Incidence of hepatitis B virus infection in young Chinese blood donors born after mandatory implementation of neonatal hepatitis B vaccination nationwide

Tang, Xi; Jp, Allain; Wang, H.; Xiao, Rong; Chen, J.; Huang, Ke; Xu, Ru; Wang, M.; Huang, Jieting; Liao, Qiao; Shan, Zhengang; Luo, Songyuan; Li, Tingting; Li, C.; Fu, Yongshui

doi:10.1111/jvh.12901

Cited by 35 publications

(36 citation statements)

References 37 publications

(90 reference statements)

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“…The CMR of liver cancer was significantly higher in rural residents than in urban residents (Figure 4A ), possibly because of the difference in the availability and adherence of receiving antiviral treatment [ 23 ]. The ASMR of liver cancer in the ≤39 years population continued to decrease, possibly because of HBV vaccination in newborns enforced in mainland China since 1992 [ 24 ]. Thus, the data of cancer death reflect not only the natural course of each cancer type but also the effects of public health actions.…”

Section: Discussionmentioning

confidence: 99%

Trends in cancer mortality in China from 2004 to 2018: A nationwide longitudinal study

Jiang

Zhang

Liu

et al. 2021

Cancer Communications

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Background: The long-term trend in cancer death in a rapidly developing country provides information for cancer prophylaxis. Here, we aimed to identify the trends in cancer mortality in China during the 2004-2018 period.Methods: Using raw data from the national mortality surveillance system of China, we assessed the mortalities of all cancer and site-specific cancers during the 2004-2018 period. The participants were divided into three age groups: ≥65 years, 40-64 years, and ≤39 years. Changing trends in cancer death by gender, residency, and tumor location were estimated using fitting joinpoint models to log-transformed crude mortality rates (CMRs) and age-standardized mortality rates (ASMRs).Results: Cancer death accounted for 24% of all-cause of death in China during 2014-2018. The CMR of all cancer was 150.0 per 100,000 persons. Cancer was the leading cause of death in the population <65 years. The six major cancer types (lung/bronchus cancer, liver cancer, stomach cancer, esophagus cancer, colorectal cancer, and pancreas cancer) accounted for 75.85% of all cancer deaths. The CMR of all cancer increased while the ASMR decreased during 2014-2018 (P < 0.001). Lung/bronchus cancer and liver cancer were the leading causes of cancer death in the population <65 years, accounting for 45.31% (CMR) and 44.35% (ASMR) of all cancer death, respectively. The ASMR of liver cancer was higher in the 40-64 years population than in the ≥65 years population, in contrast to the other five major cancers. The ASMRs of liver cancer, stomach cancer, and esophagus cancer decreased although they were higher in rural residents than in urban residents; the ASMRs of lung/bronchus cancer, colorectal cancer, and

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Section: Discussionmentioning

confidence: 99%

Trends in cancer mortality in China from 2004 to 2018: A nationwide longitudinal study

Jiang

Zhang

Liu

et al. 2021

Cancer Communications

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“…21 A study of 14,937 young blood donors born between 1992 and 1997 in China, that is, in the era of universal HBV vaccination program, found that 10 of 14,937 (0.067%) donors had detectable serum HBV DNA. 106 Nucleic acid amplification testing (NAT) has been established as a highly sensitive screening tool of blood donors for detection of all three viruses of HCV, HIV, and HBV and hence OBI in the most developed countries, as it is more sensitive than serological HBsAg, HCV antibody, and HIV antibody tests. 107,108 Thus, the implementation of HBV DNA detection by NAT is more sensitive than HBsAg assay as a preventive measure for HBV or OBI transmission via blood transfusion.…”

Section: Blood Products Transfusionmentioning

confidence: 99%

Current Knowledge of Occult Hepatitis B Infection and Clinical Implications

Yip

Wong

2019

Semin Liver Dis

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Occult hepatitis B infection (OBI) is a status of undetectable serum hepatitis B surface antigen (HBsAg) yet detectable serum and/or intrahepatic hepatitis B virus (HBV) DNA. Mutations in the preS1, preS2, and S regions of the HBsAg gene may result in undetectable HBsAg. OBI may either result from a self-limiting acute hepatitis, or in patients with chronic hepatitis B who achieved HBsAg seroclearance, which refers to the loss of detectability of serum HBsAg with or without antibody to HBsAg (anti-HBs) in chronic hepatitis B (CHB) patients. HBsAg seroclearance contributes to a significant proportion of population in seropositive OBI. Both spontaneous and antiviral treatment-induced HBsAg seroclearance rarely happens; yet both types of HBsAg seroclearance are durable. CHB patients who achieve HBsAg seroclearance generally have a favorable clinical course. There is still a low yet definite risk of HCC occurrence, particularly in male CHB patients who achieve HBsAg seroclearance after being 50 years old. Clinical implications of OBI include occurrence of cirrhosis and HCC, liver transplantation, blood products transfusion, hemodialysis, and so on. A potentially life-threatening condition would be OBI reactivation in patients during immunosuppression therapy, especially in the setting of intensified immunosuppression including in onco-hematological patients (those receiving hematopoietic stem cell transplantation and treated with the anti-CD20 monoclonal antibody [e.g., rituximab]). With more new insights into these two conditions, CHB patients who achieved HBsAg seroclearance generally have benign clinical course and good prognosis. Sensitive assay for serum HBV DNA should be considered to establish the presence of OBI in the clinical settings mentioned earlier, which will affect the management plan.

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“…demonstrated that MP‐6 NAT with a sensitivity of 22·2 IU/ml failed to detect 50% of previous donations from Italian blood donors subsequently identified with OBI (ID‐NAT, 3·7 IU/ml) . Similarly, our recent study identified nine HBV DNA+ cases by Ultrio Plus NAT (3·4 IU/ml) in 1732 donors who previously qualified Ultrio NAT (10·4 IU/ml) . These two studies and others establish that the viral load in OBI is often very low, and in the absence of anti‐HBc testing, a very sensitive NAT assay is required to detect OBI .…”

Section: The Hbv Screening Strategy In Blood Donorsmentioning

confidence: 57%

“…Similarly, our recent study identified nine HBV DNA+ cases by Ultrio Plus NAT (3·4 IU/ml) in 1732 donors who previously qualified Ultrio NAT (10·4 IU/ml) . These two studies and others establish that the viral load in OBI is often very low, and in the absence of anti‐HBc testing, a very sensitive NAT assay is required to detect OBI . In addition, a case report involved a transmission from an ID‐NAT‐negative donation in the acute window period .…”

Section: The Hbv Screening Strategy In Blood Donorsmentioning

confidence: 84%

Update on epidemiology of hepatitis B virus among blood donors in China

Huang

You

Duan

et al. 2018

ISBT Science Series

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China is one of the countries with high prevalence of hepatitis B virus (HBV) infection. It is estimated that approximately 100 million people in China are infected with HBV. We aimed to review the prevalence of HBV in Chinese blood donors. With the search term of ‘(hepatitis b virus) and (prevalence or epidemiology) and (blood donors) and (Chinese)’, we searched PubMed (https://www.ncbi.nlm.nih.gov/pubmed) and CNKI (http://www.cnki.net/) for literature in English and Chinese, respectively. The prevalence of hepatitis B surface antigen (HBsAg) in Chinese general population has declined from 9·75% in 1992 to 7·18% in 2006, as a consequence of implementation of nationwide universal neonatal HBV vaccination. The prevalence of HBsAg in blood donors is about 0·49–1·56% by enzyme immunoassays (EIAs) after predonation screening with HBsAg rapid strip test and health consultation, which is significantly lower than that in the general population. HBV DNA is detected by nucleic acid tests (NATs) at a rate of 0·01–0·11% among HBsAg‐negative blood donors, which is identified mostly as occult HBV infection (OBI). The prevalence of HBV in Chinese blood donors is about 1%. In contrast to countries with low HBV prevalence, anti‐HBc testing cannot be applied to routine screening of HBV infection because the high anti‐HBc prevalence in Chinese blood donors would lead to unacceptably high donor deferral. Therefore, to further reduce transfusion transmission of HBV, it is of great necessity to apply highly sensitive NAT to test HBV DNA in Chinese blood donors.

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Incidence of hepatitis B virus infection in young Chinese blood donors born after mandatory implementation of neonatal hepatitis B vaccination nationwide

Cited by 35 publications

References 37 publications

Trends in cancer mortality in China from 2004 to 2018: A nationwide longitudinal study

Trends in cancer mortality in China from 2004 to 2018: A nationwide longitudinal study

Current Knowledge of Occult Hepatitis B Infection and Clinical Implications

Update on epidemiology of hepatitis B virus among blood donors in China

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