HBV prevention, elimination: 8 reports from 2017

The high curative rates of direct-acting antivirals have provided a course to potential elimination of hepatitis C within the coming decades. Physicians, however, have stressed that along that route, the prevalence of hepatitis B must not be forgotten or put aside.

The following reports focus on HBV prevalence rates, its priority among the medical industry and public as a major health threat, and recommendations for vaccination.

HBV: An underprioritized public health threat

Viral hepatitis kills thousands of people each year in the United States and causes more deaths worldwide than HIV, malaria and tuberculosis. Yet when experts traveled to Washington, D.C, last year to brief members of Congress about a national strategy to eliminate hepatitis B and C, they were met with a surprising lack of interest.

Just two people showed up for a briefing at which 30 or 40 lawmakers and staff would normally have been expected to attend, according to Brian L. Strom, MD, MPH, chancellor of Rutgers Biomedical and Health Sciences and chair of the Committee on a National Strategy for the Elimination of Hepatitis B and C. Read more

Low-income nations need greater health investments to eliminate HBV

Higher-income northern and western European countries ranked the highest on the United Nation’s health-related Sustainable Development Goals index in 2016 regarding the elimination of hepatitis B, according to an analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, or GBD. Countries that ranked the lowest were in sub-Saharan Africa.

“‘Leaving no one behind’ is the cornerstone of the Sustainable Development Goals (SDGs), the international development agenda formally adopted by the UN and its member states in September 2015. To deliver on this aim, it is essential to measure where advances have been achieved — and where challenges or new threats are occurring — through routinely updated, comparable monitoring and evaluation,” the researchers wrote. Read more

HBV while pregnant increases risk for HBV vaccination failure in newborns

Researchers observed a significant association between the presence of higher hepatitis B DNA at 28 to 30 weeks of gestation in pregnant women and immunoprophylaxis failure in newborns.

“The risk of vertical transmission leading to chronic infection is dramatically reduced by administering hepatitis B immunoglobulin (HBIG) to newborns at birth together with a complete course of HBV vaccination,” the researchers wrote. “A high maternal HBV DNA level during pregnancy is the strongest risk factor leading to immunoprophylaxis failure.” Read more

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Survey finds gaps in HBV, HCV testing guides, outcome data

The European Center for Disease Prevention and Control recently published results of two semi-structured surveys that found a wide variation in existing national testing policy and lack of monitored data for hepatitis B and hepatitis C in the EU/EEA member states.

“The purpose of this work was to provide a baseline situation assessment to inform the guidance development process and to assess the availability and feasibility of collecting additional morbidity and mortality data from EU/EEA Member States,” the researchers wrote. “As a subsidiary objective, the availability of information to monitor the HBV and HCV epidemic was assessed against the core indicators defined in the WHO Regional Action Plan for viral hepatitis.” Read more

Should all adults be vaccinated against HBV?

In the United States, universal hepatitis B vaccination is recommended for all infants beginning within 24 hours of birth and any unvaccinated children aged younger than 19 years. Vaccination is recommended only for certain adult populations at an increased risk for infection.

In light of the vaccine’s effectiveness and its importance in the national plan to eliminate HBV, Healio.com/Hepatology asked Robert G. Gish, MD, scientific and medical advisor to the Hepatitis B Foundation and principle of Robert G. Gish Consulting LLC, if all adults should be vaccinated against HBV. Read more

Multiple HBV vaccines superior for seroconversion failure in patients with IBD

Patients with inflammatory bowel disease who failed seroconversion following initial hepatitis B vaccine were more likely to achieve higher titer levels after three vaccine doses compared with those who received only one or two doses, according to a presentation at Digestive Disease Week.

The retrospective study comprised 149 patients seen in a large tertiary care facility between 2000 and 2014 who had a diagnosis of either Crohn’s disease or ulcerative colitis and had inadequate baseline HBsAb titers following prior vaccination. Mean age was 46 years, 63% were older than 40 years, 54% were women, 78% were white, mean BMI was 28 kg/m² and approximately 73% had CD compared with patients who had UC. Read more

More than one - third of US patients with HIV do not receive HBV vaccination

In the United States, more than one-third of patients with HIV did not initiate vaccination for hepatitis B virus despite their higher risk for infection, according to data published in Annals of Internal Medicine.

“Persons with HIV infection are at increased risk for hepatitis B virus infection,” John Weiser, MD, MPH, from the CDC, and colleagues wrote. “In 2016, the World Health Organization resolved to eliminate hepatitis B as a public health threat by 2030.” Read more

Autotaxin accurate, noninvasive biomarker for fibrosis in chronic HBV

Serum autotaxin was an accurate, noninvasive biomarker for liver fibrosis among patients with chronic hepatitis B in a recently published study.

“Serum autotaxin (ATX) has recently been reported as a novel marker candidate to assess liver fibrosis. ATX was originally isolated from the conditioned medium of A2058 human melanoma cells as a potent cell motility-stimulating factor,” Satoru Joshita, MD, from the division of gastroenterology and hepatology at Shinshu University of Medicine, Japan, and colleagues wrote. “As the clinical features of ATX in patients with hepatitis B remain unknown, this study evaluated the performance of serum ATX in predicting histological fibrosis in chronic HBV infection.” Read more