ASSESSMENT OF VACCINATION IMPACT ON HEPATITIS B EPIDEMIOLOGY IN THE REPUBLIC OF BELARUS
Abstract
Integration of hepatitis B (HBV) vaccination into national immunization programs has resulted in a significant reduction in hepatitis B virus (HBV) transmission worldwide, and specifically in previously highly endemic countries. A key aspect of HBV elimination strategy is the administration of a birth dose followed by a further hepatitis B vaccination of newborns. Additional preventive measures include screening during pregnancy, administration of antivirals as well as the use of HB immunoglobulin. Despite a significant decrease in the number of HB cases, vaccination of adults, in particular those of high-risk groups, remains an important challenge. Objective. To evaluate the impact of vaccination strategies on HB epidemiology in the Republic of Belarus. Material and methods. HBV incidence in the Republic of Belarus has been estimated according to the data from state statistical reporting forms. The results were statistically processed using Statistica V.10.0 program (Statsoft, USA). Results. Over the period in question there has been noted a marked decrease in the incidence of acute and asymptomatic HBV forms (the rate (ТсН.) equals to -13,25% and -11,99% respectively), while the incidence of chronic hepatitis B (CHB) tends to increase (the rate (Тpr.) equals to +1,09%). Over the period of 2002-2022, CHB prevails in the etiological structure, constituting more than 70% of observations in the total structure of HB since 2018. HBV incidence pattern varies according to the regions. Currently, the leading cohort in the overall incidence is the population aged 30-49. The incidence rate of hepatitis B among individuals of this age cohort (320.57 per 100 thousand people) is 2.35 times higher than that of a 0-29-yearage cohort (136.50 per 100 thousand people) that is accounted for by a low level of preventive vaccination coverage (according to medical records), equal to 39.3% for the cohort aged 30-49. Scheduled vaccine prophylaxis introduced in 2000 has become the basis for the effective HB epidemiology surveillance in the Republic of Belarus. Conclusions. The period in question is characterized by both a marked decrease in the incidence of nosological HBV forms (the rate is 7.5%) and a moderate increase in the incidence of chronic hepatitis B (the rate (Тpr.) equals to +1,09%. Despite the undeniable progress and success of HB vaccination, it should be mentioned that an estimated over 65% of unvaccinated adult population may form a cluster for the potential spread of the virus.
References
Ventura M, O’Flaherty S, Claesson MJ, Turroni F, Klaenhammer TR, van Sinderen D, O’Toole PW. Genome-scale analyses of health-promoting bacteria: probiogenomics. Nat Rev Microbiol. 2009;7(1):61-71. https://doi.org/10.1038/nrmicro2047.
Ley RE, Hamady M, Lozupone C, Turnbaugh PJ, Ramey RR, Bircher JS, Schlegel ML, Tucker TA, Schrenzel MD, Knight R, Gordon JI. Evolution of mammals and their gut microbes. Science. 2008;320(5883):1647-51. https://doi.org/10.1126/science.1155725.
Chow J, Mazmanian SK. A pathobiont of the microbiota balances host colonization and intestinal inflammation. Cell Host Microbe. 2010; 7(4):265-276. https://doi.org/10.1016/j.chom.2010.03.004.
O’Hara AM, Shanahan F. The gut flora as a forgotten organ. EMBO Rep. 2006;7(7):688-93. https://doi.org/10.1038/sj.embor.7400731.
Jandhyala SM, Talukdar R, Subramanyam C, Vuyyuru H, Sasikala M, Nageshwar Reddy D. Role of the normal gut microbiota. World J Gastroenterol. 2015;21(29):8787-803. https://doi.org/10.3748/wjg.v21.i29.8787.
Yakubtsevich RE, Lemesh AV, Kiryachkov YuYu. Patogeneticheskie mekhanizmy formirovaniya geneticheskoj ustojchivosti k antibiotikam pri lechenii tyazhelyh infekcij v intensivnoj terapii [Pathogenetic mechanisms of development of genetic resistance to antibiotics in treatment of severe infections in intensive care units]. Zhurnal Grodnenskogo gosudarstvennogo medicinskogo universiteta [Journal of the Grodno State Medical University]. 2021;19(3):255-262. https://elibrary.ru/rtqhgv. https://doi.org/10.25298/2221-8785-2021-19-3-255-262. (Russian).
Sonnenburg JL, Xu J, Leip DD, Chen CH, Westover BP, Weatherford J, Buhler JD, Gordon JI. Glycan foraging in vivo by an intestine-adapted bacterial symbiont. Science. 2005;307:1955-1959. https://doi.org/10.1126/science.1109051.
Sheybak VM, Nikolaeva IV, Pavlyukovec AYu. Mikrobiocenoz tolstogo kishechnika i soderzhanie svobodnyh aminokislot v mikrobno-tkanevom komplekse krys. Vestnik Vitebskogo gosudarstvennogo medicinskogo universiteta. 2014;13(3):50-58. edn: SNIXMF (Russian).
Armstrong T, Fenn SJ, Hardie KR. JMM Profile: Carbapenems: a broad-spectrum antibiotic. J Med Microbiol. 2021;70(12):001462. https://doi.org/10.1099/jmm.0.001462.
Guarner F, Khan AG, Garisch J, Eliakim R. Gangl A, Thomson A, Krabshuis J, Lemair T, review team; Kaufmann P, de Paula JA, Fedorak R, Shanahan F, Sanders ME, Szajewska H, Ramakrishna BS, Karakan T, Kim N, invited outside experts. Probiotics and Prebiotics. World Gastroenterology Organisation Global Guidelines. Zeneva: World Gastroenterology Organisation; 2011. 28 p.
Weese JS. Clostridium difficile in food--innocent bystander or serious threat. Clin Microbiol Infect. 2010;16(1):3-10. https://doi.org/10.1111/j.1469-0691.2009.03108.
McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, Dubberke ER, Garey KW, Gould CV, Kelly C, Loo V, Shaklee Sammons J, Sandora TJ, Wilcox MH. Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018;66(7):e1-e48. https://doi.org/10.1093/cid/cix1085.
1.png)
