The rules about whom to screen and vaccinate for hepatitis B are now more clinician-friendly. The Curbsiders…

Background There are differences between males and females for most diseases both for exposure and course of illness, including outcome. These differences can be related to biological sex or gender i.e. socio-cultural factors that may impact exposure and healthcare access. Aim We aimed to quantify differences between males and females in infectious disease notifications in Europe and identify countries with these differences significantly different from the European Union and European Economic Area (EU/EEA) average. Methods Notifiable infectious disease surveillance data are reported by EU/EEA countries to ECDC. We retrieved surveillance data for 2012−2021. Using a cut-off median of annual disability-adjusted life years above 1 per 100,000 population, we included 16 infectious diseases. We calculated median male proportion and interquartile range by disease, year, country and age group and used boxplots to identify outliers. Results For campylobacteriosis, acute hepatitis B, Legionnaires’ disease, malaria and HIV and AIDS, all countries had male proportion above 50%. Most countries had a male proportion below 50% for pertussis (25/28 countries), STEC infection (21/28 countries) and Chlamydia trachomatis infection (16/24 countries). Chlamydia trachomatis infection and listeriosis showed the greatest dispersion of male proportion across age groups. Most outliers were countries reporting few cases. Conclusion We observed important differences in male proportion across infectious disease notifications in EU/EEA countries. For some diseases with high male proportions in all countries, such as HIV and hepatitis B, behaviours play a role in disease transmission. Screening offered to specific populations may explain differences across countries for example for C. trachomatis infection. …

This report describes progress toward eliminating hepatitis B and C in the country of Georgia.

This requires sensitivity to stigmas and awareness of hepatitis B and C prevalence in local communities. Medscape Medical News…

This report describes vaccination efforts to eliminate mother-to-child hepatitis B.

The U.S. drug regulator has declined to approve expanded use of Dynavax Technologies\' hepatitis B vaccine in a section of patients, citing insufficient data over destruction... Reuters Health Information…

BackgroundThe burden of chronic hepatitis B virus (HBV) varies across the European Union (EU) and European Economic Area (EEA). AimWe aimed to update the 2017 HBV prevalence estimates in EU/EEA countries and the United Kingdom for 2018 to 2021. MethodsWe undertook a systematic review, adding to HBV prevalence estimates from an existing (2005–2017) database. Databases were searched for original English-language research articles including HBV surface antigen prevalence estimates among the general population, pregnant women, first-time blood donors (FTB), men who have sex with men (MSM), migrants and people in prison. Country experts contributed grey literature data. Risk of bias was assessed using a quality assessment framework. FindingsThe update provided 147 new prevalence estimates across the region (updated total n = 579). Median HBV prevalence in the general population was 0.5% and the highest was 3.8% (Greece). Among FTB, the highest prevalence was 0.8% (Lithuania). Estimates among pregnant women were highest in Romania and Italy (5.1%). Among migrants, the highest estimate was 31.7% (Spain). Relative to 2017 estimates, median prevalence among pregnant women decreased by 0.5% (to 0.3%) and increased by 0.9% (to 5.8%) among migrants. Among MSM, the highest estimate was 3.4% (Croatia). Prevalence among people in prison was highest in Greece (8.3%) and the median prevalence increased by 0.6% (to 2.1%). ConclusionsThe HBV prevalence is low in the general population and confined to risk populations in most European countries with some exceptions. Screening and treatment should be targeted to people in prison and migrants. …

BackgroundGeorgia has adopted the World Health Organization European Region’s and global goals to eliminate viral hepatitis. A nationwide serosurvey among adults in 2015 showed 2.9% prevalence for hepatitis B virus (HBV) surface antigen (HBsAg) and 25.9% for antibodies against HBV core antigen (anti-HBc). HBV infection prevalence among children had previously not been assessed. AimWe aimed to assess HBV infection prevalence among children and update estimates for adults in Georgia. MethodsThis nationwide cross-sectional serosurvey conducted in 2021 among persons aged ≥ 5 years used multi-stage stratified cluster design. Participants aged 5–20 years were eligible for hepatitis B vaccination as infants. Blood samples were tested for anti-HBc and, if positive, for HBsAg. Weighted proportions and 95% confidence intervals (CI) were calculated for both markers. ResultsAmong 5–17 year-olds (n = 1,473), 0.03% (95% CI: 0–0.19) were HBsAg-positive and 0.7% (95% CI: 0.3–1.6) were anti-HBc-positive. Among adults (n = 7,237), 2.7% (95% CI: 2.3–3.4) were HBsAg-positive and 21.7% (95% CI: 20.4–23.2) anti-HBc-positive; HBsAg prevalence was lowest (0.2%; 95% CI: 0.0–1.5) among 18–23-year-olds and highest (8.6%; 95% CI: 6.1–12.1) among 35–39-year-olds. ConclusionsHepatitis B vaccination in Georgia had remarkable impact. In 2021, HBsAg prevalence among children was well below the 0.5% hepatitis B control target of the European Region and met the ≤ 0.1% HBsAg seroprevalence target for elimination of mother-to-child transmission of HBV. Chronic HBV infection remains a problem among adults born before vaccine introduction. Screening, treatment and preventive interventions among adults, and sustained high immunisation coverage among children, can help eliminate hepatitis B in Georgia by 2030. …

This report describes progress towards hepatitis B control and elimination in the World Health Organization African region.

Vaccination rates for hepatitis B virus are slightly lower among patients with psoriasis than among people without psoriasis. Medscape Medical News…

A test for HIV, hepatitis B, and hepatitis C that uses a single dried blood spot could increase testing for these viruses in high-risk and challenging settings, new data show. Medscape Medical News…

When researchers compared patients who met treatment criteria, treatment initiation was similar across races and socioeconomic status. But that finding raises other questions. Medscape Medical News…

De nyeste tal fra Statens Serum Institut viser, at der ikke blev fundet nogen hiv-positive bloddonorer i bloddonorscreeningen i 2019 og kun ganske få tilfælde af hepatitis B og C.

The previous risk-based testing approach was not successful at detecting most people living with chronic hepatitis B infection, the agency said. Medscape Medical News…

BackgroundThe World Health Organization European Action Plan 2020 targets for the elimination of viral hepatitis are that > 75% of eligible individuals with chronic hepatitis B (HBV) or hepatitis C (HCV) are treated, of whom > 90% achieve viral suppression.AimTo report the results from a pilot sentinel surveillance to monitor chronic HBV and HCV treatment uptake and outcomes in 2019.MethodsWe undertook retrospective enhanced data collection on patients with a confirmed chronic HBV or HCV infection presenting at one of seven clinics in three countries (Croatia, Romania and Spain) for the first time between 1 January 2019 and 30 June 2019. Clinical records were reviewed from date of first attendance to 31 December 2019 and data on sociodemographics, clinical history, laboratory results, treatment and treatment outcomes were collected. Treatment eligibility, uptake and case outcome were assessed.ResultsOf 229 individuals with chronic HBV infection, treatment status was reported for 203 (89%). Of the 80 individuals reported as eligible for treatment, 51% (41/80) were treated of whom 89% (33/37) had achieved viral suppression. Of 240 individuals with chronic HCV infection, treatment status was reported for 231 (96%). Of 231 eligible individuals, 77% (179/231) were treated, the majority of whom had received direct acting antivirals (99%, 174/176) and had achieved sustained virological response (98%, 165/169).ConclusionTreatment targets for global elimination were missed for HBV but not for HCV. A wider European implementation of sentinel surveillance with a representative sample of sites could help monitor progress towards achieving hepatitis control targets.…

This report describes 2021 data from National Center for Health Interview Survey on the percentage of adults who have ever had hepatitis by age group and sex.

Antallet af tilfælde med akut hepatitis B er fortsat lavt i Danmark. Kronisk hepatitis B er faldende.

Treatment with nucleos(t)ide analogues lowers risk of extrahepatic cancer in patients with hepatitis B infections. MDedge News…

The analysis focused on elderly patients after hepatectomy for hepatitis B virus–related hepatocellular carcinoma. The study was published as a preprint and has not yet been peer reviewed. …

Progress has occurred in reducing maternal-to-child transmission of hepatitis B, a leading cause of liver cancer, but is lagging, particularly in Africa. …

This report describes global progress towards the elimination of mother-to-child hepatitis B virus.

Findings presented at ILC 2022 in London revealed a cure for hepatitis B will not be easily achieved with the drugs currently in development. …

This report describes updated public health service guidelines for testing transplant candidates under 12 years of age for HIV, Hepatitis B, and Hepatitis C.

Faced with an increasing incidence of hepatitis B infection, the Centers for Disease Control and Prevention expanded its vaccination recommendation to include most adults. …

This report describes updated hepatitis B vaccination recommendations from the Advisory Committee on Immunization Practices.

The three-antigen hepatitis B vaccine received approval from the FDA in November 2021. …

Changes affect zoster, pneumococcal, and hepatitis B vaccines, and COVID-19 is now included. …

Although vaccination is not routine during pregnancy, guidelines from ACOG state that at-risk women should be screened and vaccinated for hepatitis B during pregnancy. …

With hepatitis B vaccination rates low and infection rates rising, experts hope the new recommendations will raise clinician awareness and simplify screening. …

The prehistoric origins of hepatitis B virus are painted in new color by this study analyzing the largest ever dataset of ancient viral genomes. …

This report describes progress toward hepatitis B control in the World Health Organization European Region.

This report describes donor-derived hepatitis B virus infections after liver transplantation.

Background

Analyses of temporal trends in immunisation coverage may help to identify problems in immunisation activities at specific points in time. These data are essential for further planning, meeting recommended indicators, monitoring, management and advocacy.

Aim

This study examined the trends of mandatory vaccination coverage in the period 2000–2017 in Serbia.

Methods

Data on completed immunisations were retrieved from annual national reports of the Institute of Public Health of Serbia during the period 2000–2017. To assess the trends of immunisation coverage, both linear and joinpoint regression analyses were performed. A probability p < 0.05 was considered significant.

Results

Over the period 2000–2017 linear regression analysis showed a significant decline in coverage with the primary vaccination against poliomyelitis, diphtheria, tetanus, pertussis and measles, mumps, rubella (MMR) (p ≤ 0.01). In the same period, coverage of all subsequent revaccinations significantly decreased, namely, first revaccination for pertussis (p < 0.01); first, second and third revaccination against diphtheria, tetanus and poliomyelitis (p < 0.01); and second dose against MMR before enrolment in elementary school (p < 0.05). Although linear regression analysis did not show change in vaccination coverage trend against tuberculosis (Bacillus Calmette–Guérin; BCG), hepatitis B (HepB3) in infants and diseases caused by Haemophilus influenzae type b (Hib3), the joinpoint regression analysis showed that the coverage declined for BCG after 2006, HepB3 after 2010 and Hib3 after 2008.

Conclusion

To achieve and keep optimum immunisation coverage, it is necessary to address barriers to immunisation, such as the availability of all vaccines and vaccine-hesitancy among parents and healthcare workers in Serbia.

Background

Recent and reliable estimates on the prevalence of coinfection with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) in Europe are lacking.

Aim

Leveraged on a study designed to assess HIV/HCV coinfection prevalence, we assessed the prevalence of HIV/HBV coinfection in Spain in 2018 and compared the results with five similar studies performed since 2002.

Methods

This cross-sectional prevalence study was carried out in 43 centres, and patients were selected using simple random sampling. The reference population comprised 40,322 patients and the sample size were 1,690 patients.

Results

The prevalence of HIV/HBV coinfection in Spain at the end of 2018 was 3.2%. The prevalence in 2002, 2009, 2015, 2016 and 2017 was 4.9%, 3.4%, 3%, 3.9% and 3%, respectively. Among the HIV/HBV-coinfected patients identified in 2018, 16.7% had cirrhosis according to transient elastography and 26.3% tested positive for antibodies against hepatitis D virus. All HIV/HBV-coinfected patients were receiving drugs with activity against HBV, and 97% of those tested for HBV DNA had an HBV DNA load < 80 IU/mL.

Conclusions

The prevalence of HIV/HBV coinfection in Spain remained stable at around 3% for a decade. Our data could facilitate the design of national programmes to control HBV infection and help identify areas of patient management that need improvement.

Introduction

As SARS-CoV-2 disproportionately affects adults, the COVID-19 pandemic vaccine response will rely on adult immunisation infrastructures.

Aim

To assess adult immunisation programmes in World Health Organization (WHO) Member States.

Methods

We evaluated country reports from 2018 on adult immunisation programmes sent to WHO and UNICEF. We described existing programmes and used multivariable regression to identify independent factors associated with having them.

Results

Of 194 WHO Member States, 120 (62%) reported having at least one adult immunisation programme. The Americas and Europe had the highest proportions of adult immunisation programmes, most commonly for hepatitis B and influenza vaccines (> 47% and > 91% of countries, respectively), while Africa and South-East Asia had the lowest proportions, with < 11% of countries reporting adult immunisation programmes for hepatitis B or influenza vaccines, and none for pneumococcal vaccines. In bivariate analyses, high or upper-middle country income, introduction of new or underused vaccines, having achieved paediatric immunisation coverage goals and meeting National Immunisation Technical Advisory Groups basic functional indicators were significantly associated (p < 0.001) with having an adult immunisation programme. In multivariable analyses, the most strongly associated factor was country income, with high- or upper-middle-income countries significantly more likely to report having an adult immunisation programme (adjusted odds ratio: 19.3; 95% confidence interval: 6.5–57.7).

Discussion

Worldwide, 38% of countries lack adult immunisation programmes. COVID-19 vaccine deployment will require national systems for vaccine storage and handling, delivery and waste management to target adult risk groups. There is a need to strengthen immunisation systems to reach adults with COVID-19 vaccines.

These days deciding when to stop targeted treatment for chronic hepatitis B is a bigger challenge than knowing when to start, Norah A. Terrault, MD, MPH, observed. …

This report describes progress of countries in the World Health Organization's South-East Asia region toward reaching 90% hepatitis B vaccination coverage.

This report describes the June 2020 U.S. Public Health Service guidelines which recommend actions healthcare providers can take before and after transplant to minimize the risk of infection…

Identification and management of hepatitis B infection in children and adults from countries with a high prevalence of infection, including refugees, is important for protecting their health and preventing transmission to others.

A new combination vaccine to prevent diphtheria, tetanus, whooping cough, polio, Haemphilus influenzae type b disease, and hepatitis B has been licensed, but won't be available before 2021.

May is Hepatitis Awareness Month, and May 19 is Hepatitis Testing Day. Many people with hepatitis B and hepatitis C remain unaware of their infection until serious complications occur.