Progress toward Elimination of Hepatitis B Virus Transmission in Oman: Impact of Hepatitis B Vaccination

Awaidy, Salah T. Al; Bawikar, Shyam; Busaidy, Suleiman Salim Al; Mahrouqi, Salim Al; Baqlani, Said Al; Obaidani, Idris Al; Alexander, James P.; Patel, Minal

doi:10.4269/ajtmh.13-0333

Cited by 16 publications

(8 citation statements)

References 8 publications

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“…This is unsurpising, given the dramatic reduction in the seroprevalence of chronic HBV infections in Oman following the successful introduction of HBV vaccination in 1990. 17 Similar findings have also been reported in Saudi Arabia. 33 Various decision analysis models have demonstrated the cost-effectiveness of HCC surveillance.…”

Section: Discussionsupporting

confidence: 78%

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Hepatocellular Carcinoma in Oman: An analysis of 284 cases

Al-Naamani

Al-Hashami

Al‐Siyabi

et al. 2020

Sultan Qaboos Univ Med J

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Objectives: Hepatocellular carcinoma (HCC) is the most common type of primary liver tumour worldwide and is increasing in incidence. This study aimed to describe the clinical characteristics of HCC among Omani patients, along with its major risk factors, outcomes and the role of surveillance. Methods: This retrospective case-series study was conducted between January 2008 and December 2015 at the three main tertiary care hospitals in Oman. All adult Omani patients diagnosed with HCC and visited these hospitals during the study period were included. Relevant data were collected from the patients’ electronic medical records. Results: A total of 284 HCC patients were included in the analysis. The mean age was 61.02 ± 11.41 years and 67.6% were male. The majority had liver cirrhosis (79.9%), with the most common aetiologies being chronic hepatitis C (46.5%) and B (43.2%). Only 13.7% of cases were detected by the HCC surveillance programme. Approximately half of the patients (48.5%) had a single liver lesion and 31.9% had a liver tumour of >5 cm in size. Approximately half (49.2%) had alpha-fetoprotein levels of ≥200 ng/mL. The majority (72.5%) were diagnosed using multiphase computed tomography alone. Less than half of the patients (48.9%) were offered one or more HCC treatment modalities. Conclusion: The majority of Omani HCC patients were male and had cirrhosis due to viral hepatitis. In addition, few patients were identified by the national surveillance programme and presented with advanced disease precluding therapeutic or even palliative treatment.Keywords: Hepatocellular Carcinoma; Liver Cirrhosis; Human Viral Hepatitis; Public Health Surveillance; Early Detection of Cancer; Alpha-Fetoprotein; Oman.

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Section: Discussionsupporting

confidence: 78%

“…15 Moreover, prior to the introduction of mass hepatitis B vaccinations in 1990, the estimated prevalence of HBV was 2-7%. 16,17 Overall, HCC is ranked the fourth most common solid tumour among Omani male patients. 18 However, there is a lack of national data evaluating the characteristics of HCC cases.…”

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confidence: 99%

Hepatocellular Carcinoma in Oman: An analysis of 284 cases

Al-Naamani

Al-Hashami

Al‐Siyabi

et al. 2020

Sultan Qaboos Univ Med J

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“…In 1990, Oman implemented vaccination of all newborns according to the WHO recommendation [1] . The impact on vaccination efficacy and coverage was evaluated in 2005 in a nationwide survey, showing that 15 years after introduction of HBV vaccination of newborns the prevalence of CHB in children dropped from 2.3% in 1990 to 0.5% in 2005 [21] .…”

Section: Introductionmentioning

confidence: 99%

Molecular Epidemiology and Genotyping of Hepatitis B Virus of HBsAg-Positive Patients in Oman

Baqlani

Ratsch

et al. 2014

PLoS ONE

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BackgroundHepatitis B virus (HBV) infection is a major global health burden with distinct geographic public health significance. Oman is a country with intermediate HBV carrier prevalence; however, little is known about the incidence of HBV variants in circulation. We investigated the HBV genotype distribution, the occurrence of antiviral resistance, and HBV surface antigen (HBsAg) escape mutations in HBsAg-positive patients in Oman.MethodsSerum samples were collected from 179 chronically HBV-infected patients enrolled in various gastroenterology clinics in Oman. HBV genotypes were determined by sequencing and phylogenetic analysis. Mutations in the HBV polymerase and the HBsAg gene were characterized by mutational analysis.ResultsHBV genotypes D (130/170; 76.47%) and A (32/170; 18.28%) are predominant in Oman. The HBV genotypes C and E were less frequent (each 1.18%), while the HBV genotypes B, G, F, and H were not detected. Four patients revealed HBV genotype mixtures (HBV-A/D and D/C). The analyses of vaccine escape mutations yield that 148/170 (87.06%) HBV sequences were wild type. 22/170 (12.94%) HBV sequences showed mutations in the “a” determinant of the HBsAg domain. Two patients showed the described HBV vaccine escape mutation sP120T. 8/146 (5.48%) HBV isolates harbored mutations in the HBV polymerase known to confer resistance against antiviral therapy. Especially the lamivudine resistance mutations rtL180M/rtM204V and rtM204I were detected.ConclusionThis study shows the distribution of HBV genotypes, therapy resistance, and vaccine escape mutations in HBV-infected patients in Oman. Our findings will have a major impact on therapy management and diagnostics of chronic HBV infections in Oman to control HBV infection in this intermediate HBV-endemic country.

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“…Even with the lack of evidence of hepatitis B vaccination impact among card holders in this study, evidence from other studies has shown the significant impact of hepatitis B vaccination. [32][33][34] This study had several limitations. First, the rapid test used in this study has a reported sensitivity of 95%; therefore, the HBsAg prevalence in this study might be lower than the true seroprevalence.…”

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confidence: 99%

Hepatitis B Surface Antigen Seroprevalence Among Children in Papua New Guinea, 2012–2013

Kitau¹,

Datta²,

Patel³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Approximately 8% of the population in Papua New Guinea (PNG) has chronic hepatitis B virus (HBV) infection. To decrease the burden of chronic HBV infection, a national 3-dose infant hepatitis B vaccination program was implemented starting in 1989, with a birth dose (BD) added to the schedule in 1992. To assess the impact of the hepatitis B vaccination program, we conducted a serosurvey among children born after vaccine introduction. During 2012-2013, a cross-sectional stratified four-stage cluster survey was conducted to estimate hepatitis B surface antigen (HBsAg) prevalence among children 4-6 years of age. We collected demographic data, vaccination history, and tested children for HBsAg. Of 2,133 participants, 2,130 children had vaccination data by either card or recall: 28% received a BD; 81% received 3 vaccine doses. Of 2,109 children providing a blood sample, 60 (2.3%) tested positive for HBsAg. This is the largest, most geographically diverse survey of hepatitis B vaccination and HBsAg seroprevalence done in PNG. Progress has been made in PNG toward the Western Pacific Regional goal to reduce the prevalence of chronic HBV infection to 1% by 2017 among 5-year-old children. Vaccination efforts should be strengthened, including increasing BD coverage and completing the 3-dose series.

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Progress toward Elimination of Hepatitis B Virus Transmission in Oman: Impact of Hepatitis B Vaccination

Cited by 16 publications

References 8 publications

Hepatocellular Carcinoma in Oman: An analysis of 284 cases

Hepatocellular Carcinoma in Oman: An analysis of 284 cases

Molecular Epidemiology and Genotyping of Hepatitis B Virus of HBsAg-Positive Patients in Oman

Hepatitis B Surface Antigen Seroprevalence Among Children in Papua New Guinea, 2012–2013

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