Displaying publications 1 - 20 of 44 in total

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  1. André F
    Vaccine, 2000 Feb 18;18 Suppl 1:S20-2.
    PMID: 10683538
    Asia and Africa have previously been classified as areas of high endemicity for hepatitis B virus (HBV), but in some countries highly effective vaccination programmes have shifted this pattern towards intermediate or low endemicity. Thus, China is now the only country in Asia where HBV endemicity is high. Countries with intermediate endemicity include India, Korea, the Philippines, Taiwan and Thailand, and those with low endemicity include Japan, Pakistan, Bangladesh, Singapore, Sri Lanka and Malaysia. Most countries in Africa have high HBV endemicity, with the exceptions of Tunisia and Morocco, which have intermediate endemicity. Zambia has borderline intermediate/high endemicity. In the Middle East, Bahrain, Iran, Israel and Kuwait are areas of low endemicity, Cyprus, Iraq and the United Arab Emirates have intermediate endemicity, and Egypt, Jordan, Oman, Palestine, Yemen and Saudi Arabia have high endemicity. All of these Middle East countries reach a large proportion of their population with hepatitis B vaccination, which is reducing the infection rate, particularly in Saudi Arabia. The vaccination programme in Taiwan has also greatly reduced the HBV infection rate. Future vaccination programmes must take into account the mode of transmission of HBV, the healthcare infrastructure to deliver vaccination, and the socioeconomic and political factors in each individual country, to determine the most cost-effective way of infection control.
    Matched MeSH terms: Hepatitis B/epidemiology*
  2. Wait S, Kell E, Hamid S, Muljono DH, Sollano J, Mohamed R, et al.
    Lancet Gastroenterol Hepatol, 2016 11;1(3):248-255.
    PMID: 28404097 DOI: 10.1016/S2468-1253(16)30031-0
    In 2015, the Coalition to Eradicate Viral Hepatitis in Asia Pacific gathered leading hepatitis experts from Bangladesh, India, Indonesia, Malaysia, Pakistan, the Philippines, and Thailand to discuss common challenges to the burden posed by hepatitis B virus (HBV) and hepatitis C virus (HCV), to learn from each other's experience, and identify sustainable approaches. In this report, we summarise these discussions. Countries differ in their policy responses to HBV and HCV; however, substantial systemic, cultural, and financial barriers to achievement of elimination of these infections persist in all countries. Common challenges to elimination include limited availability of reliable epidemiological data; insufficient public awareness of risk factors and modes of transmission, leading to underdiagnosis; high rates of transmission through infected blood products, including in medical settings; limited access to care for people who inject drugs; prevailing stigma and discrimination against people infected with viral hepatitis; and financial barriers to treatment and care. Despite these challenges, promising examples of effective programmes, public-private initiatives, and other innovative approaches are evident in all countries we studied in Asia Pacific. The draft WHO Global Health Sector Strategy on Viral Hepatitis 2016-21 provides a solid framework upon which governments can build their local strategies towards viral hepatitis. However, greater recognition by national governments and the international community of the urgency to comprehensively tackle both HBV and HCV are still needed. In all countries, strategic plans and policy goals need to be translated into resources and concrete actions, with national governments at the helm, to enable a sustainable response to the rising burden of hepatitis B and C in all countries.
    Matched MeSH terms: Hepatitis B/epidemiology
  3. Roshan TM, Rosline H, Ahmed SA, Rapiaah M, Khattak MN
    PMID: 20578467
    Blood donors with reactive screening test results are requested to come in for counseling by letter and telephone call. It has been noticed many donors responded to neither the letters nor the telephone calls. We evaluated 589 cases with reactive screening test results (208 positive for hepatitis C, 209 for hepatitis B, 85 for VDRL and 87 for HIV). In the hepatitis C positive group 61 donors (29.3%) did not respond and 4.7% missed their follow-up appointment. Similarly low response rates were noted with the HBV (58.9%) and VDRL (67.1%) positive groups. Among HIV positive donors 46.0% failed to respond to multiple calls. We conclude that blood donors in Malaysia have a poor response to calls from the blood transfusion unit. A review of the effectiveness of the current deferral system and an increased public knowledge of transmissible infectious diseases may encourage blood donors to have a better response rate.
    Matched MeSH terms: Hepatitis B/epidemiology
  4. Yousuf R, Rapiaah M, Ahmed SA, Rosline H, Salam A, Selamah S, et al.
    PMID: 18613548
    The objective of this study was to determine the prevalence and trends in hepatitis B infection among blood donors attending the Transfusion Medicine Unit at the Hospital Universiti Sains Malaysia, Kelantan, Malaysia. A retrospective study was carried out by reviewing the results of HBsAg among blood donors for the years 2000 to 2004. During this period, 44,658 blood donors were studied. We noted that there was a significant difference in the prevalence of hepatitis B infection between regular and first time donors. There was also a decreasing trend noticed in both study groups. The mean prevalence was significantly different between first time (1.83%) and regular donors (0.45%) (p < 0.005). There is a need to improve public awareness programs to lower the incidence of hepatitis B infection in the general population and consequently first time blood donors. Future studies are also required to determine the trends and outcomes of these programs.
    Matched MeSH terms: Hepatitis B/epidemiology*
  5. Jamal R, Fadzillah G, Zulkifli SZ, Yasmin M
    PMID: 10772566
    Regular blood transfusions for patients with thalassemia have improved their overall survival although these transfusions carry a definite risk of the transmission of certain viruses. Infection with hepatitis B virus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV) and human immunodeficiency virus (HIV) leads to complications which contribute to the morbidity and mortality of patients with thalassemia. We analyzed the blood samples taken from 85 transfusion dependent thalassemics receiving treatment at the day care center in Hospital Universiti Kebangsaan Malaysia and found that the seroprevalence rates for HBV, HCV and CMV were 2.4%, 22.4% and 91.8% respectively. None of the patients tested positive for HIV. Those positive for HBV and HCV will require further tests and treatment if chronic hepatitis is confirmed.
    Matched MeSH terms: Hepatitis B/epidemiology
  6. Tan DS, Zaini Rahman M, Fang R, Collett D, Ooi BG
    PMID: 3538435
    Sera were obtained from 494 non-icteric patients admitted with illnesses other than overt hepatitis into the medical wards of the rural and urban hospitals in Malaysia. They were tested for HBsAg, HBeAg, and anti-HBs by enzyme immunoassay. The overall HBsAg carrier rate was 18.0% ranging from 9.6% in children, (10 years and under), to a maximum of 23.5% in the adolescents (11 to 20 years), the rates decreasing subsequently to 16.5% and 20.8% in the adult and middle-age groups, respectively. The Chinese (18.6%) and Malays (19.9%) had similar HBsAg carrier rates but the rate in the Indians (9.0%) was distinctly lower. Similar rates were observed in the males (16.5%) and the females (19.8%). The carrier rate was 17.1% in rural patients compared with 21.4% in the urban ones. The 'e' antigen was found in 14 of the 89 HBsAg carriers (15.7%). The overall prevalence was 14/494 (2.8%) rising sharply from childhood (2.9%) to adolescence (5.3%), subsequently declining with advancing age. The Chinese had the highest rate (6.2%) followed by the Indians (1.5%) and the Malays (1.1%). Males had a rate of 3.3% compared to the females with 2.3%. Anti-HBs was found in 33.8% of the patients, increasing steadily from childhood (18.3%) to middle-age (46.4%). The Chinese had a higher prevalence rate (41.6%) than the Indians (32.8%) and the Malays (29.3%). The rates were similar for the males (35.6%) and the females (31.5%). Rural patients (46.1%) had a higher rate than urban patients (35.7%). Both areas showed rising prevalence with increasing age.(ABSTRACT TRUNCATED AT 250 WORDS)
    Matched MeSH terms: Hepatitis B/epidemiology*
  7. Mangalam S, Tan DS, Vijayamalar B, Collett D, Fang R
    PMID: 3787308
    Sera from 200 Malaysian male drug abusers were tested for markers of Hepatitis B virus (HBV) infection, viz. HBsAg, HBeAg, anti-HBs and anti-HBc using commercially available enzyme immunoassay (EIA) kits supplied by Abbot Laboratories, Chicago. Of these, 103 (51.5%) were positive for at least one HBV marker, 11 (5.5%) were positive for HBsAg; 4 (2%) for HBeAg, 74 (37%) for anti-HBs and 85 (42.5%) for anti-HBc. The HBsAg carrier rate was roughly the same as the carrier rate in the general population of Malaysia. The majority of drug abusers (95%) have had subclinical, asymptomatic HBV infection. Racially the Malay drug abusers had the highest exposure rate (54.2%). The HBsAg carrier rate was highest in the Chinese drug abusers (15.3%) and lowest in the Indians (0%). The mean age for the HBsAg carriers was found to be 26 years with a mean duration of drug abuse of 72 months. The Malaysian Anti-Narcotics Task Force of the National Security Council reported in the Malay Mail (July 13, 1985) that there were about 106,000 identified drug abusers in Malaysia and that 63% of these were in the 20-29 age groups. It appears from our study that this age group also coincides with the period of high HBsAg carrier rate. Age wise, those less than 21 years old had the highest HBsAg (11%) and HBeAg (5.6%) prevalence rates indicating high infectivity. After the age of 30 years, nearly 50% of the drug abusers appear to be immune with the HBe prevalence of 0%.(ABSTRACT TRUNCATED AT 250 WORDS)
    Matched MeSH terms: Hepatitis B/epidemiology*
  8. Aurpibul L, Kariminia A, Vibol U, Fong MS, Le ON, Hansudewechakul R, et al.
    Pediatr Infect Dis J, 2018 Aug;37(8):788-793.
    PMID: 29846357 DOI: 10.1097/INF.0000000000001901
    BACKGROUND: Hepatitis B (HBV)-HIV coinfection is associated with liver inflammation, which can progress to liver fibrosis/cirrhosis and hepatocellular carcinoma. We determined HBV seroprevalence in children and adolescents participating in the TREAT Asia Pediatric HIV Observational Database.

    METHODS: A multisite cross-sectional study was conducted in HIV-infected patients currently <25 years old receiving antiretroviral treatment (ART) who had HBV surface antigen (HBsAg), or HBV surface antibody (anti-HBs) or HBV core antibody (anti-HBc) tested during 2012-2013. HBV coinfection was defined as having either a positive HBsAg test or being anti-HBc positive and anti-HBs negative, reflective of past HBV infection. HBV seroprotection was defined as having a positive anti-HBs test.

    RESULTS: A total of 3380 patients from 6 countries (Vietnam, Thailand, Cambodia, Malaysia, Indonesia and India) were included. The current median (interquartile range) age was 11.2 (7.8-15.1) years. Of the 2755 patients (81.5%) with HBsAg testing, 130 (4.7%) were positive. Of 1558 (46%) with anti-HBc testing, 77 (4.9%) were positive. Thirteen of 1037 patients with all 3 tests were anti-HBc positive and HBsAg and anti-HBs negative. One child was positive for anti-HBc and negative for anti-HBs but did not have HBsAg tested. The prevalence of HBV coinfection was 144/2759 (5.2%) (95% confidence interval: 4.4-6.1). Of 1093 patients (32%) with anti-HBs testing, 257 (23.5%; confidence interval: 21.0-26.0) had positive tests representing HBV seroprotection.

    CONCLUSIONS: The estimated prevalence of HBV coinfection in this cohort of Asian HIV-infected children and adolescents on ART was 5.2%. The majority of children and adolescents tested in this cohort (76.5%) did not have protective HBV antibody. The finding supports HBV screening of HIV-infected children and adolescents to guide revaccination, the use of ART with anti-HBV activity and future monitoring.

    Matched MeSH terms: Hepatitis B/epidemiology*
  9. Leung N
    Med J Malaysia, 2005 Jul;60 Suppl B:63-6.
    PMID: 16108176
    The association of hepatitis B virus (HBV) infection and liver cancer is well documented in epidemiological study. Patients with chronic hepatitis B have increased risk of hepatocelluar carcinoma (HCC), in particular those with active liver disease and cirrhosis. The incidence of HCC increases with age and is more common among male patients. The introduction of universal HBV vaccination program for the newborn in endemic regions has started to show beneficial impact. Taiwan introduced this program two decades ago and the incidence of liver cancer among infants and young children have declined significantly. The carcinogenic events leading to HCC are under intense research. A number of hypotheses have been proposed. HBV is not directly hepatotoxic but its interaction with the host immune system creates opportunity for HBV DNA integration into the host genome. One of the main foci of research is the HBX-encoded X protein. Its integration and protein expression impose alteration in cell proliferation cycle and apoptosis process. Many other factors may be involved including viral-induced alterations in p53 and telemerase, HBV genotypes, co-infection with HCV or delta agents, patient's lifestyle such as smoking, alcohol excesses, and genetic factors of the host patient. The processes of necroinflammation, cell proliferation and fibrosis facilitate the initial carcinogenic development. HCC surveillance with tumor markers such as alpha-foetal protein, decarboxylated prothrombin, in conjunction with imaging techniques has identified early small HCC that is amenable to curative therapy. Viral load has been correlated with increase risk of HCC. The available anti-viral agents have demonstrated clinical benefit among those with maintained and sustained response. Interferon and lamivudine therapy have demonstrated reduction of HCC among responders. However, they only constitute a minority proportion of treated patients. The mainstay of prevention should lie in prevention of HBV infection and early effective therapy of chronic hepatitis B infection.
    Matched MeSH terms: Hepatitis B/epidemiology*
  10. Ross IN, Dass PK, Thavarasah AS, Noor SS
    Med J Malaysia, 1988 Dec;43(4):278-83.
    PMID: 3241593
    Matched MeSH terms: Hepatitis B/epidemiology*
  11. Ross IN, Madhavan HN, Tan SH, Abdul Rahim K
    Med J Malaysia, 1985 Dec;40(4):301-6.
    PMID: 3025569
    Serological markers were used to determine the infective agents causing acute viral hepatitis in 246 patients. The frequencies of the five viral infections investigated were: non-A, non-B hepatitis - 99 patients (40.2%); hepatitis A - 98 patients (39.8%); hepatitis B - 43 patients (17.5%); cytomegalovirus - 4 patients (1.6%); and Epstein-Barr virus - 2 patients (0.8%). The log mean ages of presentation for the three predominant infections were: hepatitis A - 18 years; hepatitis B - 25 years; and non-A, non-B hepatitis - 30 years (F = 18.8, p =< 0.001). 52% of all cases were Malays (expected 32. 7%); 32% Chinese (expected 54.6%); and 16% Indians (expected 1l.5%) (X2 = 53, p = < 0.001). Hepatitis A virus infection was more common amongst Malays whilst non-A, non-B hepatitis was more frequent amongst Chinese and Indians. 28% of children <16 years) and 50% of adults had serological markers of previous hepatitis B infection. The variation in frequency for the different forms of hepatitis amongst the three main ethnic groups would suggest that socioeconomic and/or cultural factors are important in the propagation of acute viral hepatitis in Malaysia. HBsAg-negative chronic liver disease in our community may be a product of the high incidence of non-A, non-B hepatitis.
    Matched MeSH terms: Hepatitis B/epidemiology
  12. Chan WK, Yeoh KY, Lim CY, Lai SM, Lee JL, Leow AHR, et al.
    Med J Malaysia, 2018 06;73(3):137-140.
    PMID: 29962496 MyJurnal
    INTRODUCTION: There have been no published data on the transmission of hepatitis B virus (HBV) infection among children of hepatitis B surface antigen (HBsAg) positive mothers in Malaysia.

    METHODS: This is a cross-sectional study of all the children of HBsAg-positive mothers who delivered at the University of Malaya Medical Centre between 1993 and 2000.

    RESULTS: A total of 60 HBsAg-positive mothers and their 154 children participated in the study. HBsAg was detected in four children (2.6%) while IgG antibody to the hepatitis B core antigen (anti-HBc IgG) was detected in seventeen children (11.0%). The mother's age at childbirth was significantly lower in the children with detectable HBsAg (22.5±6.1 years vs. 29.7±4.5 years, p=0.043) and anti-HBc IgG (26.6±6.1 years vs. 30.0±4.3 years, p=0.004). Children born in the 1980s were significantly more likely to have detectable HBsAg (18.8% vs. 0.7%, p=0.004) and anti-HBc IgG (37.5% vs. 8.0%, p=0.000) compared with those born later. All children with detectable HBsAg were born via spontaneous vaginal delivery, and hepatitis B immunoglobulin was either not given or the administration status was unknown. The majority of mothers with chronic HBV infection (70.4%) were not under any regular follow-up for their chronic HBV infection and the main reason was the lack of awareness of the need to do so (47.4%).

    CONCLUSION: Transmission of HBV infection among children of HBsAg-positive mothers in Malaysia is low. However, attention needs to be given to the high rate of HBsAgpositive mothers who are not on any regular follow-up.

    Matched MeSH terms: Hepatitis B/epidemiology*
  13. Kamath S, Lopez CG
    Med J Aust, 1973 Nov 3;2(18):867-8.
    PMID: 4782397
    Matched MeSH terms: Hepatitis B/epidemiology*
  14. Yap SF
    Malays J Pathol, 2004 Jun;26(1):1-12.
    PMID: 16190102
    "Parenteral" or "serum" hepatitis is known to have afflicted man for centuries. However, it was not until the mid-1960s that the causative agent of this infection, the hepatitis B virus, was discovered. Since then, the biology and the replication strategy of the virus, and the clinical features and the epidemiology of the hepatitis B infection have been determined. Knowledge about the virus and the infection it causes led to the development of firstly, a plasma-derived vaccine and later a recombinant vaccine for the prevention of the infection. Integration of the hepatitis B vaccine into newborn vaccination programmes on a worldwide basis represents a major step in the effort to eliminate this infectious disease and its complications. Laboratory tests are available for the diagnosis and monitoring of the disease. Therapies have been developed to halt the progress of the chronic infection in affected individuals. While these developments have resulted in a decrease of the frequency of infection in many countries, particularly those that have implemented universal immunization of newborns, the chronic infection remains a significant global problem. Worldwide, over 300 million individuals are infected and each year, an estimated 1 million persons die from chronic complications of the disease including hepatocellular carcinoma and hepatic failure. The therapies currently available result in elimination of the virus in only a relatively small proportion of subjects and carry with it serious side effects. Geopolitical, economic and other factors hinder the vision of elimination of the infection through immunization programmes. Nevertheless, work continues to clarify further the underlying pathological mechanism of the infection, the host and viral factors that promote elimination or persistence of the virus in the human host. It is hoped that such investigations will reveal viral targets for the design of newer and potentially more effective drugs to treat the infection.
    Matched MeSH terms: Hepatitis B/epidemiology
  15. Lopez CG
    Malays J Pathol, 1985 Aug;7:7-10.
    PMID: 3843253
    Matched MeSH terms: Hepatitis B/epidemiology*
  16. Chan TT, Chan WK, Wong GL, Chan AW, Nik Mustapha NR, Chan SL, et al.
    Am J Gastroenterol, 2020 06;115(6):867-875.
    PMID: 32149781 DOI: 10.14309/ajg.0000000000000588
    OBJECTIVES: Previous exposure to hepatitis B virus (HBV) may increase the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C. We aim to study the impact of previous HBV infection on the severity and outcomes of patients with nonalcoholic fatty liver disease (NAFLD).

    METHODS: This was a multicenter study of 489 patients with biopsy-proven NAFLD and 69 patients with NAFLD-related or cryptogenic HCC. Antihepatitis B core antibody (anti-HBc) was used to detect the previous HBV infection.

    RESULTS: In the biopsy cohort, positive anti-HBc was associated with lower steatosis grade but higher fibrosis stage. 18.8% and 7.5% of patients with positive and negative anti-HBc had cirrhosis, respectively (P < 0.001). The association between anti-HBc and cirrhosis remained significant after adjusting for age and metabolic factors (adjusted odds ratio 2.232; 95% confidence interval, 1.202-4.147). At a mean follow-up of 6.2 years, patients with positive anti-HBc had a higher incidence of HCC or cirrhotic complications (6.5% vs 2.2%; P = 0.039). Among patients with NAFLD-related or cryptogenic HCC, 73.9% had positive anti-HBc. None of the patients had positive serum HBV DNA. By contrast, antihepatitis B surface antibody did not correlate with histological severity.

    DISCUSSION: Positive anti-HBc is associated with cirrhosis and possibly HCC and cirrhotic complications in patients with NAFLD. Because a significant proportion of NAFLD-related HCC may develop in noncirrhotic patients, future studies should define the role of anti-HBc in selecting noncirrhotic patients with NAFLD for HCC surveillance.

    Matched MeSH terms: Hepatitis B/epidemiology*
  17. Shamsuddin K, Marmuji LZ
    Singapore Med J, 2010 Oct;51(10):800-5.
    PMID: 21103816
    Several strategies have been developed to reduce hepatitis B infections. These include antenatal screening, universal immunisation of newborns and immunoglobulin therapy for babies who are at risk. Antenatal screening for hepatitis B is not routinely performed, but all newborns in Malaysia are immunised against hepatitis B. We assessed the prevalence of hepatitis B and the factors associated with it among antenatal mothers in Ipoh. This information is useful in decision-making for future hepatitis B screening programmes for antenatal mothers, allowing for immunoglobulin therapies for newborns if their mother's hepatitis B virus (HBV) status is known.
    Matched MeSH terms: Hepatitis B/epidemiology*
  18. Vadivale M, Tan TC, Ong CN
    Singapore Med J, 1992 Aug;33(4):367-9.
    PMID: 1411666
    Dental employees in government institutions in a State in Peninsular Malaysia were screened for exposure to hepatitis B virus (HBV) in 1989. Almost all (96.8%) of the 217 employees responded. One quarter (24.8%) was positive for at least one serological markers to HBV; 2.4% had hepatitis B surface antigen (HBsAg) and 22.4% had anti-body to HBsAg (anti-HBs). The presence of HBsAg was unrelated to age, sex, ethnicity, geographical locality and occupations of the subjects. The prevalence of anti-HBs increased with age and was highest for ethnic Chinese (53.6%), followed by Indians (25%), compared to Malays (14.9%) (p less than 0.001) and were increased among dentists (53.1%) and assistant nurses (33.3%). The overall prevalence of HBsAg and anti-HBs were similar to the situation in the community. However, dentists and their chairside assistant nurses, with a higher proportion of Chinese, had higher anti-HBs prevalences compared with that of the general population.
    Matched MeSH terms: Hepatitis B/epidemiology*
  19. Gan CY, Yap SF, Ngeow YF, Wong HC
    Sex Transm Dis, 1991 4 1;18(2):84-8.
    PMID: 1862464 DOI: 10.1097/00007435-199118020-00006
    This study documents the prevalence of Hepatitis B serological markers among STD patients who have had multiple sexual partners in Kuala Lumpur, Malaysia, and compares the rates with those of a sample of the population with single or no sexual partners. A total of 336 Chinese STD patients (multiple partners group) and 234 Chinese control subjects (non-multiple partner group) were screened. Those with a history of blood transfusion or parenteral drug abuse had been excluded from the study, and all study subjects were heterosexuals. The overall carrier rate was 9.2% for the multiple partner group (MP group) and 6.8% for the non-multiple partner group (NMP group). Infection rates were 64.3% for the MP-group and 38.9% for the NMP group. After adjustments for age and sex, there was no significant difference in carrier rates between the two groups, but infection rates were significantly different with the MP group, being 3.2 times more likely to acquire infection than the NMP group. The study concludes that in heterosexuals, those with multiple sexual partners have increased chances of acquiring HBV infection.
    Matched MeSH terms: Hepatitis B/epidemiology*
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