Hepatitis B Virus Elimination in the U.S.: Time to Dismantle Barriers and Implement Solutions

Wang, Su; Cohen, Chari; Tang, Amy S; Graham, Camilla S.

doi:10.1007/s11901-020-00557-3

Cited by 6 publications

(5 citation statements)

References 38 publications

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“…However, if a person does not have risk factors, the result might be a false positive; repeat testing with the same assay is warranted to confirm the results (121). A false-positive isolated core antibody result means the person is susceptible and should be offered HepB vaccine per current ACIP recommendations (105).…”

Section: Persons With Isolated Core Antibodymentioning

confidence: 99%

Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations — United States, 2023

et al. 2023

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Chronic hepatitis B virus (HBV) infection can lead to substantial morbidity and mortality. Although treatment is not considered curative, antiviral treatment, monitoring, and liver cancer surveillance can reduce morbidity and mortality. Effective vaccines to prevent hepatitis B are available. This report updates and expands CDC's previously published Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection (MMWR Recomm Rep 2008;57[No. RR-8]) regarding screening for HBV infection in the United States. New recommendations include hepatitis B screening using three laboratory tests at least once during a lifetime for adults aged ≥18 years. The report also expands risk-based testing recommendations to include the following populations, activities, exposures, or conditions associated with increased risk for HBV infection: persons incarcerated or formerly incarcerated in a jail, prison, or other detention setting; persons with a history of sexually transmitted infections or multiple sex partners; and persons with a history of hepatitis C virus infection. In addition, to provide increased access to testing, anyone who requests HBV testing should receive it, regardless of disclosure of risk, because many persons might be reluctant to disclose stigmatizing risks.

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Section: Persons With Isolated Core Antibodymentioning

confidence: 99%

Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations — United States, 2023

et al. 2023

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“…There is significant potential overlap between the lifestyle interventions recommended to prevent the development of these conditions, their optimal medical management and the care for people living with CHB [ 19 , 49 – 53 ]. An integrated approach which manages CHB and these comorbidities concurrently—rather than the siloed approach that is seen too frequently—would be expected to translate into both better liver and general health outcomes [ 54 , 55 ]. Although a single individual was diagnosed with HCC in the region in the 2020 calendar year, 25 individuals required aeromedical evacuation from the region for an acute coronary syndrome during the same time period [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

The high burden of comorbidities in Aboriginal and Torres Strait Islander Australians living with chronic hepatitis B in Far North Queensland, Australia, and the implications for patient management

Riddell

Hempenstall²,

Nakata³

et al. 2023

PLoS ONE

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Background Aboriginal and Torres Strait Islander Australians living with chronic hepatitis B virus (HBV) infection have a significant burden of hepatocellular carcinoma (HCC). The prevalence of comorbidities that increase the risk of HCC in this population is incompletely defined. Methods This cross-sectional study was performed in remote tropical Queensland, Australia in January 2021. All individuals living with chronic HBV in the region were identified; the prevalence of relevant comorbidities was determined by reviewing medical records. Results All 236 individuals in the cohort identified as Aboriginal and Torres Strait Islander Australians; their median (interquartile range (IQR)) age was 48 (40–62) years; 120/236 (50.9%) were female. Of the 194/236 (82.2%) engaged in HBV care, 61 (31.4%) met criteria for HBV therapy and 38 (62.2%) were receiving it. However, 142/236 (60.2%) were obese, 73/236 (30.9%) were current smokers and 57/236 (24.2%) were drinking alcohol hazardously; 70/236 (29.7%) had ≥2 of these additional risk factors for HCC, only 43/236 (18.2%) had none. Among the 19 patients with confirmed cirrhosis, 9 (47%) were obese, 8 (42%) were currently—or had a history of—drinking alcohol hazardously and 5 (26.3%) were current smokers. Patients also had a median (IQR) of 3 (2–4) cardiovascular risk factors (cigarette smoking, hypertension, impaired glucose tolerance, dyslipidaemia, renal impairment/proteinuria). Only 9/236 (3.8%) did not have one of these 5 comorbidities. Conclusions Aboriginal and Torres Strait Islander Australians living with chronic HBV in this region of remote Australia have a high engagement with HBV care and the majority of individuals eligible for antiviral therapy are receiving it. However, a significant comorbidity burden increases their risk of cirrhosis, HCC, and premature death. It is essential to integrate chronic HBV care with management of these comorbidities—rather than focusing on HBV alone—to achieve optimal health outcomes.

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“…According to the Advisory Committee for Immunisation Practices of the Centres for Disease Control and Prevention, effective hepatitis B infection prevention necessitates hepatitis B testing, complete hepatitis B vaccination, and post-vaccination anti-HBs titre testing [4][5][6]. Hepatitis B testing detects the presence of the hepatitis B surface antigen (HBsAg) or viral DNA [7]. Effective protection against hepatitis B infection requires complete vaccination (at least three doses of the hepatitis B vaccine at 0-, 1-, and 6-month intervals) and anti-HBs titre testing 1-2 months after completion of the vaccine series [8].…”

Section: Introductionmentioning

confidence: 99%

Factors influencing the utilisation of anti-HBs titre testing services among nursing students in Northwest Ghana: A cross-sectional study

Balegha

2024

PLOS Glob Public Health

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Understanding the impact of hepatitis B testing, vaccination, the number of vaccine doses, and socio-demographics on post-vaccination anti-HBs titre testing, is essential for hepatitis B prevention. The aim of the study was to determine the prevalence of hepatitis B testing, hepatitis B vaccination, number of vaccine doses received, socio-demographic characteristics, and their impact on anti-HBs titre testing among nursing students in Northwest Ghana. A stratified sample of 402 nursing students from Wa and Lawra nursing colleges in Ghana’s Upper West Region was surveyed in November 2020 using an online cross-sectional design. STATA 13 was used to analyse the data, which described socio-demographics, hepatitis B testing, hepatitis B vaccination, and post-vaccination anti-HBs titre testing with frequencies and percentages. Hierarchical binary logistic regression models were used to investigate the relationships between post-vaccination anti-HBs titre testing and hepatitis B testing, vaccination, the number of vaccine doses, and their socio-demographics. The study discovered that while hepatitis B testing was high (89.0%), rates for hepatitis B vaccination (72.1%), obtaining the recommended vaccine doses (59.5%), and post-vaccination anti-HBs titre testing (19.4%) were lower. Nursing students who accepted hepatitis B vaccination were significantly more likely to undergo anti-HBs titre testing [aOR = 12.34; 95% CI = 1.80–84.54; p < 0.05]. Those who received ≥ 3 vaccine doses were over 8 times more likely to utilise anti-HBs titre testing [aOR = 8.31; 95% CI = 2.73–25.34; p < 0.001]. Wa NTC students were 74% less likely to access anti-HBs titre testing [aOR = 0.26; 95% CI = 0.15–0.47; p < 0.001]. Students with parents who had tertiary education were significantly more likely to undergo anti-HBs titre testing [aOR = 2.50; 95% CI = 1.42–4.42; p < 0.01]. The study reveals high hepatitis B testing but low vaccination rates, emphasizing the need for required vaccine doses and post-vaccination anti-HBs testing. Key predictors include hepatitis B vaccination, ≥3 doses, Wa NTC enrollment, and parental education. The study advocates mandatory testing, vaccination, and affordable access to anti-HBs titre testing. Unvaccinated students, those with <3 doses, Wa NTC attendees, and those with lower parental education for nursing school admission should be prioritised.

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Hepatitis B Virus Elimination in the U.S.: Time to Dismantle Barriers and Implement Solutions

Cited by 6 publications

References 38 publications

Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations — United States, 2023

Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations — United States, 2023

The high burden of comorbidities in Aboriginal and Torres Strait Islander Australians living with chronic hepatitis B in Far North Queensland, Australia, and the implications for patient management

Factors influencing the utilisation of anti-HBs titre testing services among nursing students in Northwest Ghana: A cross-sectional study

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