Browsing by Subject "Hepatitis B"

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    Hepatitis B infection awareness, vaccine perceptions and uptake, and serological profile of a group of health care workers in Yaoundé, Cameroon
    (2016) Tatsilong, Henri Olivier Pambou; Noubiap, Jean Jacques N; Nansseu, Jobert Richie N; Aminde, Leopold N; Bigna, Jean Joel R; Ndze, Valentine Ngum; Moyou, Roger Somo
    Abstract Background Cameroon is one of the countries in Africa with the highest burden of Hepatitis B infection. Health care workers are known to be at risk of occupational exposure to blood and other infectious bodily fluids. The aim of this study was to assess the profile of serological markers of hepatitis B virus (HBV) infection, knowledge and perceptions regarding HBV infection among health care workers in a health area in Yaoundé. Methods A cross-sectional study was conducted in the Mvog-Ada Health Area of the Djoungolo Health District from March 1 to November 31, 2014. All consenting health care workers were included in the study. Serological markers of HBV (HBs Ag, Hbe Ag, anti-HBs Ab, anti-HBe Ab, anti-HBc Ab) were qualitatively tested using Biotech®(OneHBV-5 parameter rapid test website) in each participant and the anti-HBs antibodies were quantified by ELISA (Biorex) among those who were positive with the qualitative test. Chi square test or its equivalents were used to compare qualitative variables and a p-value less than or equal to 0.05 was considered significant. Result A total of 100 participants were retained for the study out of 163 in the health area giving a response rate of 61.34 %; the mean age was 30.5 (SD 6.8) years and 71 % of participants were women. Forty seven percent (47 %) of workers had good level of knowledge of HBV infection. The men were 3.20 times (95 % CI: 1.02–9.19, p = 0.04) more likely to have a good level of knowledge than women. Participants with a university study level were more (95 % CI: 3.17–25, p < 0.0001) likely to have a good level of knowledge than those with a high school study level. Ninety-six percent of participants thought that they were at a greater risk of becoming infected with HBV than the general population, 93 % felt that the vaccine should be compulsory and all (100 %) were willing to recommend it to others. However, only 19 % had received at least one dose of the vaccine. The proportion of HBs Ag was 11 %. The different serological profiles with regard to HBV infection were naive subjects (62 %), chronic carriers (11 %), vaccinated (19 %) and subjects naturally immunized (8 %). Three out of the 19 participants who received at least one dose of the vaccine, only 9 (47.4 %) of whom had titers ≥100 IU/l indicating a good response to vaccination. Among those who received three doses of the vaccine (n = 12, 63 %), 2 (16, 66 %) had poor response to vaccination (HBs Ab titers < 100 IU/l). Conclusion The prevalence of HBs Ag among health care workers in the Mvog-Ada Health Area is high (11 %). These workers are at high risk of HBV infection because of very low vaccine uptake and poor post-exposure practices. Their knowledge of HBV infection is non-optimal.
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    Highlights from the 3rd international HIV/viral hepatitis Co-infection meeting - HIV/viral hepatitis: improving diagnosis, antiviral therapy and access
    (BioMed Central, 2017-04-20) Maponga, Tongai G; Matsha, Matteau Rachel; Morin, Sébastien; Scheibe, Andrew; Swan, Tracy; Andrieux-Meyer, Isabelle; Spearman, C Wendy; Klein, Marina B; Rockstroh, Jürgen Kurt
    The International AIDS Society convened the 3rd International HIV/Viral Hepatitis Co-Infection Meeting on 17 July 2016 as part of the pre-conference program preceding the 21st International AIDS Conference held in Durban, South Africa. The meeting brought together a diversity of scientific, technical and community interests to discuss opportunities and challenges for increased prevention, diagnosis and treatment of viral hepatitis in people living with HIV, particularly in low- and middle-income settings. The objectives of the meeting were: i. To review the latest therapeutic developments in viral hepatitis; ii. To identify challenges such as high cost of medications for hepatitis C virus (HCV) and risk of developing viral resistance, and successes, such as the provision of HCV treatment in community-based settings, movements to reduce drug costs and increasing access, in relation to scaling up diagnosis, screening, antiviral treatment and prevention of viral hepatitis; iii. To advance the agenda for elimination of viral hepatitis as a public health problem. Discussions centred around the six key interventions outlined by the World Health Organization Global Health Sector Strategy on Viral Hepatitis 2016–2021: hepatitis B virus (HBV) vaccination (including birth dose); safe injection practices plus safe blood; harm reduction among people who inject drugs; safer sex practices; hepatitis B treatment; and hepatitis C cure. This article summarizes the main issues and findings discussed during the pre-conference meeting. One of the recommendations from the meeting delegates is universal implementation of birth dose vaccination for HBV without further delay to prevent mother-to-child transmission of infection. There is also the need to implement screening and treatment of hepatitis among pregnant women. A call was made for concerted efforts to be put together by all stakeholders towards addressing some of the structural barriers, including criminalization of drug use, discrimination and stigma that people living with viral hepatitis face. Finally, the need for greater advocacy was highlighted to enable access to therapy of viral hepatitis at lower cost than currently prevails. Implementation of these resolutions will help in achieving the target of eliminating viral hepatitis as a public health threat.
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    Low prevalence of liver disease but regional differences in HBV treatment characteristics mark HIV/HBV co-infection in a South African HIV clinical trial
    (Public Library of Science, 2013) Ive, Prudence; MacLeod, William; Mkumla, Nompumelelo; Orrell, Catherine; Jentsch, Ute; Wallis, Carole L; Stevens, Wendy; Wood, Robin; Sanne, Ian; Bhattacharya, Debika
    BACKGROUND: Hepatitis B virus (HBV) infection is endemic in South Africa however, there is limited data on the degree of liver disease and geographic variation in HIV/HBV coinfected individuals. In this study, we analysed data from the CIPRA-SA 'Safeguard the household study' in order to assess baseline HBV characteristics in HIV/HBV co-infection participants prior to antiretroviral therapy (ART) initiation. METHODS: 812 participants from two South African townships Soweto and Masiphumelele were enrolled in a randomized trial of ART (CIPRA-SA). Participants were tested for hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and HBV DNA. FIB-4 scores were calculated at baseline. RESULTS: Forty-eight (5.9%) were HBsAg positive, of whom 28 (58.3%) were HBeAg positive. Of those with HBV, 29.8% had an HBV DNA<2000 IU/ml and ALT<40 IU/ml ; 83.0% had a FIB-4 score <1.45, consistent with absent or minimal liver disease. HBV prevalence was 8.5% in Masiphumelele compared to 3.8% in Soweto (relative risk 2.3; 95% CI: 1.3-4.0). More participants in Masiphumelele had HBeAg-negative disease (58% vs. 12%, p = 0.002) and HBV DNA levels ≤2000 IU/ml, (43% vs. 6% p<0.007). CONCLUSION: One third of HIV/HBV co-infected subjects had low HBV DNA levels and ALT while the majority had indicators of only mild liver disease. There were substantial regional differences in HBsAg and HbeAg prevalence in HIV/HBV co-infection between two regions in South Africa. This study highlights the absence of severe liver disease and the marked regional differences in HIV/HBV co-infection in South Africa and will inform treatment decisions in these populations.
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    Prevalence of hepatitis B and C infection in persons living with HIV enrolled in care in Rwanda
    (2017) Umutesi, Justine; Simmons, Bryony; Makuza, Jean D; Dushimiyimana, Donatha; Mbituyumuremyi, Aimable; Uwimana, Jean Marie; Ford, Nathan; Mills, Edward J; Nsanzimana, Sabin
    BACKGROUND: Hepatitis B (HBV) and C (HCV) are important causes of morbidity and mortality in people living with human immunodeficiency virus (HIV). The burden of these co-infections in sub-Saharan Africa is still unclear. We estimated the prevalence of the hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCVAb) among HIV-infected individuals in Rwanda and identified factors associated with infection. METHODS: Between January 2016 and June 2016, we performed systematic screening for HBsAg and HCVAb among HIV-positive individuals enrolled at public and private HIV facilities across Rwanda. Results were analyzed to determine marker prevalence and variability by demographic factors. RESULTS: Overall, among 117,258 individuals tested, the prevalence of HBsAg and HCVAb was 4.3% (95% confidence interval [CI] (4.2-4.4) and 4.6% (95% CI 4.5-4.7) respectively; 182 (0.2%) HIV+ individuals were co-infected with HBsAg and HCVAb. Prevalence was higher in males (HBsAg, 5.4% [5.1-5.6] vs. 3.7% [3.5-3.8]; HCVAb, 5.0% [4.8-5.2] vs. 4.4% [4.3-4.6]) and increased with age; HCVAb prevalence was significantly higher in people aged ≥65 years (17.8% [16.4-19.2]). Prevalence varied geographically. CONCLUSION: HBV and HCV co-infections are common among HIV-infected individuals in Rwanda. It is important that viral hepatitis prevention and treatment activities are scaled-up to control further transmission and reduce the burden in this population. Particular efforts should be made to conduct targeted screening of males and the older population. Further assessment is required to determine rates of HBV and HCV chronicity among HIV-infected individuals and identify effective strategies to link individuals to care and treatment.
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    Preventing hepatitis B and hepatocellular carcinoma in South Africa: The case for a birth-dose vaccine
    (2014) Spearman, C W N; Sonderup, Mark W
    Hepatitis B is a global public health issue, with some 2 billion people having current or past infection. In Africa, 65 million are chronically infected, an estimated 2.5 million of them in South Africa (SA). Hepatitis B and the associated complications of cirrhosis and hepatocellular carcinoma are entirely vaccine preventable. SA was one of the first ten countries in Africa to introduce universal hepatitis B vaccination in April 1995, but has no birth dose or catch-up programme. Although universal infant vaccination in SA has been successful in increasing population immunity to hepatitis B, improvements in terms of implementing protocols to screen all pregnant mothers for hepatitis B surface antigen (HBsAg) and ensuring full hepatitis B coverage, especially in rural areas, is justified. The World Health Organization has recommended a birth dose of hepatitis B vaccine in addition to the existing hepatitis B vaccine schedule in order to further decrease the risk of perinatal transmission. We recommend that SA implement a birth-dose vaccine into the existing schedule to attenuate the risk of perinatal transmission, prevent breakthrough infections and decrease HBsAg carriage in babies born to HIV-positive mothers.