Prevalence of hepatitis A, B and C in the Flemish population

Viral hepatitis is a serious health problem throughout the world. No recent prevalence data on hepatitis A, B and C were available for the population in Flanders, Belgium. For this reason, a sero-epidemiological study was undertaken in 1993–1994 in a sample of the general population. The purpose of this study was to obtain a clear picture of the prevalence of hepatitis A, B and C. Between April 1993 and February 1994, 4,058 blood samples were drawn and collected in 10 hospitals in Flanders. The study group was representative for the Flemish population. For hepatitis A a seroprevalence of 55.1% was found. In the non-Belgian residents the HAV prevalence was significantly higher than in Belgians (62% versus 52%; ² = 8.05; p = 0.005). For hepatitis B, 9.9% of the study group showed serological evidence of hepatitis B markers: 6.9% of the participants was positive for anti-HBs/anti-HBc, 0.7% appeared to be HBsAg positive and 3.5% was solely anti-HBs positive. The prevalence of HBV markers in Belgians was 6.9%, significantly lower compared to the 13.4% among non-Belgians (² = 14.05; p = 0.00018). 4055 serum samples were analysed for hepatitis C serology by second generation anti-HCV tests. Anti-HCV was detected in 0.87% of the serum samples. No statistically significant difference was found in HCV prevalence between Belgians and non-Belgians. Results of this study should help policy makers in their decisions on the most appropriate hepatitis A and B vaccination strategy and on the most effective prevention strategy for hepatitis C.     

Seroprevalence of hepatitis A, B and C markers in Greek warship personnel

A seroepidemiological study was conducted to assess the seroprevalence of hepatitis A, B and C markers in 285 males (mean age: 24.4 ± 4.4 years) aboard a Greek warship. Two hundred and sixty three serum samples were tested. None was found to be positive for HAV antibodies, three persons (1.1%) were positive for HBsAg, four persons (1.5%) were positive for anti-HBc and one person (0.4%) was positive for anti-HCV. Forty-five persons (17.1%) had developed titles anti-HBs >10 IU/L. The establishment of a vaccination policy against hepatitis A among warship personnel is strongly recommended.     

Prevalence of markers for hepatitis A, B and C in the German population. Results of the German National Health Interview and Examination Survey 1998

The prevalence of serological parameters indicative of infection with hepatitis A, B and C was determined using sera collected from representative population samples in the former East German (new) federal states and the West German (old) federal states during the German National Health and Examination Survey in 1998. Sera were tested for antibodies to hepatitis A virus (HAV), to hepatitis B core antigen (HBc) and to hepatitis B surface antigen (HBsAg), hepatitis C Virus (HCV), as well as for the presence of HBsAg and HCV-RNA. The mean weighted prevalence of anti-HAV was 46.5% (95% CI: 45.3–47.7) and increased markedly with age. The mean weighted prevalence of past infection with hepatitis B was 7.7% (95% CI: 7.0–8.4) in the old federal states and 4.3% (95% CI: 3.2–5.3) in the new federal states, corresponding to an overall prevalence of 7.0% (95% CI: 6.4–7.6). The mean weighted prevalence of HBsAg carriage was 0.6% (95% CI: 0.4–0.8), while the prevalence of HCV antibodies was 0.4% (95% CI: 0.2–0.5).     

Prevalence of antibodies to hepatitis A among children and adolescents in Larnaca area, Cyprus

The prevalence of antibodies to hepatitis A virus was investigated in 385 children and adolescents (52.2% males), aged 6 to 18, in the Larnaca area of Cyprus. This is the first study investigating the prevalence of hepatitis A in Cyprus for this age group. The population was stratified into two groups: 6 to 12 years old and 13 to 18 years old. None of the subjects in the first group were positive. The prevalence of hepatitis A in the age of group 13 to18 was 1.6%. In conclusion, the low prevalence of anti-HAV demonstrates the susceptibility of young Cypriots to hepatitis A. This is a cause for concern as these unprotected young adults are frequently exposed to potentially infected individuals.     

Hepatitis B and C virus infections in Turkish children with cancer

In this study, we tested 137 Turkish children with cancer (51 with acute leukemia, 48 with lymphoma, 38 with solid tumors) while they were undergoing chemotherapy, and a control group of 45 for evidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections using the enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). The control group included children with other disease who had applied to the outpatient clinic during the study period and had no history of jaundice or transfusion. Sixty-five (47.4%) patients with cancer and 7 (20%) children in the control group were positive for hepatitis B surface antigen (HBsAg) (p < 0.01). HBV DNA was detected in 59 (43.1%) patients and in 9 (20%) controls (p < 0.01). HCV specific antibody (anti-HCV) was detected in 8 (5.8%) patients and in 1 (2.2%) control (p > 0.05). Eight patients (5.8%) had circulating HCV RNA, but none had in the control group (p = 0.09). Ten (13.9%) of the 72 patients who were negative for HBsAg had circulating HBV DNA, and 7 (5.4%) of the 129 patients who were negative for anti-HCV had circulating HCV RNA. We concluded that HBV and HCV infections are common among Turkish children with cancer. In countries where HBV infection is widespread among the general population as in Turkey, children with cancer are under greater risk for HBV infection.     

A population-based prevalence study of hepatitis A, B and C virus using oral fluid in Flanders, Belgium

Ten years after the first seroprevalence study performed in Flanders, the aim of this cross sectional study was to follow the evolution of hepatitis A, B and C prevalence. The prevalence of hepatitis A antibodies, hepatitis B surface antigen and hepatitis C antibodies was measured in oral fluid samples collected by postal survey. Using the National Population Register, an incremental sampling plan was developed to obtain a representative sampling of the general population. A total of 24,000 persons were selected and 6,000 persons among them contacted in a first wave. With 1834 participants a response rate of 30.6% was achieved. The prevalence was weighted for age and was 20.2% (95% CI 19.43–21.08) for hepatitis A, 0.66% (95% CI 0.51–0.84) for hepatitis B surface antigen and 0.12% (95% CI 0.09–0.39) for hepatitis C. The prevalence of hepatitis A and C in the Flemish population is lower in 2003 compared with the results of the study performed in 1993. The difference may be due to a real decrease of the diseases but also to differences in the methodology. The prevalence of hepatitis B surface antigen remains stable. Considering the 30% response rate and the high quality of the self-collected samples as reflect of a good participation of the general population, saliva test for prevalence study is a good epidemiological monitoring tool.     

Hepatitis B and C markers among alcoholics in Israel: High incidence of HCV infection

Patients with alcoholic liver disease have an increased prevalence of viral hepatitis. However, the role of demographic characteristics has not been adequately delineated. Therefore, we examined and compared the seroprevalences of hepatitis B and C in Israeli alcoholic patients to that of blood donors control group by their country of birth and origin. Hepatitis B surface antigen, hepatitis B core antibody and hepatitis C virus antibody testing (second generation ELISA) and a confirmatory recombinant immunoblot assay was performed on 496 alcoholic attending an alcoholic abstinence program and compared to 193,806 randomly non-alcoholic blood donors on the basis of their country of birth. Three hundred twenty-eight alcoholic patients (66%) were immigrants and Israeli born Jews and 168 (34%) were Israeli Arabs. Of the 496 alcoholic patients, 24 (4.8%) were HBsAg positive, 38 (7.6%) were anti HCV positive, and 2 (North African Jews) were positive for both markers. HBsAg was detected in 13 (3.9%) immigrant and Israeli Jews and 11 (6.5%) Israeli Arabs, significantly higher than in the adjusted non alcoholic blood donors (p < 0.01). Anti-HCV was detected in 33 (10%) immigrants and Israeli Jews and 5 (2.9%) Israeli Arabs, significantly higher than in the control group (p < 0.005). In the subgroup alcoholic Jews there was no significant difference in hepatitis B seropositivity among alcoholic that were native Israeli, Eastern Europe and former USSR, and western Europe and American immigrants comparing to the control group. In contrast, anti-HCV recombinant immunoblot assay seropositivity in alcoholic Jews from all subgroups was significantly greater than in non alcoholic blood donors (p < 0.001). Odds analysis of all ethnic groups revealed that alcoholism requiring detoxification have a significant risk factor for hepatitis C more than hepatitis B (p < 0.001). The increased seroprevalence of hepatitis C among Israeli alcoholic patients, regardless their country of birth and origin, suggest that alcoholism is likely to have a predisposing factor for HCV infection.     

Prevalence of hepatitis B,hepatitis C,syphilis and HIV in Georgian blood donors

Prevalence of human immunodeficiency (HIV), hepatitis B (HBV), hepatitis C (HCV) virus and syphilis in the population of blood donors in Georgia has been investigated. Out of 4970 donors 7.3% had anti-HCV (6.9% confirmed), HbsAg was positive in 4.1% (3.4% confirmed), Seroprevalence of Syphilis was 2.3%. Three individuals had HIV. Prevalence of HCV and HBV in Georgia is higher than national prevalence estimates of viral hepatitis in neighboring countries.     

Prevalence of hepatitis C infection among general practice patients in the Lyon area, France

Study objective: To estimate the prevalence of hepatitis C virus (HCV) infection among patients in general practices. Design and Participants: A screening campaign requested by the French Health Insurance Fund and involving 271 general practitioners (GPs) and 96% of the 95 medical laboratories was conducted in the Lyon area. Each GP participated for one week and offered an HCV screening to all patients aged 18–69 years during this period. Risk factors were estimated by a medical questionnaire (MQ) filled in by the physician. Main results: From May to October 1997, 11,805 subjects were recruited into the study. Among them, 101 were known HCV positive. The MQ was filled up in 86% of the 11,704 remaining patients. Only 59% of those (6876/11,704) went to a laboratory to be tested. Fifty-one were ELISA positive of whom 30 were confirmed by RIBA or PCR. If we add 101 patients that were known HCV positive and estimate the prevalence among patients who did not go to the laboratory, this study gives a total estimated prevalence of 1.3%. Conclusions: The prevalence of HCV infection among patients of GPs is about 1.3%, very close to the estimate in the French general population. The substantial number of patients known HCV positive is probably related to the participation of GPs sensitised to HCV issues and who already have screened most of their HCV patients.     

Hepatitis B,C, and D Virus Infections and AFP Tumor Marker Prevalence Among the Elderly Population in Mongolia: A Nationwide Survey

ObjectivesInfections with hepatitis B, C, and D virus (HBV, HCV, and HDV) are a major public health problem and lead to serious complications such as cirrhosis and hepatocellular carcinoma. We aimed to determine the seroprevalence of hepatitis B surface antigen (HBsAg), anti-HCV, anti-HDV immunoglobulin G, alpha-fetoprotein (AFP), and dual and triple hepatitis virus infections in Mongolia.MethodsA total of 2313 participants from urban and rural regions were randomly recruited for this cross-sectional study. A questionnaire was used to identify the risk factors for hepatitis virus infections, and the seromarkers were measured using immunoassay kits.ResultsAmong all participants, the prevalence of HBV, HCV, and HDV was 15.6%, 36.6%, and 14.3%, respectively. The infection rates were significantly higher in females and participants with a lower education level, rural residence, older age, and a history of blood transfusion. HBV and HCV co-infection was found in 120 (5.2%) participants and HBV, HCV, and HDV triple infection was detected in 67 (2.9%) participants. The prevalence of elevated AFP was 2.7%, 5.5%, and 2.6% higher in participants who were seropositive for HBsAg (p=0.01), anti-HCV (p<0.001), and anti-HDV (p=0.022), respectively. Elevated AFP was more prevalent in participants co-infected with HBV and HCV (5.8%, p=0.023), HBV and HDV (6.0%, p<0.001), and triple-infected with HBV, HCV, and HDV (7.5%) than in uninfected individuals.ConclusionsNearly half (49.8%) of the study population aged ≥40 years were infected with HBV, HCV, or HDV, and 22.4% had dual or triple infections.     

山西有偿献血地区某村HBV、HCV、HIV感染现状分析

目的了解山西省农村有偿献血地区HBV、HCV、HIV感染状况及有偿献血对其分布的影响.方法对某村的946名20～65岁居民进行调查,采用ELISA法分别检测血清中HBsAg、HBsAb、HBeAg、HBeAb、anti-HCV和HIV抗体.结果HIV抗体全为阴性,HBsAg、HBsAb、HBeAg、HBeAb、anti-HCV的阳性率分别为5.3%、54.5%、2.5%、22.5%、1.7%;其中有偿献血人员108名,相应的阳性率分别为0.9%、63.9%、0.9%、18.5%、4.6%,从未有偿献血人员838名,相应的阳性率分别为5.8%、53.3%、2.7%、23.0%、1.3%.与未有偿献血的研究对象相比,曾经有偿献血的研究对象HBsAg、HBsAb和anti-HCV的阳性率差异有显著性.结论该村未发现HIV感染者,HBV、HCV感染与其他地区无明显不同,有偿献血人员HCV感染率较高.     

肿瘤患者肝炎病毒感染分析

目的以2070例肿瘤患者为研究对象,分析其乙型肝炎(HBV)及丙型肝炎(HCV)感染率,研究HBV及HCV感染与恶性肿瘤的关系。方法采用回顾性分析方法,按肿瘤类别、年龄和性别进行分组,对检测结果进行统计分析。结果肝癌的HBV、HCV及混合感染的感染率最高,分别为82.87%、6.71%和4.86%;45～55岁年龄段HBV及HCV单项感染率最高,为22.26%、3.71%;而55～65岁年龄段HBV及HCV混合感染率最高,为2.91%;肝癌及胃癌HBV和HCV单项感染率男性高于女性,而肺癌及结肠癌HBV及HCV单项感染率男性低于女性,肝癌及结肠癌的HBV及HCV混合感染率男性高于女性,肺癌及胃癌则男性低于女性。结论肝癌的HBV、HCV及混合感染的感染率最高;在HBV及HCV单项感染情况下,45～55岁年龄段感染率最高并且男性高于女性。     

清远市不同人群艾滋病、梅毒、丙型肝炎、乙型肝炎感染状况调查

目的了解清远市不同人群艾滋病、梅毒、丙型肝炎、乙型肝炎感染状况,为制定艾滋病等传染病预防控制策略提供科学依据。方法2005年1月—2009年5月分别对清远市辖戒毒所吸毒人群、英德监狱服刑人员、清远市区从事商业性活动的性服务工作者及从事餐饮、旅业、桑拿按摩、美容美发行业的从业人员进行问卷调查,同时抽取血标本进行HIV抗体、梅毒抗体、HCV抗体、HBsAg血清学检测。结果调查和检测不同人群共11229人,HIV抗体、梅毒抗体、HCV抗体、HBsAg总体阳性率分别为0.43%、1.59%、8.71%、5.15%;其中吸毒人群1073人,阳性率分别为3.08%、9.97%、45.01%、22.93%;监狱服刑人群4973人,阳性率分别为0.30%、0.62%、9.63%、2.03%;性服务人群551人,阳性率分别为0、3.63%、1.81%、3.81%;从业人群4632人,阳性率分别为0、0.45%、0.13%、4.53%。结论清远市吸毒人群和监狱服刑人群有较高的艾滋病、梅毒、丙型肝炎和乙型肝炎的感染率;性服务人群有较高的梅毒感染率;静脉吸毒者和性乱是艾滋病等传染病感染的主要因素;应加强对吸毒人群、监狱服刑人群、性服务人群的疾病监测、宣传及行为干预,继续加强对从业人员的卫生监督。     

Prevalence of Hepatitis C Infection in New York City, 2004

Hepatitis C virus (HCV) is the leading cause of chronic liver disease in the United States. Accurate hepatitis C prevalence estimates are important to guide local public health programs but are usually unavailable to local health jurisdictions. National surveys may not reflect local variation, a particular challenge for urban settings with disproportionately large numbers of residents in high-risk population groups. In 2004, the New York City Department of Health and Mental Hygiene conducted the NYC Health and Nutrition Examination Survey, a population-based household survey of non-institutionalized NYC residents ages 20 and older. Study participants were interviewed and blood specimens were tested for antibody to HCV (anti-HCV); positive participants were re-contacted to ascertain awareness of infection and to provide service referrals. Of 1,786 participants with valid anti-HCV results, 35 were positive for anti-HCV, for a weighted prevalence of 2.2% (95% confidence interval [CI] 1.5% to 3.3%). Anti-HCV prevalence was high among participants with a lifetime history of injection drug use (64.5%, 95% CI 39.2% to 83.7%) or a lifetime history of incarceration as an adult (8.4%, 95% CI 4.3% to 15.7%). There was a strong correlation with age; among participants born between 1945 and 1954, the anti-HCV prevalence was 5.8% (95% CI 3.3% to 10.0%). Of anti-HCV positive participants contacted (51%), 28% (n = 5) first learned of their HCV status from this survey. Continued efforts to prevent new infections in known risk behavior groups are essential, along with expansion of HCV screening and activities to prevent disease progression in people with chronic HCV.     

河北省某献血村村民丙型肝炎病毒流行状况调查及危险因素分析

丙型肝炎病毒(HCV)主要经血液传播。在我国《献血法》颁布之前的20世纪80—90年代初，农村地区非法卖血现象十分普遍，多地献血人群因此引起严重的血源性HCV感染。     

Decline of hepatitis B infection in Greece

Hepatitis B has long been a serious public health problem in Greece. In recent years, a decline in hepatitis B infection is observed ascribable to many factors such as demographic and socioeconomic changes, medical precautions, use of disposable medical equipments, screening of blood donors and vaccination. We studied the prevalence of HBV infection in a sample of 1050 Greek male Navy recruits. 343 subjects (32.6%) had previously been vaccinated and were anti-HBs positive. We observed that during the last decade, the prevalence of immunes declined to 1.33% and the prevalence of any HBV marker declined to 2.28%. The HBsAg carrier rate declined from 3.9% in 1973 to 0.9% in 1986. Since then, it is stable at 0.95% because perinatal and vertical transmissions are still responsible for the majority of HBV chronic infections. Universal prenatal screening and infant immunization will contribute to a further decline of HBV infection.     

Prevalence,risk factors and evaluation of a screening strategy for chronic hepatitis C and B virus infections in healthy company employees

A cross-sectional study was carried out in employees of 17 Greek companies with the aim of assessing the prevalence of hepatitis B (HBV) and hepatitis C (HCV) virus, identifying associated prognostic/risk factors and evaluating the effectiveness of a questionnaire as a pre-screening tool. All participants were asked to complete a questionnaire and a random sample of them was asked to provide a blood sample for hepatitis B core antibody (anti-HBc), hepatitis B surface antigen (HBsAg) and antibodies to hepatitis C (anti-HCV) testing. Individual questions or combinations of them were evaluated in terms of their ability to detect HBV or HCV(+) cases. Of 9085 eligible employees, 6074 (67%) completed the questionnaire. Of 990 samples obtained, 19.9% were anti-HBc(+), 2.6% HBsAg(+) and 0.5% anti-HCV(+). All anti-HCV(+) cases had multiple parenteral risk factors. Multiple logistic regression identified associations between anti-HBc and older age, family members with chronic hepatitis, job category and history of transfusion before 1992. HBsAg(+) was associated with older age and history of transfusion before 1992. None of the risk/prognostic factors had sufficient sensitivity and specificity for HBV but report of at least one risk factor identified all HCV(+) cases. Anti-HCV screening of those with at least two parenteral risk factors not only identified all anti-HCV(+) cases but also resulted in 86% decrease in the screening cost. Under the light of recent treatment advances, targeted questionnaire-based screening of asymptomatic people may prove to be a cost-effective way to face hepatitis C.     

健康幼儿甲型肝炎灭活疫苗及甲乙型肝炎联合灭活疫苗再免疫血清学效果及安全性研究

目的评价甲型肝炎（甲肝）灭活疫苗（Hepatitis A Vaccine,Inactivated;HepA—I）和甲乙型肝炎联合灭活疫苗（Hepatitis A and B Combined Vaccine,Inactivated;HepAB—I）一剂再免疫的血清学效果和安全性。方法采用开放式临床研究设计,选择210名已经完成乙型肝炎（乙肝）疫苗（Hepatitis B Vaccine,HepB）全程免疫、且接种甲肝减毒活疫苗（Hepatitis A Attenuated Live Vaccine,HepA-L）≥6个月的24-38月龄儿童,分为2个试验组,分别接种1剂HepA—J和HepAB—I,并在免疫前和免疫后1个月,对受试者采血检测抗甲肝病毒抗体（Antibodyto Hepatitis A Virus,Anti—HAV）与抗乙肝病毒表面抗原抗体（Antibodvto Hepatitis B Virtus Surface Antigen,Anti-HBs）,并对受试者连续3d测体温,并观察可能发生的任何临床症状和随访,以评价两种疫苗的安全性。结果HepA—I组受试者再免疫1个月后,Anti—HAV阳性[≥20毫国际单位（mIU）／毫升（ml）]率由免疫前的95．1％上升到100．0％,几何平均浓度（Geometric Mean Concentration,GMC）由免疫前的124．41mIU／ml上升到7269.31mIU／ml,增长55．74倍。HepAB—I组,Anti—HAV阳性率由免疫前的88．8％上升到98．9％,GMC由免疫前的98．03mIU／ml上升到5174．76mlU／ml,增长58．35倍。HepAB—I组Anti—HBs阳性[≥10mIU／m1]率由免疫前的72．9％上升到97．8％;GMC由免疫前的22．20mlU／ml上升到1226．14mIU／ml,增长54．49倍。此次试验共观察到12例不良反应,均为发热,发生率为5．7％;未发现其他不良反应。结论在健康幼儿再免疫1剂HepA—I、HepAB—I后,血清学效果和安全性良好。     

Prevalence of hepatitis B and C viruses infection in chronic alcoholics with or without liver disease in Ioannina, Greece: Low incidence of HCV infection

Intravenous heroin abusers comprise a high risk group for hepatitis B and C viruses (HBV and HCV) infection. Chronic alcoholics with liver disease (LD) also comprise a high risk group for HBV infection whereas the frequency of antibodies to HCV (anti-HCV) ranges from 27–42.6%. In this study, HBV and HCV infection markers were determined in alcoholic patients with (83 patients) or without LD (68 patients) in order to assess the prevalence of these markers (HBsAg, HBsAb, HBcAb and anti-HCV). The reason for the study was a lack of established data in this group of patients in Greece. The disease control groups consisted of 70 non-alcoholic hospitalized patients and 60 heroin addicts, whereas 1342 healthy blood donors were also investigated. Our results showed significantly increased prevalence of HBV infection markers in chronic alcoholic patients compared to healthy controls and non-alcoholic hospitalized patients. The findings were independent of the presence or absence of LD. In contrast to heroin addicts, where anti-HCV antibodies were observed in 90%, there was no difference in the prevalence of anti-HCV antibodies in chronic alcoholics (with or without LD), nonalcoholic hospitalized patients or healthy controls. In conclusion, we found that in this area of northwestern Greece, chronic alcoholics, independent of the presence of LD, comprise a high risk group for HBV infection but very rarely have HCV infection. The latter finding may reflect technical or socioeconomic differences regarding the lifestyle of our patients, and our population in general.