hepatitis-B vaccine

Lipid parameters but not inflammatory indices predict hepatitis B vaccine responses in hemodialysis patients.

Ekici Hilal H, Mirza Arzu A, Baltacı Sevgi S, Eren Davut D et al.

Hepatitis B virus (HBV) vaccination is essential in hemodialysis (HD) populations, yet seroprotection remains suboptimal. Inflammation-related hematologic indices are frequently used in clinical practice, but their ability to predict HBV vaccine response in HD patients is uncertain. We evaluated clinical and laboratory determinants of HBV vaccine response, with a focus on lipid-derived indices and inflammatory ratios. In this multicenter retrospective study, adult HD patients followed between 2015 and 2025 who received at least three doses of HBV vaccine and had available anti-HBs measurements were included (n = 341). Vaccine response was defined as anti-HBs ≥10 IU/L; non-response as <10 IU/L. Neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), monocyte-to-lymphocyte (MLR), neutrophil percentage-to-albumin ratio (NPAR), and lipid ratios (TG/HDL, TC/HDL, LDL/HDL) were calculated. Additional analyses using percentile-based categorization of NPAR confirmed the absence of a significant association with vaccine response. Multivariable logistic regression and receiver operating characteristic analyses were performed. After the primary vaccination series, seroprotection was 77.4% and increased to 88.6% after revaccination/boosters; it declined to 78.3% at 1 year and 69.2% at 2 years. Non-responders were older and had higher triglyceride levels and lower HDL cholesterol levels. In contrast, inflammatory indices (NLR, PLR, MLR, and NPAR) did not differ significantly between groups. These indices also demonstrated limited discriminative ability for predicting vaccine response. In multivariable analysis, HDL cholesterol remained positively associated with vaccine response [odds ratio (OR): 1.046, 95% confidence interval (CI): 1.006-1.086, P = .022], and triglyceride levels were negatively associated with vaccine response (OR: 0.992, 95% CI: 0.984-0.999, P = .024). The TG/HDL ratio showed borderline statistical significance (OR: 1.235, 95% CI: 0.983-1.551, P = .070), suggesting a potential but limited contribution to vaccine response prediction. In HD patients, hematologic inflammatory indices were not informative for HBV vaccine response, whereas an atherogenic lipid profile-particularly lower HDL and higher triglycerides-showed a consistent association. Lipid parameters may support risk stratification and tailored post-vaccination monitoring strategies.

Prevalence of Hepatitis B Virus Infection in Cameroon: A Systematic Review and Meta-Analysis.

Maliki Iya I, Webb Edward J D EJD, Ada Rose Armelle RA, Dawkins Bryony B et al.

Chronic hepatitis B virus (HBV) infection is a global public health problem, and many regions of Sub-Saharan Africa are disproportionately affected, including Cameroon, where prevalence has previously been shown to be high. This study aimed to provide up-to-date estimates of HBV prevalence in Cameroon. We searched Medline, Global Health, Embase, Web of Science, Cochrane Library, Africa Index Medicus and the Journal of Health Science and Disease at the University of Yaounde. We included studies reporting HBV surface antigen (HBsAg) prevalence in the general population and subpopulations. A random-effects meta-analysis was used to generate pooled estimates of HBsAg prevalence, overall and for population subgroups including those considered at relatively higher-risk and relatively lower-risk of HBV infection. Heterogeneity was assessed using the index of heterogeneity (I2). Quality was assessed using the Joanna Briggs Institute critical appraisal tool. Out of 1236 records, 92 papers with 100 studies were included in the meta-analysis. Overall prevalence of HBV in Cameroon was 9.98% (95% confidence interval [CI] 9.00-11.02) with high heterogeneity (I2 = 98.10%). The prevalences for relatively lower-risk and higher-risk populations were8.94% (95% CI 7.84-10.11) and 12.70% (95% CI 10.28-15.32), respectively. In subgroup analyses, we found that sex, geographical area (regions), population risk groups and study design were the main sources of heterogeneity. Overall, HBV prevalence remains high in Cameroon. Our findings suggest an urgent need for health interventions to halt the spread of the disease, with particular attention needed for males and regions with the highest prevalence.

Viral load rather than transaminase: an international perspective on the KASL-EALA 2026 guideline for chronic hepatitis B.

Kanto Tatsuya T, Zoulim Fabien F, Yu Ming-Lung ML

A scoping review of the acceptability, feasibility and effectiveness of opt-out blood-borne virus (BBV) testing in secondary healthcare settings, in the UK and similar settings, using APEASE criteria.

Metcalfe Becky B, Maxwell Karen J KJ, Trayner Kirsten K, Wilkinson Max M et al.

Earlier diagnosis of blood-borne viruses (BBVs)-HIV, hepatitis B (HBV) and hepatitis C (HCV)-remains a significant public-health focus. Opt-out testing in secondary healthcare settings can improve early diagnosis and linkage to care as part of BBV transmission elimination targets. This scoping review used APEASE criteria (acceptability, practicability, effectiveness, affordability, side-effects and equity) to evaluate opt-out BBV testing interventions in emergency departments (EDs) and medical assessment units (MAUs). A systematic search of three databases was conducted for peer-reviewed literature up to 30th June 2025. Inclusion criteria were: (a) opt-out BBV testing intervention; (b) taking place within a secondary care setting; and (c) in the UK, Ireland, Australia and Canada. Data were extracted and analysed using APEASE criteria. Twenty-eight studies met inclusion criteria. Opt-out testing was acceptable to patients and healthcare professionals, particularly when supported by clear communication, staff training and leadership engagement. Practicability varied by setting; barriers included time constraints, unclear responsibilities and logistical challenges. Automation using electronic systems facilitated implementation. Effectiveness was demonstrated through increased testing uptake and case identification, especially in EDs. Minimal evidence exists on affordability and is likely to vary by population prevalence. No significant side effects (unintended outcomes) were reported, and universal testing was associated with reduced stigma. Opt-out testing can improve access to testing for underserved populations, supporting its role in promoting health equity. Opt-out BBV testing in secondary care settings (EDs and MAUs) is a feasible, effective and equitable intervention when supported by appropriate infrastructure and resources. Efforts should focus on optimizing implementation strategies and extending opt-out testing, including to lower-prevalence settings.