Hepatitis B virus infection among residents of a nursing home for the elderly: Seroepidemiological study and molecular evolutionary analysis

Abstract

A seroepidemiological study of HBV infection was carried out to investigate the seroprevalence of hepatitis B surface antigen (HBsAg) and the transmission routes of hepatitis B virus (HBV) infection among residents of a nursing home for the elderly. HBV serum markers were examined in 119 residents and 71 healthcare workers in the institution, as also in 1330 healthy subjects from the same geographical area, as the control group. HBsAg was detected in 6 (5%), 0 and 20 (1.5%) residents, healthcare workers and healthy subjects, respectively. Four residents (A-D) who had HBV-DNA in the serum were studied by molecular evolutionary analysis. The strains derived from residents A, B and D were clustered together within a close range of evolutionary distances. Residents B and D, who were not positive for HBsAg at the time of admission to the institution, subsequently became HBsAg-positive asymptomatic carriers. These results suggested intrainstitutional transmission of HBV in the nursing home for the elderly, and confirmed that the source of transmission of HBV to residents B and D was resident A who was positive for HBsAg. Residents in a nursing home for the elderly should be considered as being a high-risk group for HBV infection, and vaccination against HBV of these groups is recommended.

Hepatitis B Virus and Hepatitis C Virus Seroprevalence in the Elderly Living in Nursing Homes

“…The most important reason for this is the semiclosed environment of the nursing home and the increased contact with body fluids, in addition to the risk of HBV or HCV. 7 …”

Hepatitis B and elders: An underestimated issue

“…Nursing home studies show a highly variable prevalence of HBsAg: 0% in a US population and 5% in Japan and in Taiwan . In Turkey, a medium‐endemic country (incidence between 3% and 8%), the prevalence in nursing homes is high (11.2%) .…”

“…70 Finally, long-term antiviral therapy decreases mortality in this population. 65 Vaccination must be performed as soon as possible in nursing home residents, 32,22 especially in diabetics, 71 for whom the contamination risk is higher. However, the immune response is lower in elderly, 72 probably due to a deficient role of T lymphocytes 73,35 and low anti-HBs levels.…”

Envejecimiento y enfermedades del hígado

“…El elevado riesgo que comporta la hepatitis B en la población de edad avanzada obliga a considerar la vacunación de los contactos domésticos u otros convivientes de los pacientes con infección crónica B 36 . Debe tenerse en cuenta que el efecto inmunógeno de la vacuna de la hepatitis B es menor en los ancianos que en los adultos jóvenes 37 .…”