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Peer reviewedAcute hepatitis BHepatitis BHepatitis D

Acute hepatitis B in the vaccination era: Predictors of functional cure and chronicity

World Journal of Hepatology·

David Yardeni, Julianna Gershbaum Tobin, Bryan Itkowitz, Inna Lipnizkiy, Ali Abu Juma’a, Naim Abu-Freha, Ayelet Keren-Naus, May Turgeman, Anat Nevo-Shor, Robert Gareth Gish, Ohad Etzion

DOI
10.4254/wjh.124108
PMID
PMCID
OpenAlex
Study type
Journal article
Publisher
Baishideng Publishing Group Inc.
Article type
journal-article
Integrity
current

Why this research matters now

The findings suggest acute HBV infection in the vaccination era carries higher-than-expected chronicity risk, particularly among patients with metabolic disease and socioeconomic disadvantage. This supports the need for early risk stratification and targeted follow-up for vulnerable populations despite vaccine availability.

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Structured evidence summary

Research question

The study evaluated whether epidemiologic shifts in populations susceptible to acute hepatitis B virus (HBV) infection in the vaccination era alter immune responses and affect rates of functional cure versus progression to chronic infection.

Study design

Retrospective cohort study of patients aged 18 and older with acute HBV infection in Southern Israel from 2004 to 2022, analyzing clinical, biochemical, metabolic, and socioeconomic variables associated with functional cure or chronic infection.

Population and setting

Adults with acute HBV infection in Southern Israel during 2004-2022, a period and region with widespread vaccine availability. The cohort included 78 patients.

Main findings

Among 78 patients, 65.3% achieved functional cure while 34.6% progressed to chronic HBV. Patients achieving functional cure had significantly higher peak alanine aminotransferase levels at presentation compared to those developing chronic infection (2117 vs 1103 IU/mL, P=0.01). Progression to chronic infection was significantly more common among patients with low socioeconomic status (70% vs 41%, P=0.04) and diabetes mellitus (26% vs 3.9%, P=0.007). Early antiviral therapy initiation did not differ between outcome groups.

Public-health relevance

The findings suggest acute HBV infection in the vaccination era carries higher-than-expected chronicity risk, particularly among patients with metabolic disease and socioeconomic disadvantage. This supports the need for early risk stratification and targeted follow-up for vulnerable populations despite vaccine availability.

Important limitations

The summary is limited to the supplied single-article abstract and metadata. Full interpretation requires access to the complete study, including detailed methodology, statistical analyses, definitions of acute infection and functional cure, duration of follow-up, potential confounders, and generalizability considerations.

GIDS interpretation

This article was classified under acute hepatitis B, hepatitis B treatment, and vaccination topics in Israel. It provides context on chronicity risk factors in vaccinated populations but does not constitute surveillance data or confirm active disease trends.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 8 auditable classifier relationships to diseases, places, topics, and study design.

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