant hepatitis B (HepB) vaccination in 2001 with >90% coverage over the last decade. In 2015, a nationwide serosurvey demonstrated an anti-hepatitis B core antibody (anti-HBc) prevalence of 25.9% and hepatitis B surface antigen (HBsAg) prevalence of 2.9% among adults ≥18 years. No prevalence data were available for children. In 2021, we assessed hepatitis B virus (HBV) infection prevalence among children and updated estimates for adults in a combined COVID-19, hepatitis C and hepatitis B serosurvey of persons aged ≥5 years. Method: We used a stratified, multi-stage cluster design. We collected data on demographics, medical and exposure history;we tested blood samples for anti-HBc and, if positive, for HBsAg. Nationally representative weighted proportions and 95% confidence intervals (CI) for anti-HBc and HBsAg were calculated. Participants aged 5–20 years had been eligible for routine HepB vaccination as infants. Results: Among children aged 5–17 years, 0.7% were anti-HBc+ and 0.03%were HBsAg+ (Table). Among adults ≥18 years, 21.7%were anti- HBc+ and 2.7%were HBsAg+. Anti-HBc prevalence increased with age from 1.3% among 18–23-year-olds to 28.6% among ≥60 years. HBsAg prevalence was lowest (0.2%) among 18–23-year-olds and highest (8.6%) among 35–39-year-olds. Males had higher HBsAg prevalence than females (3.6% versus 2.0%;p = 0.003). Anti-HBc prevalence was highest in Samegrelo-Zemo Svaneti, Adjara, and Imereti regions. Higher education and income were associated with lower anti-HBc, and unemployment-with higher HBsAg prevalence. (Table Presented) Conclusion: The impact of HepB vaccination in Georgia is demonstrated by a low HBsAg prevalence among children that is below the 0.5% European regional hepatitis B control target and meets the ≤0 .1% seroprevalence target for elimination of mother-to-child transmission of HBV. Chronic HBV infection remains a problem among adults born before routine infant HepB vaccination. Focusing efforts on screening, treatment, and preventive interventions among adults, along with sustaining high immunization coverage among children, can help Georgia achieve elimination of hepatitis B as public health threat by 2030.

17.
Gastroenterology ; 162(7):S-1169, 2022.
Article in English | EMBASE | ID: covidwho-1967421

ABSTRACT

Introduction: Perinatal infection with Hepatitis B virus (HBV) becomes chronic in 90% of cases with subsequent risk of developing serious liver disease. To prevent this, American Academy of Pediatrics has set recommendations for 3 groups of newborns weighing $ 2,000 grams: (1) maternal Hepatitis B surface antigen (HbSAg) negative: administration of HBV vaccine by 24 hours of life (HoL);(2) maternal HbSAg unknown: administration of HBV vaccine by 12 HoL (and HBV immune globulin by hospital discharge if status remains unknown);and (3) maternal HbSAg positive: administration of HBV vaccine and immune by 12 HoL. These timings maximize effectiveness of the HBV vaccine in preventing vertical transmission. Given poor compliance with current HBV vaccination demonstrated by the National Immunization Survey, this study aims to better understand factors associated with vaccine implementation at a large women's and children's center during the SARS-CoV-2 pandemic. Methods: This study was a retrospective chart review of newborns born from January 2019-September 2021 at Texas Children's Hospital in Houston, Texas (n=17,294). All newborns$2,000 grams were included and stratified by maternal HbSAg result (negative, unknown, or positive by 12 HoL) (see Figure). Univariate analysis was used to identify factors associated with timely receipt of the HBV vaccine and/or HBV immune globulin. Results: In the group with negative maternal HbsAg (n=17,185), 70.3% (n=12,077) received the HBV vaccine by 24 HoL. Those not receiving the vaccine prior to discharge (6.9%, n= 1,180) were more likely to be Caucasian, have commercial insurance, and not receive vitamin K or erythromycin. In the group with unknown maternal HbSAg (n=74), 17.6% (n=13) received the HBV vaccine by 12 HoL while 75.7% (n=56) received it between 12 HoL and discharge. In the group with positive maternal HbSAg (n=35), 91.4% (n=31) received the HBV vaccine and immune globulin by 12 HoL. Overall deviation from vaccination guidelines was highest in newborns admitted to intensive care units, and similar vaccination rates occurred in the period before and during the SARS-CoV-2 pandemic. Conclusions: Newborn HBV vaccination practices are not meeting American Academy of Pediatrics recommendations, which suggests a need to reevaluate current hospital protocol. Given that newborns with maternal HBV positive or unknown status are at highest risk of vertical transmission, initial interventions to improve timely vaccination should target these groups first, especially in intensive care settings. While 30% of newborns born to HbSAg negative mothers were not vaccinated by the recommended 24 HoL, only 7% had not received HBV vaccination prior to discharge. Dialog to increase HBV vaccine acceptance with individual families will likely be required to improve these rates. (Figure Presented)

18.
World Journal of Gastroenterology ; 28(26):3081-3091, 2022.
Article in English | EMBASE | ID: covidwho-1957484

ABSTRACT

A relevant gradual reduction of both the incidence rate of acute hepatitis B (AHB) and prevalence of chronic hepatitis B has occurred in Italy in the last 50 years, due to substantial epidemiological changes: Improvement in socioeconomic and hygienic conditions, reduction of the family unit, accurate screening of blood donations, abolition of re-usable glass syringes, hepatitis B virus (HBV)-universal vaccination started in 1991, use of effective well tolerated nucleo(t)side analogues able to suppress HBV replication available from 1998, and educational mediatic campaigns against human immunodeficiency virus infection focusing on the prevention of sexual and parenteral transmission of infections. As an example, AHB incidence has gradually decreased from 10/100000 inhabitants in 1985 to 0.21 in 2020. Unfortunately, the coronavirus disease 2019 (COVID-19) pandemic has interrupted the trend towards HBV eradication. In fact, several HBV chronic carriers living in the countryside have become unable to access healthcare facilities for screening, diagnosis, clinical management, and nucleo(t)side analogue therapy in the COVID-19 pandemic, mainly for anxiety of becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), movement restrictions, and reduced gains from job loss. In addition, one-third of healthcare facilities and personnel for HBV patients have been devolved to the COVID-19 assistance.

19.
Pathogens ; 11(7)2022 Jul 21.
Article in English | MEDLINE | ID: covidwho-1938937

ABSTRACT

Universal hepatitis B virus (HBV) vaccination has been applied for years in most countries, but HBV infection remains an unresolved public health problem worldwide, with over one-third of the world's population infected during their lifetime and approximately 248 million hepatitis B surface antigen (HBsAg) chronic carriers. HBV infection may reactivate with symptomatic and sometimes life-threatening clinical manifestations due to a reduction in the immune response of various origins, due to chemotherapy or immunosuppressive therapy, treatments increasingly practiced worldwide. SARS-CoV-2 and its COVID-19 associated disease have introduced new chances for HBV reactivation due to the use of dexamethasone and tocilizumab to counteract the cytokine storm. This could and should be prevented by accurate screening of HBV serologic markers and adequate pharmacologic prophylaxis. This article describes the case of a patient with COVID-19 who developed HBV reactivation and died of liver failure and analyzes published data on this setting to provide useful information to physicians who manage these patients during the SARS-CoV-2 pandemic.

20.
Research Journal of Pharmacy and Technology ; 15(4):1653-1658, 2022.
Article in English | EMBASE | ID: covidwho-1929143

ABSTRACT

World Health Organization (WHO) has assessed that coronavirus disease 2019 (COVID-19) as an epidemic. However, an effective antiviral for COVID-19 is still uncertain. Since the onset of the outbreak, the scientific and clinical community keep proposing many agents that would have efficacy against COVID-19. Arbidol is an indole core with proven effectiveness against influenza over the past few years apart from critics. The concrete hypothesis of arbidol interaction with spike glycoprotein prevents the entry of virus. Further, demonstrated clinical efficiency of arbidol against RNA virus and broad-spectrum inhibition of influenza A and B virus, adenovirus, and other viruses, including hepatitis C virus, drives us to seek more understating of the molecule and its clinical possibilities. In this review, we attempt to describe the many possible hypotheses of arbidol against Covid-19.

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