Epidemiology of Hepatitis B and Hepatitis C Infections and Benefits of Programs for Hepatitis Prevention in Northeastern China: A Cross-Sectional Study

Zhang, Qian; Qi, Wenqian; Wang, Xu; Zhang, Yonggui; Xu, Yan; Qin, Shaoyou; Zhao, Ping; H, Guo; Ji, Jiao; Zhou, Chunyuan; Ji, Shang-wei; Wang, Jiangbin

doi:10.1093/cid/civ859

Cited by 74 publications

(68 citation statements)

References 20 publications

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“…China is among the countries with high endemicity with HBsAg-positivity rates varying by geography and subpopulation [16–18]. However, the results of HCV infection prevalence have been variegated in previous studies [19, 20].…”

Section: Discussionmentioning

confidence: 99%

Epidemiological study of hepatitis B and hepatitis C infections in Northeastern China and the beneficial effect of the vaccination strategy for hepatitis B: a cross-sectional study

Wang¹,

Yu-Hui²,

Tao

et al. 2018

BMC Public Health

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BackgroundViral hepatitis, mainly hepatitis B and C, is a serious public health problem worldwide. In China, the prevalence of hepatitis B virus (HBV) infection remains high, while that of hepatitis C virus (HCV) infection is controversial. This study investigated the epidemiology of HBV and HCV infections and assessed the beneficial effect of the vaccination strategy for hepatitis B in Northeastern China.MethodsFrom June 2016 to August 2016, 6541 residents of Changchun in Northeastern China were recruited for this cross-sectional study. Demographic characteristics as well as HBV and HCV serological test results were reviewed and analyzed.ResultsAmong all study participants, 3.8% and 0.36% tested positive for hepatitis B surface antigen (HBsAg) and anti-HCV, respectively. The HBsAg- and anti-HCV-positive rates were significantly higher in male participants (4.58% and 0.43%) than in female individuals (3.0% and 0.33%). Notably, among all age groups, the lowest rate of HBsAg positivity (0.2%) was found in children born after the implementation of the vaccination strategy for hepatitis B. Conversely, participants aged 40–49 years had significantly greater positive rates of HBsAg (5.9%) compared with those of other age groups. Furthermore, the highest rates of anti-HCV positivity (1.1%) were observed in participants aged 50–59 years.ConclusionsThe rate of HBsAg-positivity declined significantly following successful implementation of the policy on hepatitis B vaccination, indicating a beneficial impact on the control of HBV infection. However, only a slight decrease was observed in the anti-HCV–positivity rate, identifying an area in need of improvement within viral hepatitis prevention and control programs in China.

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Section: Discussionmentioning

confidence: 99%

Epidemiological study of hepatitis B and hepatitis C infections in Northeastern China and the beneficial effect of the vaccination strategy for hepatitis B: a cross-sectional study

Wang¹,

Yu-Hui²,

Tao

et al. 2018

BMC Public Health

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“…Despite the national HBV vaccination campaign in China, HBV remains endemic, with 7% of the total Chinese population identified as afflicted with CHB[21,22]. Meanwhile, recent epidemiological study in China has indicated a past HEV infection rate of 20%-40% (anti-HEV IgG positivity) and an additional 1% of new infections annually[23-25].…”

Section: Discussionmentioning

confidence: 99%

Clinical features of acute hepatitis E super-infections on chronic hepatitis B

Chen¹,

Zhang²,

Zhang³

et al. 2016

WJG

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AIMTo examine the clinical features and risk factors for adverse outcomes in chronic hepatitis B (CHB) superimposed with hepatitis E virus (HEV).METHODSThis retrospective cohort study included 228 patients with acute HEV infection (showing clinical acute hepatitis symptomology and positivity for anti-HEV immunoglobulin M) with underlying CHB (confirmed by positivity for hepatitis B surface antigen and/or hepatitis B virus (HBV) DNA over 6 mo) who had been admitted to the Shanghai Public Health Clinical Center, which represents the regional tertiary hospital for infectious diseases in Shanghai city, China. Data for adverse outcomes were collected, and included severe liver diseases (defined as liver failure and/or acute liver decompensation) and liver-related mortality. Logistic regression modeling was performed to determine the risk factors for adverse outcomes.RESULTSThe symptoms caused by superimposed acute hepatitis E (AHE) were much more severe in cirrhotic patients (n = 94) than in non-cirrhotic patients (n = 134), as evidenced by significantly higher liver complications (77.7% vs 28.4%, P < 0.001) and mortality rate (21.3% vs 7.5%, P = 0.002). Most of the cirrhotic patients (n = 85, 90.4%) had no prior decompensation. Among the non-cirrhotic patients, superimposed AHE caused progressively more severe diseases that corresponded with the CHB disease stages, from immune tolerant to immune reactivation phases. Few risk factors were identified in the cirrhotic patients, but risk factors for non-cirrhotic patients were found to be intermediate HBV DNA levels (OR: 5.1, P = 0.012), alcohol consumption (OR: 6.4, P = 0.020), and underlying diabetes (OR: 7.5, P = 0.003) and kidney diseases (OR: 12.7, P = 0.005). Only 28.7% of the cirrhotic patients and 9.0% of the non-cirrhotic patients had received anti-HBV therapy previously and, in all cases, the efficacy had been suboptimal.CONCLUSIONCHB-related cirrhosis and intermediate HBV DNA level were associated with severe disease in superinfected patients, and successful antiviral treatment might counter this outcome.

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“…A recent study from China showed that HBV prevalence in men in rural China has changed from highly endemic into intermediate endemic in the past two decades, but the absolute number of HBV-infected men and the susceptible population is still large 2 . Another recent study from China also showed that the hepatitis B surface antigen (HBsAg) positive rate was 6.1% 3 . Chronic hepatitis B (CHB) can lead to a progressive accumulation of liver fibrosis which progressively evolves to cirrhosis, hepatocellular carcinoma (HCC), liver failure, and death 4 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of eLIFT for Non-invasive Assessment of Liver fibrosis and Cirrhosis in Patients with Chronic Hepatitis B Virus Infection

et al. 2017

Sci Rep

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Recently, the easy Liver Fibrosis Test (eLIFT), a sum of points attributed to age, gender, gammaglutamyl transpeptidase, aspartate transaminase, platelets, and prothrombin time, was developed for diagnosing advanced fibrosis and cirrhosis in chronic liver disease. We aimed to evaluate the performance of eLIFT to predict liver fibrosis and cirrhosis in patients with chronic hepatitis B (CHB). Histologic and laboratory data of 747 CHB patients were analyzed. The performance of eLIFT for diagnosing liver fibrosis and cirrhosis was compared with that of aspartate transaminase to platelet ratio index ( Chronic hepatitis B virus (HBV) infection is very common: worldwide, 240 million have chronic HBV infection 1 . A recent study from China showed that HBV prevalence in men in rural China has changed from highly endemic into intermediate endemic in the past two decades, but the absolute number of HBV-infected men and the susceptible population is still large 2 . Another recent study from China also showed that the hepatitis B surface antigen (HBsAg) positive rate was 6.1% 3 . Chronic hepatitis B (CHB) can lead to a progressive accumulation of liver fibrosis which progressively evolves to cirrhosis, hepatocellular carcinoma (HCC), liver failure, and death 4 . Both the prognosis and the management of CHB patients are closely linked to the level of liver fibrosis. In CHB patients, the clinically relevant endpoints are: (1) detection of advanced fibrosis, which indicates that patients should receive antiviral treatment immediately to prevent further progression to cirrhosis and its complications; (2) detection of cirrhosis, which indicates that patients should not only potentially be treated for longer duration but also monitored for complications related to large esophageal varices and regularly screened for HCC 1 .Liver biopsy is the reference procedure for liver fibrosis evaluation; however, limitations of this procedure include invasive nature, cost, and risk of serious complications. These limitations of liver biopsy make it unsuitable as first-line test to screen liver fibrosis in CHB patients. Recently, assessments of liver fibrosis by non-invasive tests have been developed. The FibroScan has been used for the non-invasive evaluation of liver fibrosis in clinical practice, and provides an exciting alternative to liver biopsy 5 . However, the FibroScan device is expensive and only accessible in specialized centers in developing countries, and not all CHB patients can be referred to the specialized centers. Therefore, the development of tests that can be easily used by all physicians to detect liver fibrosis and cirrhosis is greatly urgent.

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Epidemiology of Hepatitis B and Hepatitis C Infections and Benefits of Programs for Hepatitis Prevention in Northeastern China: A Cross-Sectional Study

Abstract: ChiCTR-ECS-13004009.

Cited by 74 publications

References 20 publications

Epidemiological study of hepatitis B and hepatitis C infections in Northeastern China and the beneficial effect of the vaccination strategy for hepatitis B: a cross-sectional study

Epidemiological study of hepatitis B and hepatitis C infections in Northeastern China and the beneficial effect of the vaccination strategy for hepatitis B: a cross-sectional study

Clinical features of acute hepatitis E super-infections on chronic hepatitis B

Evaluation of eLIFT for Non-invasive Assessment of Liver fibrosis and Cirrhosis in Patients with Chronic Hepatitis B Virus Infection

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