Hepatitis B is one of the major diseases of mankind, estimated to cause about 800,000 deaths per year mostly from liver cancer and cirrhosis. The history of the epidemiology of hepatitis B represents a landmark in the general understanding of viral infections, their distributions and their outcomes. In 2010 and 2014 resolutions of the World Health Assembly, have acknowledged at the political level that viral hepatitis is a global public health problem, ranking HBV as the 15th cause of death in all cause global mortality. The global prevalence of chronic carriage varies between 0.1 and more than 20 %. Approximately 15–40 % of chronically infected patients will develop liver cirrhosis, liver failure, or hepatocellular carcinoma and 15–25 % will ultimately die. As of today (2014), approximately 2 billion people have been infected worldwide and 240 million are chronic carriers of HBV. This represents a decrease of 31 % in HBsAg prevalence as compared to the former published figures of 350–400 million. The decrease is mainly observed in younger age groups and it is likely due to the availability of better population based data, population wide vaccination against hepatitis B in newborns, young children and adolescents, improved screening of blood products and improved safe injection procedures. However, globally an increase in both genders was observed between the 1990s and 2005 causing a change from low to a low-intermediate endemicity level in young men. It is important to note the great impact of routine infant and childhood hepatitis B immunization programs, which have caused a dramatic reduction of HBsAg carriage in immunized cohorts of children, and have led to significant decreases in HBV transmission and the occurrence of related cirrhosis and liver cancer in various populations. However, the work is not finished and a lot remains to be done to prevent new HBV infections and to cure chronically infected individuals.

Global Epidemiology of Hepatitis B Virus Infection

Although, chronic hepatitis B (HBV) is considered to be of significant public health importance in Ghana, not many reviews detailing the burden (prevalence) of the disease have been conducted. This study was aimed at summarizing the available information and to make an accurate estimate of HBV infection prevalence in Ghana over the last two decades (1995–2015). A systematic search was conducted in PubMed, ScienceDirect, Google Scholar and Africa Journals Online (AJOL) databases to retrieve primary studies published between 1st January 1995 and 4th October 2015, assessing the prevalence of HBV among populations in Ghana. This was supplemented by a manual search of retrieved references. Thirty (30) studies across all the ten (10) regions of Ghana and involving an overall population size of 105,435 were analyzed. The national prevalence of HBV as determined by HBsAg seropositivity was 12.3 %. HBV prevalence among voluntary blood donors (VBDs), replacement blood donors (RBDs) and pregnant women were 10.8, 12.7 and 13.1 % respectively. HBV infection prevalence was highest among studies published within the period 1995–2002 (17.3 %), followed by those published within 2003–2009 (14.7 %) and the lowest prevalence rate being recorded across studies published in the period 2010–2015 (10.2 %). Regional prevalence were determined for Ashanti, Greater Accra, Eastern, Northern, central and Brong-Ahafo regions as 13.1, 10.6, 13.6, 13.1, 11.5 and 13.7 % respectively. No aggregate data were derived for Volta, Western, Upper East and Upper West regions. Higher prevalence of HBV infection was attained for rural (13.3 %) compared to urban settings (12.2 %). Across the country, highest HBV infection prevalence rates were recorded in persons within the age group 16–39 years. Hepatitis B infection is clearly an important public health problem in Ghana. The burden of the disease as dictated by a high prevalence rate calls for urgent public health interventions and strategic policy directions to controlling the disease to avert any potential future explosion.

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Hepatitis B in Ghana: a systematic review & meta-analysis of prevalence studies (1995-2015).

More than two billion people have been infected with hepatitis B virus (HBV). Globally, 350-400 million suffer from chronic HBV infection. It is postulated that dentists and dental staff are infected and transmit the virus to their patients more than any other occupation. The aim of this article is to review the HBV incidence in dental society, the points of view of dentists and their patients regarding transmission of the virus during dental procedures, the occurrence of HBV outbreaks in dental clinics and the importance of methods of preventing HBV infection in dentistry.

Hepatitis B virus infection in dentistry: a forgotten topic

Epidemiology and natural history of hepatitis B

https://www.journal-of-hepatology.eu/article/S0168-8278(12)00343-1/pdf

High prevalence of occult hepatitis B virus infection in children born to HBsAg-positive mothers despite prophylaxis with hepatitis B vaccination and HBIG.

Results: Fourteen studies met the inclusion criteria. They were from 7 (out of 30) provinces in which about 40 percent of the country population live. These provinces (HBsAg positive prevalence) were Golestan (6.3%), Tehran (2.2%), East Azarbaijan (1.3%), Hamedan (2.3%), Isfahan (1.3%), Kermanshah (1.3%) and Hormozgan (2.4%). The HBV infection prevalence in Iran is estimated to be 2.14 percent (95%CI: 1.92-2.35), in men and women 2.55 percent (95%CI: 2.252.85) and 2.03 percent (95%CI: 1.6-2.46 percent) respectively. Conclusions: About 1.5 million people in Iran are living with HBV infection (mild to moderate prevalence according to WHO classification) and it is assumed that 15% to 40% of them are at risk of developing cirrhosis and/or hepatocellular carcinoma (HCC) without intervention. The prevalence of HBV infection has been reported higher in more recent studies compared to the study in 2000-2001.

Hepatitis B Virus Infection in Iran: A Systematic Review

BACKGROUND AND AIMS: Pegylation of Interferon (IFN) prolongs the medication half-life, which has resulted in introducing Pegylated Interferon (PEG-IFN) as the new modality for treatment of chronic hepatitis C. This clinical trial was conducted to assess the efficacy and safety of Peg-INF in combination with ribavirin in a number of Iranian patients with chronic hepatitis C or cirrhosis. METHODS: Fifty two patients with HCV RNA in serum, persistently elevated aminotransferase levels, and chronic hepatitis (n=45) or cirrhosis (n=7) on liver biopsy were enrolled to this study. The patients received PEG-IFN (40 kD) 180 micg per week plus ribavirin 10-15 mg/kg per day. Treatment lasted 48 weeks and was followed by a 24-week follow up period to assess sustained virologic response (SVR). The patients consisted of 46 males and 6 females with a mean age of 38.5 ± 10.9 years. RESULTS: In an intention-to-treat analysis HCV RNA was undetectable in 43 patients (83.7%) at week 48 and SVR was achieved in 28 patients (53.8%). SVR was achieved in 62.9% of naive patients, 35.3% of the patients who had a past failed treatment with IFN-based therapy, 60.0% of patients with chronic hepatitis and 14.3% of cirrhotic patients. In two patients (3.8%) adverse event led to treatment discontinuation and in eight patients (15.3%) dose modification of medication was required.

Hajarizadeh Behzad

Papers

Hepatitis B Virus Infection in Iran: A Systematic Review

Efficacy and Safety of Pegylated Interferon Alfa-2a plus Ribavirin for Treatment of Chronic Hepatitis C and Cirrhosis in Iranian

Attempted suicide in two patients with chronic hepatitis C while being treated with Interferon-alpha

Combination Therapy of Interferon-alpha (PDferon B®) and Ribavirin for Chronic Hepatitis C