Epidemiologic and socioeconomic factors impacting hepatitis B virus and related hepatocellular carcinoma

Gnyawali, Bipul; Pusateri, Antoinette; Nickerson, Ashley; Jalil, Sajid; Mumtaz, Khalid

doi:10.3748/wjg.v28.i29.3793

Cited by 26 publications

(17 citation statements)

References 70 publications

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“…Many patients demonstrated relative socioeconomic disadvantage for both local born and resettled children, determined by low IRSAD deciles (Table 1). Important markers of disadvantage, including over‐crowding, household density, housing itinerancy, education and health literacy are also risk factors for HBV infection transmission and suboptimal health system engagement 2,21 . Notably, these factors were not well documented in our cohort (Table 1) and highlight future improvement through consultation and counselling of household risks.…”

Section: Discussionmentioning

confidence: 78%

Epidemiology and assessment of Hepatitis B positive children in Western Australia

Bartley,

Turner,

Ford

et al. 2024

J Paediatrics Child Health

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AimTo describe the characteristics of patients with chronic hepatitis B (CHB) presenting to a tertiary paediatric hospital in Perth, Western Australia. Review of implementation of previous follow‐up recommendations for the cohort was also undertaken.MethodA retrospective data analysis of all individuals aged between 0 and 17 years presenting to the tertiary children's hospital who were hepatitis B surface antigen (HBsAg) positive over 8 years (2013–2020). Demographic features, clinical progress and follow up are described, including proportion transferred to adult services.ResultsSeventy‐four patients were identified to have CHB; mean age at diagnosis 11 years; standard deviation 4 years; 41 (55%) male. Cultural and ethnolinguistic diversity was high; 74% (n = 55) were from refugee‐like backgrounds. Many did not demonstrate English proficiency (23/40; 75%) and 7 (10%) Australian born including 4 patients who were Aboriginal. Most patients (58%) with CHB were in the hepatitis B e antigen‐positive chronic infection phase with no intervention provided. Seventeen children had undergone liver ultrasonography and one underwent liver biopsy; none received antiviral treatment. Follow up was concerning; 28 (38%) had at least one clinic non‐attendance, 24 (32%) lost to follow‐up and interpreter utilisation was poorly documented. Thirty‐nine (53%) were transferred to adult services with only 56% attending follow‐up.ConclusionCHB burden is higher in those from culturally and ethnolinguistically diverse backgrounds. There is a significant loss to follow‐up and suboptimal transfer to adult services. Improved recall, education and referral processes are necessary to overcome language, socioeconomic and cultural barriers. Although childhood complications are infrequent, longitudinal monitoring is crucial to prevent long‐term complications and adult morbidity.

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Section: Discussionmentioning

confidence: 78%

Epidemiology and assessment of Hepatitis B positive children in Western Australia

Bartley,

Turner,

Ford

et al. 2024

J Paediatrics Child Health

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“…In a study conducted in Ethiopia, the likelihood of advanced liver disease (ALD) was higher in men (29).These outcome, experts agree; are largely driven by the asymptomatic nature of HBV -only presenting when advanced-stage sequelae emerge (30). Importantly, the higher likelihood of ALD in males is potentially linked to differential exposure to hepatotoxins (hazardous alcohol consumption, a atoxins (a toxin from Aspergillus avus and Aspergillus parasiticus in locally brewed alcoholic drinks, and tobacco use, among others) or other high-risk behavior (25).…”

Section: Discussionmentioning

confidence: 99%

Real-world experience with nucleos (t) ide analogue therapy and patient survival rates in chronic viral hepatitis B Treatment Centers in Asmara, Eritrea: A multicenter retrospective observational cohort study

Solomon,

Ghebremeskel,

Achila

et al. 2024

Preprint

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Background Real-world data on treatment outcomes or the quality of large-scale chronic hepatitis B (CHB) treatment programs in sub-Saharan Africa is extremely difficult to obtain. In this study, our aim was to present data on the clinical characteristics of CHB patients and to evaluate results in patients on nucleos(t)ide analogue (NUC) in multiple treatment sites in Asmara, Eritrea. Methodology: A multicenter retrospective cohort study was conducted on CHB patients in government-funded follow-up programs in Asmara, Eritrea (period: 2016–2021). Demographic, clinical, and laboratory information was collected from patients’ cards using a structured check-list. Relevant parametric and nonparametric statistics were employed to evaluate differences between groups. Kaplan–Meier (K-M) estimates and multivariate Cox proportional hazard models were used to explore risk factors for lost follow-up (LTFU). Results A total of 413 patients with HBV (median age (IQR) at diagnosis: 39 (IQR: 28–50 years, females: 118(28.6%) followed for a total of 22,921 person days of follow-up). Baseline ALT and AST were elevated in 99(31.2%) and 101(32.8%), respectively. Importantly, FIB-4 score and APRI score estimates suggested that prevalence of cirrhosis plus indeterminate and /or cirrhosis possible was 33(14%) + 49(20.8%) and 26(10.6%) + 65(26.4%), respectively. During the follow-up period, 4.6% (95%CI: 2.5–6.6%) died, while 23.9% (95%CI: 19.8–28%) were LTFU. The dominant reasons for treatment eligibility were cirrhosis and elevated HBV-DNA. After 12 weeks of treatment, the overall virologic response (VR) was 50.8% (95%CI: 46.9–74.6). Importantly, VR in TDF vs TDF + LAM were similar, 14/31(45.2%) vs 17/31(54.4%), respectively, p-value = 0.3. However, significant changes in biochemical parameters (ALT, AST, FIB-4, and APRI) were observed in both treatment groups following treatment. In adjusted Cox proportional hazards model, LTFU was independently associated with baseline serum HBV DNA (IU/mL) (aHR = 1.3, 95% CI 1.04–1.7; p-value = 0.02); Not initiated on NUC (aHR = 3.9, 95% CI: 1.1–13.7, p-value = 0.02); and FIB-4 Score (aHR = 1.05, 95% CI: 1-1.1; p-value = 0.01). Conclusion This study uncovered multiple system- and patient-centered gaps in the three HBV treatment programs in Asmara, Eritrea. Interventions should target improvements in laboratory infrastructure, adherence to patient monitoring guidelines, HBV literacy, better tracking of patients, and documentation of patients’ information.

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“…It seems that HBV will keep its importance in our agenda for a long time, with the number of people infected with hepatitis B infection, to which more than 1.5 million new cases are added annually, and with the current 300 million cases. 23…”

Section: Discussionmentioning

confidence: 99%

Positive status of Hepatis B Virus seroprevalence in local people and immigrants

METİN¹,

Demir²

2023

Turkish Journal of Internal Medicine

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Background In our study, we aimed to examine the seroprevalence of hepatitis B virus (HBV) infection and whether there is a sociodemographic difference between the two groups according to the hepatitis B surface antigen (HBsAg) results obtained in the blood samples given by the Turkish population and Syrian immigrants living in Bursa in their primary, secondary, and tertiary care applications. Material and Methods All patients with HBsAg serology who applied to family health centers, migrant health centers, 2nd and 3rd level hospitals in Bursa province during the 5-year period from January 2017 to the end of December 2021 were included in our study. Results During our study, HBsAg tests were taken from 955,528 people until the end of 2017-2021. The rate of Turkish citizens was 96.1% (n: 918,140), and the rate of Syrian origin was 3.9% (n: 37,388). Of all patients, 39.4% (n: 376,388) were male, and 60.6% (n: 579,140) were female. The HBsAg test was negative in 96.4% (n: 921,582) and positive in 3.6% (n: 33,946) of the patients. HBsAg positivity was found to be 3.6% in Turks and 2.4% in Syrians. HBsAg positivity was found to be 4.6% in men and 2.9% in women. The highest HBsAg positivity rate was 7.4% in the 50-59 age group. Conclusions The dissemination of the hepatitis B vaccine, which is currently in use, seems to be the most crucial weapon in the hands of humanity to prevent this infection and the diseases it will cause.

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Epidemiologic and socioeconomic factors impacting hepatitis B virus and related hepatocellular carcinoma

Cited by 26 publications

References 70 publications

Epidemiology and assessment of Hepatitis B positive children in Western Australia

Epidemiology and assessment of Hepatitis B positive children in Western Australia

Real-world experience with nucleos (t) ide analogue therapy and patient survival rates in chronic viral hepatitis B Treatment Centers in Asmara, Eritrea: A multicenter retrospective observational cohort study

Positive status of Hepatis B Virus seroprevalence in local people and immigrants

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