Displaying publications 21 - 40 of 294 in total

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  1. Lim CK, Tan JT, Khoo JB, Ravichandran A, Low HM, Chan YC, et al.
    Int J Med Sci, 2006;3(1):14-20.
    PMID: 16421626
    This study was carried out to determine the effects of hepatitis B virus genotypes, core promoter mutations (A1762G1764-->T1762A1764) as well as precore stop codon mutations (TGG-->TAG) on HBeAg expression and HBeAg/ anti-HBe status. Study was also performed on the effects of codon 15 variants (C1858/ T1858) on the predisposition of precore stop codon mutations (TGG-->TAG). A total of 77 sera samples were analyzed. Fifty one samples were successfully genotyped of which the predominant genotype was genotype B (29/ 51, 56.9 %), followed by genotype C (16/ 51, 31.4 %). Co-infections by genotypes B and C were observed in four samples (7.8 %). To a lesser degree, genotypes D and E (2.0 % each) were also observed. For core promoter mutations, the prevalence was 68.8 % (53/ 77) for A1762G1764 wild-type and 14.3 % (11/ 77) for T1762A1764 mutant while 9.1 % (7/ 77) was co-infected by both strains. The prevalence of codon 15 variants was found to be 42.9 % (33/ 77) for T1858 variant and 16.9 % (13/ 77) for C1858 variant. No TAG mutation was found. In our study, no associations were found between genotypes (B and C) and core promoter mutations as well as codon 15 variants. Also no correlation was observed between HBeAg/ anti-HBe status with genotypes (B and C) and core promoter mutations.
    Matched MeSH terms: Hepatitis B Antibodies; Hepatitis B e Antigens; Hepatitis B virus
  2. Hudu SA, Harmal NS, Saeed MI, Alshrari AS, Malik YA, Niazlin MT, et al.
    Eur J Clin Microbiol Infect Dis, 2015 Jul;34(7):1349-59.
    PMID: 25792010 DOI: 10.1007/s10096-015-2358-1
    Hepatitis B virus surface mutants are of enormous importance because they are capable of escaping detection by serology and can infect both vaccinated and unvaccinated populations, thus putting the whole population at risk. This study aimed to detect and characterise hepatitis B-escaped mutants among blood donors and vaccinees. One thousand serum samples were collected for this study from blood donors and vaccinees. Hepatitis B surface antigen, antibodies and core antibodies were tested using a commercial enzyme-linked immunosorbent assay (ELISA) kit. DNA detection was performed via nested polymerase chain reaction (PCR), and the S gene was sequenced and analysed using bioinformatics. Of the 1,000 samples that were screened, 5.5% (55/1,000) were found to be HBsAg-negative and anti-HBc- and HBV DNA-positive. All 55 isolates were found to belong to genotype B. Several mutations were found across all the sequences from synonymous and non-synonymous mutations, with the most nucleotide mutations occurring at position 342, where adenine was replaced by guanine, and cytosine at position 46 was replaced by adenine in 96.4% and 98% of the isolates, respectively. Mutation at position 16 of the amino acid sequence was found to be common to all the Malaysian isolates, with 85.7% of the mutations occurring outside the major hydrophilic region. This study revealed a prevalence of 5.5% for hepatitis B-escaped mutations among blood donors and vaccinated undergraduates, with the most common mutation being found at position 16, where glutamine was substituted with lysine.
    Matched MeSH terms: Hepatitis B/epidemiology*; Hepatitis B/prevention & control; Hepatitis B/virology*; Hepatitis B Surface Antigens/genetics*; Hepatitis B Surface Antigens/immunology; Hepatitis B virus/genetics*; Hepatitis B virus/immunology; Hepatitis B Vaccines/immunology
  3. Rasuli R, Mohamad M, Yaacob SS
    Med J Malaysia, 2023 Dec;78(7):883-889.
    PMID: 38159922
    INTRODUCTION: Despite substantial progress in reducing hepatitis B prevalence in the general population, the indigenous population in Malaysia continues to face a significant burden of infection, with high seroprevalence rates. It is hypothesised that transmission patterns differ between the indigenous and non-indigenous populations. This study aimed to compare key risk factors for hepatitis B transmission in indigenous and non-indigenous cases.

    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.

    Matched MeSH terms: Hepatitis B Surface Antigens*; Hepatitis B virus
  4. Sinniah M, Halimah M, Krishnamurthy T, Lye MS, Choo CH, Shamsiah I
    Med J Malaysia, 1994 Dec;49(4):336-40.
    PMID: 7674968
    Immunisation of health care workers and staff working in laboratory and hospital settings has been implemented since 1988. However due to the high cost of currently available HBV vaccine, many health personnel outside the Ministry of Health are not being immunised. This study sought to determine the immunogenicity of three doses of a low cost plasma-derived Korean HBV vaccine on employees of an institute for mentally handicapped and their spouses and children. We found that the Hepatitis B Vaccine-KGCC to be safe and immunogenic. The response to 10 mcg and 20 mcg Hepatitis B Vaccine-KGCC after third dose was good with 100% seroconversion.
    Matched MeSH terms: Hepatitis B Antibodies/analysis*; Hepatitis B Vaccines/immunology*
  5. Azmi AN, Tan SS, Mohamed R
    World J Gastroenterol, 2014 Sep 14;20(34):12045-55.
    PMID: 25232242 DOI: 10.3748/wjg.v20.i34.12045
    The natural history of chronic hepatitis B is characterized by different phases of infection, and patients may evolve from one phase to another or may revert to a previous phase. The hepatitis B e antigen (HBeAg)-negative form is the predominant infection worldwide, which consists of individuals with a range of viral replication and liver disease severity. Although alanine transaminase (ALT) remains the most accessible test available to clinicians for monitoring the liver disease status, further evaluations are required for some patients to assess if treatment is warranted. Guidance from practice guidelines together with thorough investigations and classifications of patients ensure recognition of who needs which level of care. This article aims to assist physicians in the assessment of HBeAg-negative individuals using liver biopsy or non-invasive tools such as hepatitis B s antigen quantification and transient elastography in addition to ALT and hepatitis B virus DNA, to identify who will remain stable, who will reactivate or at risk of disease progression hence will benefit from timely initiation of anti-viral therapy.
    Matched MeSH terms: Hepatitis B/blood; Hepatitis B/diagnosis*; Hepatitis B/drug therapy*; Hepatitis B/virology; Hepatitis B e Antigens/blood*; Hepatitis B virus/drug effects*; Hepatitis B virus/immunology; Hepatitis B virus/pathogenicity
  6. Hossain MG, Mahmud MM, Nazir KHMNH, Ueda K
    Int J Mol Sci, 2020 Jan 15;21(2).
    PMID: 31952213 DOI: 10.3390/ijms21020546
    Mutations in the hepatitis B virus (HBV) genome can potentially lead to vaccination failure, diagnostic escape, and disease progression. However, there are no reports on viral gene expression and large hepatitis B surface antigen (HBsAg) antigenicity alterations due to mutations in HBV isolated from a Bangladeshi population. Here, we sequenced the full genome of the HBV isolated from a clinically infected patient in Bangladesh. The open reading frames (ORFs) (P, S, C, and X) of the isolated HBV strain were successfully amplified and cloned into a mammalian expression vector. The HBV isolate was identified as genotype C (sub-genotype C2), serotype adr, and evolutionarily related to strains isolated in Indonesia, Malaysia, and China. Clinically significant mutations, such as preS1 C2964A, reverse transcriptase domain I91L, and small HBsAg N3S, were identified. The viral P, S, C, and X genes were expressed in HEK-293T and HepG2 cells by transient transfection with a native subcellular distribution pattern analyzed by immunofluorescence assay. Western blotting of large HBsAg using preS1 antibody showed no staining, and preS1 ELISA showed a significant reduction in reactivity due to amino acid mutations. This mutated preS1 sequence has been identified in several Asian countries. To our knowledge, this is the first report investigating changes in large HBsAg antigenicity due to preS1 mutations.
    Matched MeSH terms: Hepatitis B/immunology*; Hepatitis B/virology; Hepatitis B Surface Antigens/genetics; Hepatitis B Surface Antigens/immunology*; Hepatitis B Surface Antigens/metabolism; Hepatitis B virus/classification; Hepatitis B virus/genetics; Hepatitis B virus/immunology*
  7. Ong HT, Duraisamy G, Kee Peng N, Wen Siang T, Seow HF
    Microbes Infect., 2005 Mar;7(3):494-500.
    PMID: 15792534
    Hepatitis B virus (HBV) has been classified into eight genotypes, designated A-H. These genotypes are known to have distinct geographic distributions. The clinical importance of genotype-related differences in the pathogenicity of HBV has been revealed recently. In Malaysia, the current distribution of HBV remains unclear. The aim of this study was to determine the genotypes and subtypes of HBV by using PCR, followed by DNA sequencing, as well as to analyse the mutations in the immunodominant region of preS and S proteins. The S gene sequence was determined from HBV DNA of four apparently healthy blood donors' sera and three sera from asymptomatic chronic hepatitis B carriers. Of this batch of sera, the preS gene sequence was obtained from HBV DNA from three out of the four blood donors and two out of the three chronic carriers. Due to insufficient sera, we had to resort to using sera from another blood donor to make up for the sixth DNA sequence of the preS gene. Based on the comparative analysis of the preS sequences with the reported sequences in the GenBank database, HBV DNA from two normal carriers was classified as genotype C. Genotype B was assigned to HBV from one blood donor and two hepatitis B chronic carriers, whereas HBV of one chronic carrier was of genotype D. Based on the S gene sequences, HBV from three blood donors was of genotype C, that of one blood donor and one chronic carrier was of genotype B, and the remaining, of genotype D. In the five cases where both preS and S gene sequences were determined, the genotypes assigned based on either the preS or S gene sequences were in concordance. The nature of the deduced amino acid (aa) sequences at positions 125, 127, 134, 143, 159, 161 and 168 of the S gene enabled the classification of these sequences into subtypes, namely, adrq+, adw2 and ayw2. The clustering of our DNA sequences into genotype groups corresponded to their respective subtype, that is, adw2 in genotype B, adrq in genotype C and ayw in genotype D. Analysis of the point mutations revealed that five of the sequences contained aa substitutions at immunodominant epitopes involved in B or/and T cell recognition. In conclusion, despite the low numbers of samples studied, due to budget constraints, these data are still worthwhile reporting, as it is important for the control of HBV infections. In addition, the genotype and mutational data obtained in this study may be useful for designing new treatment regimes for HBV patients.
    Matched MeSH terms: Hepatitis B Surface Antigens/genetics*; Hepatitis B Surface Antigens/chemistry; Hepatitis B virus/classification; Hepatitis B virus/genetics*; Hepatitis B, Chronic/virology*
  8. 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/complications; Hepatitis B/epidemiology*; Hepatitis B/prevention & control; Hepatitis B virus/immunology; Hepatitis B Vaccines*
  9. Merican I, Guan R, Amarapuka D, Alexander MJ, Chutaputti A, Chien RN, et al.
    J Gastroenterol Hepatol, 2000 Dec;15(12):1356-61.
    PMID: 11197043
    Of the estimated 50 million new cases of hepatitis B virus (HBV) infection diagnosed annually, 5-10% of adults and up to 90% of infants will become chronically infected, 75% of these in Asia where hepatitis B is the leading cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC). In Indonesia, 4.6% of the population was positive for HBsAg in 1994 and of these, 21% were positive for HBeAg and 73% for anti-HBe; 44% and 45% of Indonesian patients with cirrhosis and HCC, respectively, were HBsAg positive. In the Philippines, there appear to be two types of age-specific HBsAg prevalence, suggesting different modes of transmission. In Thailand, 8-10% of males and 6-8% of females are HBsAg positive, with HBsAg also found in 30% of patients with cirrhosis and 50-75% of those with HCC. In Taiwan, 75-80% of patients with chronic liver disease are HBsAg positive, and HBsAg is found in 34% and 72% of patients with cirrhosis and HCC, respectively. In China, 73% of patients with chronic hepatitis and 78% and 71% of those with cirrhosis and HCC, respectively, are HBsAg positive. In Singapore, the prevalence of HBsAg has dropped since the introduction of HBV vaccination and the HBsAg seroprevalence of unvaccinated individuals over 5 years of age is 4.5%. In Malaysia, 5.24% of healthy volunteers, with a mean age of 34 years, were positive for HBsAg in 1997. In the highly endemic countries in Asia, the majority of infections are contracted postnatally or perinatally. Three phases of chronic HBV infection are recognized: phase 1 patients are HBeAg positive with high levels of virus in the serum and minimal hepatic inflammation; phase 2 patients have intermittent or continuous hepatitis of varying degrees of severity; phase 3 is the inactive phase during which viral concentrations are low and there is minimal inflammatory activity in the liver. In general, patients who clear HBeAg have a better prognosis than patients who remain HBeAg-positive for prolonged periods of time. The outcome after anti-HBe seroconversion depends on the degree of pre-existing liver damage and any subsequent HBV reactivation. Without pre-existing cirrhosis, there may be only slight fibrosis or mild chronic hepatitis, but with pre-existing cirrhosis, further complications may ensue. HBsAg-negative chronic hepatitis B is a phase of chronic HBV infection during which a mutation arises resulting in the inability of the virus to produce HBeAg. Such patients tend to have more severe liver disease and run a more rapidly progressive course. The annual probability of developing cirrhosis varies from 0.1 to 1.0% depending on the duration of HBV replication, the severity of disease and the presence of concomitant infections or drugs. The annual incidence of hepatic decompensation in HBV-related cirrhosis varies from 2 to 10% and in these patients the 5-year survival rate drops dramatically to 14-35%. The annual risk of developing HCC in patients with cirrhosis varies between 1 and 6%; the overall reported annual detection rate of HCC in surveillance studies, which included individuals with chronic hepatitis B and cirrhosis, is 0.8-4.1%. Chronic hepatitis B is not a static disease and the natural history of the disease is affected by both viral and host factors. The prognosis is poor with decompensated cirrhosis and effective treatment options are limited. Prevention of HBV infection thorough vaccination is still, therefore, the best strategy for decreasing the incidence of hepatitis B-associated cirrhosis and HCC.
    Matched MeSH terms: Hepatitis B virus/genetics; Hepatitis B virus/physiology; Hepatitis B, Chronic/complications; Hepatitis B, Chronic/epidemiology*; Hepatitis B, Chronic/physiopathology; Hepatitis B, Chronic/virology
  10. Ng KP, Saw TL
    Med J Malaysia, 1994 Jun;49(2):117-21.
    PMID: 8090089
    A total of 250 hepatitis B surface antigen positive sera were screened for antibody to hepatitis B surface antigen. It was found that seven (3%) sera showed concurrently circulating surface antigen and surface antibody to hepatitis B virus. The level of antibody to surface antigen was not affected by HBeAg and most of the cases were found in chronic hepatitis B carriers.
    Matched MeSH terms: Hepatitis B/immunology*; Hepatitis B Antibodies/blood*; Hepatitis B e Antigens/blood; Hepatitis B Surface Antigens/blood*
  11. Goh CL, Kamarudin A, Chan SH, Rajan VS
    Genitourin Med, 1985 Apr;61(2):127-9.
    PMID: 3980022
    The prevalence of hepatitis B virus markers in 121 men and 239 women prostitutes was studied. Of 33 (9.7%) with hepatitis B surface antigen (HBsAg), nine (27.3%) also had hepatitis Be antigen, which was more prevalent in men than women. Antibodies to HBsAg (anti-HBs) and to hepatitis B core antigen (anti-HBc) were found in about 71% of men and women prostitutes. Hepatitis B virus markers were more prevalent in men than in women prostitutes. Compared with other people, prostitutes had a significantly greater prevalence of hepatitis B virus markers. This study strongly suggested the importance of sexual transmission of infection with hepatitis B virus in a country where infection is endemic.
    Matched MeSH terms: Hepatitis B Core Antigens/immunology; Hepatitis B e Antigens/analysis; Hepatitis B Surface Antigens/analysis; Hepatitis B virus/immunology*
  12. George E, Ilina I, Yasmin AM, George R, Duraisamy G
    Med J Malaysia, 1988 Dec;43(4):284-7.
    PMID: 3241594
    Matched MeSH terms: Hepatitis B/blood; Hepatitis B/etiology*; Hepatitis B/immunology; Hepatitis B Surface Antigens/blood
  13. Gane EJ, Charlton MR, Mohamed R, Sollano JD, Tun KS, Pham TTT, et al.
    J Viral Hepat, 2020 05;27(5):466-475.
    PMID: 31785182 DOI: 10.1111/jvh.13244
    Asia has an intermediate-to-high prevalence of and high morbidity and mortality from hepatitis B virus (HBV) infection. Optimization of diagnosis and initiation of treatment is one of the crucial strategies for lowering disease burden in this region. Therefore, a panel of 24 experts from 10 Asian countries convened, and reviewed the literature, to develop consensus guidance on diagnosis and initiation of treatment of HBV infection in resource-limited Asian settings. The panel proposed 11 recommendations related to diagnosis, pre-treatment assessment, and indications of therapy of HBV infection, and management of HBV-infected patients with co-infections. In resource-limited Asian settings, testing for hepatitis B surface antigen may be considered as the primary test for diagnosis of HBV infection. Pre-treatment assessments should include tests for complete blood count, liver and renal function, hepatitis B e-antigen (HBeAg), anti-HBe, HBV DNA, co-infection markers and assessment of severity of liver disease. Noninvasive tests such as AST-to-platelet ratio index, fibrosis score 4 or transient elastography may be used as alternatives to liver biopsy for assessing disease severity. Considering the high burden of HBV infection in Asia, the panel adopted an aggressive approach, and recommended initiation of antiviral therapy in all HBV-infected, compensated or decompensated cirrhotic individuals with detectable HBV DNA levels, regardless of HBeAg status or alanine transaminase levels. The panel also developed a simple algorithm for guiding the initiation of treatment in noncirrhotic, HBV-infected individuals. The recommendations proposed herein, may help guide clinicians, to optimize the diagnosis and improvise the treatment rates for HBV infection in Asia.
    Matched MeSH terms: Hepatitis B/diagnosis*; Hepatitis B/therapy*; Hepatitis B e Antigens/blood; Hepatitis B virus
  14. 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/immunology; Hepatitis B/epidemiology*; Hepatitis B/transmission; Hepatitis B Surface Antigens/analysis*
  15. Kamath S, Lopez CG
    Med J Aust, 1973 Nov 3;2(18):867-8.
    PMID: 4782397
    Matched MeSH terms: Hepatitis B/epidemiology*; Hepatitis B Antibodies/analysis; Hepatitis B Antigens/analysis
  16. Ton SH, Lopez CG, Hasnah H
    PMID: 483004
    A study of Kuala Lumpur blood donors for HBsAG, anti-HBc and DNA polymeraes showed that 5.5% in the sample population was positive for HBsAG, 50.1% for anti-HBc and 10.1% for DNA polymerase activity. There was no significant difference of the HBsAG among the Malay, Chinese and Indian groups. However, a significant difference was observed for the anti-HBc and DNA polymerase activity between the Indian and the Malay/Chinese groups. Both analysis were significantly lower in the Indians but there was no significant difference between the Chinese and the Malays.
    Matched MeSH terms: Hepatitis B Antibodies/analysis*; Hepatitis B Core Antigens/analysis*; Hepatitis B Surface Antigens/analysis
  17. Rajakumar MK, Ton SH, Lim KF, Oorloff KH
    Med J Malaysia, 1984 Mar;39(1):65-8.
    PMID: 6513842
    179 heterosexuals, selected for VDRL testing on the basis of a history of involvement in promiscuous sexual activity, mainly prostitution, had their serum also tested for hepatitis B infection markers, HBsAg, HBeAg and anti-HBe. 51 samples (29%) were found to be positive for at least one of the three markers, at levels higher than the already high levels in voluntary random blood donors in Malaysia.
    Matched MeSH terms: Hepatitis B/transmission*; Hepatitis B Antibodies/analysis*; Hepatitis B Antigens/analysis*; Hepatitis B e Antigens/analysis*; Hepatitis B Surface Antigens/analysis*
  18. Tan WS, Ho KL
    World J Gastroenterol, 2014 Sep 7;20(33):11650-70.
    PMID: 25206271 DOI: 10.3748/wjg.v20.i33.11650
    Hepatitis B virus (HBV) has killed countless lives in human history. The invention of HBV vaccines in the 20(th) century has reduced significantly the rate of the viral infection. However, currently there is no effective treatment for chronic HBV carriers. Newly emerging vaccine escape mutants and drug resistant strains have complicated the viral eradication program. The entire world is now facing a new threat of HBV and human immunodeficiency virus co-infection. Could phage display provide solutions to these life-threatening problems? This article reviews critically and comprehensively the innovative and potential applications of phage display in the development of vaccines, therapeutic agents, diagnostic reagents, as well as gene and drug delivery systems to combat HBV. The application of phage display in epitope mapping of HBV antigens is also discussed in detail. Although this review mainly focuses on HBV, the innovative applications of phage display could also be extended to other infectious diseases.
    Matched MeSH terms: Hepatitis B virus/drug effects*; Hepatitis B virus/genetics; Hepatitis B virus/immunology; Hepatitis B virus/pathogenicity; Hepatitis B Vaccines/therapeutic use*; Hepatitis B, Chronic/diagnosis; Hepatitis B, Chronic/drug therapy*
  19. Hudu SA, Malik YA, Niazlin MT, Harmal NS, Alshrari AS, Sekawi Z
    Ann Saudi Med, 2013;33(6):591-4.
    PMID: 24413864 DOI: 10.5144/0256-4947.2013.591
    BACKGROUND AND OBJECTIVES: Hepatitis B core antibodies (anti-HBc) are detected in almost every patient with previous exposure to hepatitis B virus (HBV). However, with this marker alone, one cannot understand the activity of the disease; therefore, this study aimed to identify the implication of isolated hepatitis B core antibody and evaluate the effect of hepatitis B vaccine booster in isolated anti-HBc among adults who received the HBV vaccine as infants.

    DESIGN AND SETTINGS: A prospective cohort study of vaccinated undergraduate students of University Putra Malaysia.

    PATIENTS AND METHODS: A total of 408 undergraduate students who received infant hepatitis B vaccination volunteered for this study; 5 mL of venous blood was taken from the volunteers. Hepatitis B surface antigen (HBsAg) and core antibodies were tested using a commercially available enzyme-linked immunosorbent assay kit according to the manufacturer's instructions (DRG international Inc., USA). Molecular detection of hepatitis B viral DNA was performed using nested polymerase chain reaction.

    RESULTS: The prevalence of isolated anti-HBc among the vaccinated cohort was found to be 5.0%, out of which 80% had a hepatitis B surface antibodies (anti-HBs) titer higher than 10 IU/L, while 20% had less than 10 IU/L anti-HBs titer. All the anti-HBc positivesubjects had detectable hepatitis B viral DNA in their serum. Anamnestic response was found to be 100% among isolated anti-HBc with negative antibody.

    CONCLUSION: Isolated anti-HBc developed protective levels of anti-HBs after a single dose of recombinant hepatitis B vaccination. HBV DNA was detected in all isolated anti-HBc indicating occult chronic HBV infection with undetectable HBsAg.

    Matched MeSH terms: Hepatitis B Antibodies/blood*; Hepatitis B Surface Antigens/immunology*; Hepatitis B Vaccines/administration & dosage*; Hepatitis B Vaccines/immunology; Hepatitis B, Chronic/diagnosis; Hepatitis B, Chronic/immunology
  20. Tong NK, Beran J, Kee SA, Miguel JL, Sánchez C, Bayas JM, et al.
    Kidney Int, 2005 Nov;68(5):2298-303.
    PMID: 16221232
    Due to their impaired immune system, patients with renal insufficiency have a suboptimal response to hepatitis B (HB) vaccination and frequent boosters are needed to maintain protection. GlaxoSmithKline Biologicals has developed a HB vaccine containing a new adjuvant system AS04 for use in this immunocompromised patient population.
    Matched MeSH terms: Hepatitis B/immunology; Hepatitis B/prevention & control*; Hepatitis B Vaccines/administration & dosage*; Hepatitis B Vaccines/adverse effects; Hepatitis B Vaccines/immunology*
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