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The detection of hepatitis B surface antigen positivity in pregnant women before delivery is crucial to preventing mother-to-child transmission of hepatitis B virus.This study aimed to evaluate the status and rate of testing for hepatitis B surface antigen, rate of hepatitis B surface antigen positivity, hepatitis B surface antigen positivity distribution rate by age, and changes in hepatitis B surface antigen positivity rate in pregnant women over the study period.We conducted a multicentre, cross-sectional, descriptive study covering the period January 2005 to June 2019 for 2 145 668 pregnant women from 27 provinces in all 7 regions of Turkey, collected using Microsoft Excel before statistical analysis.We found that 1 012 593 (47.1%) pregnant women were tested for hepatitis B surface antigen over the 15-year period, out of which 11 471 (1.1%) were hepatitis B surface antigen-positive. Overall, 97% of the hepatitis B surface antigen positive women were born before 1998, the year that national HBV vaccination was launched in Turkey. The rate of hepatitis B surface antigen positivity in that group was 1.1%, compared with 0.3% among women born after 1998.There was a downward trend in the hepatitis B surface antigen positivity rate among pregnant women in the younger age groups, especially among those born after universal hepatitis B vaccination was inaugurated, and low rate of HBsAg testing during pregnancy.تقييم 15 عامًا من التغييرات في معدل النتائج الإيجابية للمُستضَدِّ السطحي للالتهاب الكبدي B/ المستضد الأسترالي لدى النساء الحوامل في تركيا: التأثير البارز للتطعيم على المستوى الوطني.سلمى طوسون، عائشة أردوغان، عائش تورن، سلمى سيفر، سيبيل ألتونتاس، إلكنور يلديز، حسين كوتلو، محمد سيلان، بيمبي يسيلباج، بيهان بكتوري، نفيس أوزتوبراك، بوكيت جونجور، سيزين كوبران، جولنور كول، علي أولوت، بولنت ألتونتاش، فريق دراسة متعدد المراكز.ثمة أهمية كبرى لاكتشاف النساء الحوامل الإيجابيات للمستضدات السطحية للالتهاب الكبدي B اكتشافًا مبكرًا في مرحلة ما قبل الولادة، لتَوقِّي انتقال فيروس الالتهاب الكبدي B من الأم إلى الطفل.هدفت هذه الدراسة إلى تقييم حالة ومعدل اختبار المستضدات السطحية للالتهاب الكبدي B، ومعدل الحالات الإيجابية لهذه المستضدات، وتوزيع الحالات حسب العمر، والتغيُُّّرات في معدل النتائج الإيجابية للمستضدات لدى النساء الحوامل على امتداد فترة الدراسة.أجرينا دراسة وصفية مقطعية متعددة المراكز عن المدة من يناير/ كانون الثاني 2005 إلى يونيو/ حزيران 2019، وشملت ما مجموعه 2145668 امرأة حاملًًا من 27 محافظة في جميع المناطق السبع في تركيا، وجُُمعت البيانات باستخدام برنامج مايكروسوفت إكسيل قبل إجراء التحليل الإحصائي.وجدنا أن 1012593 امرأة حاملًًا (47.1٪) قد خضعن لاختبار المستضد السطحي للالتهاب الكبدي B على مدى 15 عامًا، وجاء بينهن 11471 عينة إيجابية (1.1٪) لهذه المستضدات. وإجمالًًا، تبيََّّن أن 97٪ من النساء الإيجابيات للمستضدات قد وُلدن قبل عام 1998، وهو العام الذي دُشِّنَ فيه التلقيح الوطني ضد فيروس التهاب الكبد B في تركيا. وبلغ معدل الإيجابية تجاه المستضدات السطحية للالتهاب الكبدي B في هذه المجموعة 1.1٪، مقارنة بنسبة 0.3٪ بين النساء اللاتي وُلدن بعد عام 1998.تبيََّّن وجود اتجاه لانخفاض في معدل النتائج الإيجابية تجاه المستضدات السطحية للالتهاب الكبدي B بين النساء الحوامل في الفئات العمرية الأصغر، ولا سيما بين أولئك اللاتي قد وُلدن بعد تدشين التطعيم الشامل ضد التهاب الكبد B، وانخفاض معدل اختبار المستضدات السطحية للالتهاب الكبدي B في أثناء الحمل.Quinze ans d'évaluation de l'évolution du taux de positivité de l'AgHBs chez les femmes enceintes en Turquie : l'effet majeur de la vaccination nationale.La détection d'une positivité à l'antigène de surface de l'hépatite B chez les femmes enceintes avant l'accouchement est cruciale pour prévenir la transmission mère-enfant du virus de l'hépatite B.La présente étude visait à évaluer le statut et le taux de dépistage de l'antigène de surface de l'hépatite B, le taux de positivité à l'antigène de surface de l'hépatite B, le taux de distribution de l'antigène de surface de l'hépatite B selon l'âge, et l'évolution du taux de positivité de l'antigène de surface de l'hépatite B chez les femmes enceintes au cours de la période d'étude.Nous avons mené une étude multicentrique, transversale et descriptive couvrant la période allant de janvier 2005 jusqu'à juin 2019 pour 2 145 668 femmes enceintes de 27 provinces dans les sept régions de Turquie, collectée à l'aide de Microsoft Excel avant l'analyse statistique.Nous avons constaté que 1 012 593 (47, 1 %) femmes enceintes avaient été testées pour l'antigène de surface de l'hépatite B au cours de cette période de 15 ans, dont 11 471 (1,1 %) étaient positives. Globalement, 97 % des femmes positives à l'antigène de surface de l'hépatite B étaient nées avant 1998, année où la vaccination nationale contre le VHB a été lancée en Turquie. Le taux de positivité à l'antigène de surface de l'hépatite B dans ce groupe était de 1,1 %, contre 0,3 % chez les femmes nées après 1998.On a constaté une tendance à la baisse du taux de positivité à l'antigène de surface de l'hépatite B chez les femmes enceintes des groupes d'âge plus jeunes, en particulier chez celles nées après le lancement de la vaccination universelle contre l'hépatite B, et un faible taux de dépistage de l'AgHBs pendant la grossesse.

IntroductionHepatitis B virus (HBV) is a bloodborne virus which can be transmitted via percutaneous and mucocutaneous exposure to infected body fluid. Healthcare workers (HCWs) who are continuously exposed to different body fluids are at an increased risk of contracting and transmitting this virus. It is thus important to evaluate the knowledge and attitude of HCWs towards HBV and the prevalence of HBV infection among them.MethodsThis cross-sectional study was carried out between April and September 2017. Overall, 398 HCWs were recruited for this study. Knowledge on the route of HBV transmission and attitude towards HBV were evaluated using a well-structured questionnaire. Hepatitis B surface antigen (HBsAg) positivity was obtained using the Monolisa HBsAg ULTRA kit (Bio-Rad). Data were analysed using SPSS V.20.ResultsAmong the HCWs who participated in this study, 338 (84.9%) had heard of HBV, and 269 (67.6%) of them had adequate knowledge on the route of HBV transmission. Medical doctors were the most knowledgeable among biomedical workers and students (76.5%). The rate of stigma was highest among nurses (87, 38.8%). The prevalence of HBsAg positivity was high (42, 10.6%) given that there is an efficient and available vaccine. Overall, over 70% of HCWs invited to participate in this study responded.ConclusionKnowledge on the route of HBV transmission was fair, and the level of stigmatisation of HBV-infected patients and the prevalence of HBV infection were high in this study. A sensitisation campaign should be carried out to educate HCWs on HBV, thus reducing the level of stigma associated with HBV as well as the probability of contracting HBV as a nosocomial infection.

Hepatitis B (HBV) infection is a significant health problem around the world. Turkey is a country with moderate endemicity. This study aims to investigate the seroprevalence of HBV and anti-Hbs seropositivity among children and young adults aged 1 to 18 years living in Usak province of Turkey. This is a retrospective review of 720 children, 394 boys and 326 girls, aged 1 to 18 years who were admitted to Usak Private Medical Park Hospital for any reason between January 2017 and December 2018. Anti-Hbs seropositivity was identified in 471 children including 63% of the boys (249/394) and 68% of the girls (222/326) in the study cohort. Only one case of HbsAg positivity (0.001%) was specified among 720 children. Anti-Hbs seropositivity was 83% in Group 1 (82/99), 61% in Group 2 (62/101), 55% in Group 3 (51/92), 56% in Group 4 (43/77) and 66% in Group 5 (233/350). To the best of our knowledge, this hospital-based cross-sectional study is the first clinical research of the 1-18-year age group for HbsAg seroprevalence and anti-Hbs seropositivity in Usak province. When compared with other provinces and Turkey in general, HbsAg seropositivity rate is relatively low in this study. [Med-Science 2020; 9(4.000): 967-9]

Objectives : The aim of this study is to investigate the seroprevalence of HBsAg and frequency of anti-HBs positivity in 0- 18 years old children in Ankara province. Material and Methods : Retrospectively, 4210 boys and 2983 girls between 0-18 years who applied to Ankara Gazi Mustafa Kemal State Hospital between January 2009 and June 2014 and were examined for HBsAg and anti- HBs levels by using Micro ELISA technics were included. Children were categorized into five age groups. Results: 4231 HBsAg levels were measured and HBsAg positivity was found to be 0.80% (34/4231). 64.70% (22/34) of these were male, 35.30%; (12/34) were female. There was no significant relationship between the two groups regarding HBsAg positivity (p=0,389). 2962 anti-HBs levels were measured and anti-HBs seropositivity was found as 75.30% (2231/2962); anti-HBS seropositivity were 73.40%; (1173/1599) for males and 77,60%; (1057/1363) for females. There was significant relationship between two groups regarding antiHBs seropositivity (p=0,011). According to the age groups, seropositivity ratios were found as 78.70% (118/150), 60.60% (260/429), 64.20% (312/486), 85.10% (798/938) and 77.40% (743/960) in first, second, third, fourth and fifth groups respectively; and statistically significant relationship was found between them. Conclusion: Our study is important for evaluating the seroepidemiology of hepatitis B vaccination that has been administered for 16 years and before. It may also be useful for similar studies comparing different regions.

To clarify whether maternal HBsAg positivity may add risk for adverse neonatal outcomes and even affect child's growth.The perinatal data and neonatal outcomes in 380 HBsAg-positive and 428 HBsAg-negative women delivered during 2002-2004 were investigated. Furthermore, 271 (71.3%) children of HBsAg-positive and 297 (69.4%) of HBsAg-negative mothers were followed at ages of 5-7 years. Child's growth including weight, height, and health conditions were evaluated.The prevalence of preterm birth was relatively higher in HBsAg-positive group (2.9% versus 1.4%), but it failed to reach statistical significance (p = 0.140). There was no difference in other neonatal outcomes including stillbirth (0.5% versus 0.2%), neonatal death (0.5% versus 0.5%) and congenital malformation (0.8% versus 1.4%). Logistic regression analyses demonstrated maternal HBsAg positivity had no adverse influence on neonatal outcomes. Abnormal health conditions, other than adverse neonatal outcomes, was identified in one child (0.3%) of HBsAg-positive mother and four children (0.9%) of HBsAg-negative mothers at follow-up (p = 0.444). No maternal death occurred in HBsAg-positive or -negative mothers.Maternal HBsAg carrier status does not add risk for adverse neonatal outcomes or child's growth; therefore, heightening surveillance for adverse neonatal complications in HBV-infected pregnant women may be unnecessary.

This study aimed at developing strategies for screening, predicting, and diagnosing intrauterine HBV infection in infants born to HBsAg positive mothers. A total of 1,360 infants born to 1,355 HBsAg positive mothers were followed for 1 year. All newborn infants received active and passive immunization within 24 hr after birth. Maternal and infant blood samples were collected and tested for the status of serum HBsAg, HBeAg, and HBV DNA positivity. The accuracy of infant HBsAg positivity, HBV DNA positivity, HBsAg and HBV DNA double positivity, and HBsAg and/or HBV DNA positivity at birth in the diagnosis of intrauterine HBV infection was evaluated by receiver operating characteristic curve analysis. Of 1,360 infants, 145 tested positive for HBsAg and/or HBV DNA at birth. Twenty-one (1.5%) infants, who were diagnosed with intrauterine HBV infection, showed HBsAg positivity from birth to 7 and 12 months of age. Infant HBsAg positivity at birth had the highest sensitivity in predicting intrauterine HBV infection, while neonatal HBsAg and HBV DNA double positivity had the highest specificity. These findings suggest that infants, who were born to HBsAg positive mothers and were positive for both HBsAg and HBV DNA at birth, may be at a higher risk for intrauterine HBV infection. HBsAg positivity at birth may be a good marker for screening intrauterine HBV infection. Infant HBsAg positivity both at birth and 7 months of age may be used as a diagnostic criterion to simplify diagnostic procedures and improve diagnostic efficiency. J Med. Virol. 85:1705–1711, 2013. © 2013 Wiley Periodicals, Inc.

Objectives: This study was conducted to determine the effectiveness of a multicomponent intervention in Sanliurfa Gynecology and Obstetrics Hospital (SGOH), which is designed to overcome the obstacles encountered in the application of HBsAg testing to all delivering women, the administration of hepatitis B vaccine and Hepatitis B Immunglobulin(HBIG) to newborns of HBsAg positive pregnant women. Methods: This is an intervention study, conducted between December 15, 2007 and December 30, 2008. Intervention procedure is composed of four methods; namely, motivation of all parties through academic leadership, implementation of workshops to determine the obstacles, provision of administrative commitment, and training of healthcare personnel. Results: In 2007, a total of 18,709 deliveries were realized in SGOH; HBsAg testing was performed in only 16.5% of the pregnant women and 0.8% of these women were found to be HBsAg positive. It was determined that HBIG was administered to 28.2% of newborns of HBsAg positive mothers and hepatitis B vaccine was given to 71.4% (n=13349) of all newborns. After the intervention, the increase in HBsAg test application status, HBsAg positivity, HIBG administration and hepatitis B vaccination was 6.0, 5.8, 2.0 and 1.2 fold, respectively (P

Background. The aim of this study was to monitor the cases identified as hepatitis B carriers during premarital tests, to vaccinate their prospective spouses with a rapid vaccination scheme, and to compare the anti-HBs responses with the traditional vaccination scheme.Methods. Blood samples of 1250 couple spouses were tested for HBsAg and anti-HBs. HBsAg positive cases' fiancées which were found HBV negative were administered a rapid three-dose vaccination scheme on days 0, 7, and 21. Forty controls with similar age and gender were also were administered three doses of the same vaccine.Results. Out of 1250 cases (625 couples), 46 (3.6%) were HBsAg positive, and 40 of them aged between 18 and 39 were admitted to the rapid vaccination program.Conclusion. Upon determination of HBsAg positivity in premarital tests, a rapid vaccination program provides early protection, but the 6th and 12th month vaccinations are also required. Anti-HBs response should be monitored.

Objective The purpose of the study was to quantitatively evaluate the effect of the hepatitis B vaccine based on 33 years of data published on the HBsAg- and anti-HBs-positive rates. Methods All data were obtained from studies in published Chinese scientific journals from 1977 to 2009. The HBsAg- or anti-HBs-positive rate over a certain observation period was presented. Results When the anti-HBs-positive rate was low, the ability of anti-HBs to control the HBsAg-positive rate is not apparent. When the anti-HBs level is high, the ability of anti-HBs to control the HBsAg-positive rate increases gradually, and a linear relationship was observed between the HBsAg-positive rate and the anti-HBs-positive rate. However, the rate of decrease of HBsAg positivity was markedly higher than the theoretical rate. Conclusion The effect of other known or unknown factors, in addition to the vaccination campaign, could have contributed to the decrease in the prevalence of HBV infection.

In this issue the European consensus panel’s report about hepatitis B virus (HBV) and hepatitis C virus (HCV) infected health care workers (HCWs) thoroughly discusses the various aspects of managing HBV infected HCWs. For prevention the importance of systematic vaccination against HBV is stressed; for diagnosis the documentation of anti-HBs titres and the investigation of nonresponders for HBsAg positivity. In the past the actual management of a HBsAg-positiv eH CWs was primarily guided by being involved in the transmission of HBV, job characteristics (performance of exposure prone procedures), and HBeAg-positivity as surrogate marker of high viremia. With the documentation of HBV transmission by HBeAg-negative surgeons and the

Current investigation attempted to uncover common risk factors associated with HBsAg positivity among the suspected patients of Hepatitis B viral infection. Blood specimens were collected from patients prescribed to undergo HBsAg positivity test and tested for the detection of HBsAg through enzyme-linked immunosorbent assay (ELISA). HBsAg positivity was analyzed in relation to age, family history of HBV infection, unprotected sex, multiple sexual partners, blood transfusions, frequency of needle pricks, intravenous drug addiction, dental surgery and other surgical operations of the patients. Out of 50 patients, 23 were found to be HBsAg positive. After statistical analysis of all the factors it was deduced that patients who had unprotected sex and whose families (especially the mother of the patient) had a history of HBV infection were mostly found to be HBsAg positive. Detection of HBsAg positive cases with multiple associated risk factors revealed that the general people in Bangladesh need to be more conscious on the possible infection aware of getting infected with HBV as they are being frequently exposed subjected to the risk factors.

From February 1988 to April 1990, we collected blood for hepatitis B surface antigen (HBsAg) from all women coming to the Texas Tech University Health Science Center in Lubbock for prenatal care. These patients were from rural western Texas and eastern New Mexico. They were also screened for hepatitis B risk factors, as outlined by the Centers for Disease Control. We reviewed the prenatal records of all HBsAg-positive women. Six of 4452 women (0.13%) had a positive HBsAg test. Four of the six women had identifiable risk factors and two did not; two were non-Hispanic caucasian (Anglo), two were Hispanic, and two were black. Anglos comprised 49.5% of the rural population, Hispanics 34.9%, blacks 12.8%, and Asians 2.8%. No Asian women were positive for HBsAg. The prevalence of HBsAg positivity was lower in this rural population than in previously reported urban populations. While the prevalence in the studied blacks and Hispanics was similar to that in previous reports, the prevalence in the rural Anglos was lower.

In this study, the HBsAg carrier state and the role of horizontal transmission were investigated among primary and high school students in southeastern Anatolia where HBsAg seropositivity is remarkably high. In total, 350 students from primary school first grade, 350 students from fifth grade, 400 students from high school eleventh grade and 400 healthy adults as a control group were studied. In all cases HBsAg and anti-HBs were screened by ELISA. HBsAg positivity was 2.4% in first grade, 6.1% in fifth and 6.7% in eleventh grade students. Anti-HBs positivity was 14% in first grade, 20% in fifth and 21% in eleventh grade students. HBsAg positivity was 9% and anti-HBs, 49% in the control group. There is a significant difference between first and fifth grade students for HBsAg positivity (2.1% vs 6.1% and P0.05). This difference decreased during the high school years (6.2% and P0.05). There is also a similar statistically significant difference for anti-HBs positivity during the primary school years (14% vs 20%, P0.05). These findings show that the risk of horizontal transmission of HBV is especially important during elementary school years between the ages of 7 and 11 y. All infants or at least elementary school first grade students in Turkey should have HBV vaccinations.

Hepatitis B vaccine can induce transient hepatitis B surface antigen positivity not only in adult hemodialysis patients but also in normal adults and children. Hence hepatitis B vaccinees may be mistaken for confirmed hepatitis B surface antigen-positive carrier. Hence blood donors should not donate blood in this early post-vaccination period and renal dialysis patients should not be screened for hepatitis B surface antigen for at least 21 to 28 days after hepatitis B vaccination. These guidelines could prevent individuals in the early post-inoculation period from being erroneously labeled as having hepatitis B viral infection.

AIM: To study the prevalence and clinical effects of occult HBV infection in haemodialysis patients with chronic HCV. METHODS: Fifty chronic hemodialysis patients with negative HbsAg, and positive anti-HCV were included in the study. These patients were divided into two groups: HCV-RNA positive and HCV-RNA negative, based on the results of HCV-RNA PCR. HBV-DNA was studied using the PCR method in both groups. RESULTS: None of the 22 HCV-RNA positive patients and 28 HCV-RNA negative patients revealed HBV-DNA in serum by PCR method. The average age was 47.2 ± 17.0 in the HCV-RNA positive group and 39.6 ± 15.6 in the HCV-RNA negative group. CONCLUSION: The prevalence of occult HBV infection is not high in haemodialysis patients with chronic HCV in our region. This result of our study has to be evaluated in consideration of the interaction between HBsAg positivity (8%-10%) and frequency of HBV mutants in our region.

Persistent hepatitis B infections among patients and frequent new hepatitis B infections among both patients and staff were a major problem in our dialysis unit during its first two and one-half years of operation. During this time the mean quarterly rate of conversion to HBsAg positivity among patients ranged from 0-60% (mean 12%); in staff it ranged from 0-13%. Control efforts, including strict temporal isolation, improved sanitary measures, and use of parallel plate dialyzers without geographic or machine isolation, were begun late in 1976. After a four-month lag, new HBsAg conversions ceased among the 30 patients and staff at risk, despite continued dialysis of eight HBsAg-positive patients (at least four of whom were HBeAg-positive). Over the succeeding three years the conversion rate was zero in both patients and staff. This experience suggests that conservative control measures without geographic separation of patients may be sufficient to control an established outbreak of hemodi-alysis-related hepatitis B. Controlled prospective trials of this hypothesis are warranted.

The ABO blood groups and their relationship with Australia antigen (HBsAg) were studied in 500 blood donors and 76 patients. Most of the blood donors belonged to group ‘B’ while the Australia antigen (HBsAg) was prevalent in the blood group ‘A’ (9·30%). 76 patients clinically diagnosed as viral hepatitis showed a similar trend, having the highest percentage of HBsAg positivity in ‘A’ group (35·71%). In both, this was found statistically significant (P > 0·005). None of those with AB blood group showed HBsAg.

Two families with persistent hepatitis B infections are described. The patterns of HBsAg positivity in the parents and offspring are not compatible with the theory that susceptibility to chronic hepatitis B infection is inherited as an autosomal recessive trait.