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CSU 85/2011: HEPATITIS UPDATES

Friday, 11th of March 2011

The global prevalence of hepatitis E virus and susceptibility: A systematic review

 

This report presents the results of a systematic review of the literature of the global prevalence of hepatitis E virus infection. This information is summarized by 21 regions as defined by the Global Burden of Disease Study (www.globalburden.org). The target audience includes researchers, health professionals, policy makers, and other experts. The work will contribute to an understanding of the global burden of disease from hepatitis E virus infection when the information is used to inform later models.

 

http://www.who.int/immunization/documents/WHO_IVB_10.14/en/index.html

 

The Global Prevalence of Hepatitis A Virus Infection and Susceptibility: A Systematic Review

 

This report presents the results of a systematic review of the literature of the global prevalence of hepatitis A virus infection. This information is summarized by 21 regions as defined by the Global Burden of Disease Study (www.globalburden.org). The target audience includes researchers, health professionals, policy makers, and other experts. The work will contribute to an understanding of the global burden of disease from hepatitis A virus infection when the information is used to inform later models.

 

http://www.who.int/immunization/documents/WHO_IVB_10.01/en/index.html

 

Vaccine. 2010 Sep 24;28(41):6653-7. Epub 2010 Aug 17.

Hepatitis A virus seroprevalence by age and world region, 1990 and 2005.

Jacobsen KH, Wiersma ST.

Department of Global & Community Health, George Mason University, 4400 University Drive MS 5B7, Fairfax, VA 22030, USA. kjacobse@gmu.edu

Abstract

OBJECTIVE: To estimate current age-specific rates of immunity to hepatitis A virus (HAV) in world regions by conducting a systematic review and meta-analysis of published data. The estimation of the global burden of hepatitis A and policies for public health control are dependent on an understanding of the changing epidemiology of this viral infection.

METHODS: Age-specific IgG anti-HAV seroprevalence data from more than 500 published articles were pooled and used to fit estimated age-seroprevalence curves in 1990 and 2005 for each of 21 world regions (as defined by the Global Burden of Disease 2010 Study).

FINDINGS: High-income regions (Western Europe, Australia, New Zealand, Canada, the United States, Japan, the Republic of Korea, and Singapore) have very low HAV endemicity levels and a high proportion of susceptible adults, low-income regions (sub-Saharan Africa and parts of South Asia) have high endemicity levels and almost no susceptible adolescents and adults, and most middle-income regions have a mix of intermediate and low endemicity levels.

CONCLUSION: Anti-HAV prevalence estimates in this analysis suggest that middle-income regions in Asia, Latin America, Eastern Europe, and the Middle East currently have an intermediate or low level of endemicity. The countries in these regions may have an increasing burden of disease from hepatitis A, and may benefit from new or expanded vaccination programs.

 

Liver Int. 2010 Nov 28. doi: 10.1111/j.1478-3231.2010.02373.x. [Epub ahead of print]

Treatment of chronic hepatitis B virus infection in resource-constrained settings: expert panel consensus.

Wiersma ST, McMahon B, Pawlotsky JM, Thio CL, Thursz M, Lim SG, Ocama P, Esmat G, Maimuna M, Bell D, Vitoria M, Eramova I, Lavanchy D, Dusheiko G.

World Health Organization, FCH/IVB, Geneva, Switzerland Alaska Native Medical Center, CDC Arctic Investigations Program, Anchorage, AK, USA Department of Virology, Hopital Henri Mondor, Paris, France Department of Medicine, Johns Hopkins University, Baltimore, MD, USA Department of Academic Medicine, St Mary's Hospital Campus, Imperial College, London, UK Department of Medicine, National University Hospital, Singapore, Singapore Department of Medicine, Makerere University, Mulago Hospital, Kampala, Uganda Faculty of Medicine, Cairo University, Cairo, Egypt Medical Research Council Laboratory, Banjul, The Gambia US Centers for Disease Control and Prevention, Division of Viral Hepatitis, Atlanta, USA World Health Organization, HIV/AIDS, Geneva, Switzerland World Health Organization, EURO, Copenhagen, Denmark World Health Organization, HSE, Geneva, Switzerland Royal Free Hospital, School of Medicine, London, UK.

Abstract

Most of the estimated 350 million people with chronic hepatitis B virus (HBV) infection live in resource-constrained settings. Up to 25% of those persons will die prematurely of hepatocellular carcinoma (HCC) or cirrhosis. Universal hepatitis B immunization programmes that target infants will have an impact on HBV-related deaths several decades after their introduction. Antiviral agents active against HBV are available; treatment of HBV infection in those who need it has been shown to reduce the risk of HCC and death. It is estimated that 20-30% of persons with HBV infection could benefit from treatment. However, drugs active against HBV are not widely available or utilized in persons infected with HBV. Currently recommended antiviral agents used for treatment of human immunodeficiency virus (HIV) infection do not adequately suppress HBV, which is of great concern for the estimated 10% of the HIV-infected persons in Africa who are co-infected with HBV. Progressive liver disease has been shown to occur in co-infected persons whose HBV infection is not suppressed. In view of these concerns, an informal World Health Organization consultation of experts concluded that: chronic HBV is a major public health problem in emerging nations; all HIV-infected persons should be screened for HBV infection; HIV/HBV co-infected persons should be treated with therapies active against both viruses and that reduce the risk of resistance; standards for the management of chronic HBV infection should be adapted to resource-constrained settings. In addition, a research agendum was developed focusing on issues related to prevention and treatment of chronic HBV in resource-constrained settings.