METHODS: This prospective open-label single-arm observational clinical trial enrolled 41 patients who underwent liver transplantation between 2010 and 2016 because of a condition related to chronic HBV infection. At the time of enrollment, all patients had taken entecavir and discontinued HBIG administration. When hepatitis B surface antibody titer was undetectable after the withdrawal of HBIG, a recombinant HBV vaccine was injected intramuscularly at month 0, 1, and 6.
RESULTS: After excluding 5 patients who dropped out and 2 patients who had a persistent hepatitis B surface antibody titer, 9 (26.5%) of 34 patients had a positive vaccination response. The median hepatitis B surface antibody titer at seroconversion was 86 (12-1000) IU/L, and those at the end of follow-up were 216 (30-1000) IU/L. No patients experienced HBV recurrence during the study period. Sex (female, odds ratio 32.91 [1.83-592.54], P = .018) and the dosing interval of HBIG before withdrawal (≥90 days, 16.21 [1.21-217.31], P = .035) were independent contributing factors for positive response to the vaccination.
CONCLUSION: HBV vaccination still deserves consideration as active immunoprophylaxis after liver transplantation because it could provide added immunity to nucleoside/nucleotide analogs monotherapy with excellent cost-effectiveness.
MATERIALS AND METHODS: This retrospective cohort study was performed in a tertiary referral liver centre in Malaysia, using data from electronic medical record from January 2015 to December 2019. A total of 1457 medical records of female with HBV infection were screened. The inclusion criteria of the study were pregnant women with HBsAg positive or known to have HBV infection during the study period. We excluded patients with co-infections of other types of viral hepatitis or human immunodeficiency virus, concurrent liver diseases (e.g.: autoimmune hepatitis, Wilson’s disease), previous organ transplant and malignancy—except for hepatocellular carcinoma (HCC).
RESULTS: This study included 117 pregnancies and 21/117 (17.9%) were on antiviral therapy (AVT) for HBV. In 2017– 2019, 13/18 (72.2%) of those with HBV DNA >200,000IU/ml were on AVT, compared to 5/9 (55.6%) for 2015–2016, indicating 58% (95% CI −63% to 568%) higher odds of being on AVT in post GHSSVH group after accounting for HBV DNA.
CONCLUSION: Uptake of maternal AVT for the prevention of MTCT shows an increased trend since the introduction of GHSSVH, with room for improvement.
MATERIALS AND METHODS: This is a comparative crosssectional study using secondary data from the eNotifikasi system and hepatitis B case investigation forms between 2018 and 2022 from four district health offices in Pahang, Malaysia. Demographic data, hepatitis B vaccination status and risk factors were assessed. Data analysis employed were independent chi-squared tests, t-tests and binary logistic regression.
RESULTS: The study included 285 cases (141 indigenous and 145 non-indigenous). Among the indigenous cases, 72.3% were unvaccinated and 59.6% reported a history of infected mother, followed by percutaneous exposure, multiple sexual partners, and sharing syringe. The odds for those with a history of an infected mother being indigenous group is 2.5 times (95% CI: 1.4-4.4) compared to those with a history of an infected mother being non-indigenous group.
CONCLUSION: Significant difference exists in hepatitis B risk factors between indigenous and non-indigenous populations. The main risk factor for indigenous community is history of infected mother. Thus, the necessity of incorporating hepatitis B screening into the current practice of antenatal HIV screening, specifically targeting the indigenous community, should be given consideration.