World Hepatitis Day was July 28th, and PLOS ONE is observing the day by raising awareness with a few of our many open access articles on viral hepatitis that we’ve published in the past year. According to the World Hepatitis Alliance, despite hepatitis being a widespread illness and having close to the same mortality rate as HIV/AIDS, it seems to lack the same level of awareness among the general population. Below is a sampling of research articles about hepatitis to help broaden our awareness on this important day, including research on how over the counter pain relievers can impact vaccination, on infection of infants born to mothers with hepatitis, and on reinfection and clearance of hepatitis C in people who inject drugs. For more background information on this disease, check out this intro to the hepatitis viruses on the World Hepatitis Day website.
Vaccination and Pain Relief
Sometimes vaccinations can cause soreness at the vaccination site and low grade fever. Over the counter (OTC) paracetamol, also known as acetaminophen—the main active ingredient in pain-relieving products like Tylenol—is sometimes used before or after vaccination to prevent or treat this pain and fever. Researchers have previously shown that taking paracetamol during hepatitis B vaccination makes it less effective in babies, and the authors of this PLOS ONE study sought to determine if the same might be true for young adults 18 years old or older receiving the vaccination. In this randomized, controlled clinical trial, researchers compared three groups: one group was given paracetamol before vaccination, one group was given paracetamol after, and the third group received no paracetamol. The results showed that the vaccinated adults experienced modest suppression of their immune systems and lower production of antibodies if they received paracetamol before being given the vaccine, but not if they received it post-vaccine. Due to concerns about reduced effectiveness, the authors recommend further investigation into the timing of taking paracetomol to treat any hepatitis B vaccine side effects.
Infants Born to Mothers with Hepatitis B in Cameroon
The World Health Organization recommends vaccinating infants against hepatitis B when they are born to mothers with the disease, and a program to do just that began in Cameroon in 2007. PLOS ONE authors in this study tested pregnant women in North Cameroon between 2009 and 2010 and found that 20% of the women tested positive for hepatitis B even though most of them exhibited no symptoms. Since Cameroon is a high risk area where hepatitis B is common, this study supports previous research and provides further support for the WHO recommendation in favor of routine hepatitis B vaccines at birth for children of at-risk mothers.
Hepatitis C Clearance and Reinfection in People Who Inject Drugs
Researchers have previously shown that 20-40% of people infected with hepatitis C fight off and clear the virus from their body without any medical intervention. This does not mean, though, that these individuals are immune to reinfection. Researchers in Australia report nine confirmed and 17 possible cases of hepatitis C reinfections in 188 drug-injecting study participants in this PLOS ONE study. Additionally, many of those who were re-infected did not clear the virus as they did the first time, suggesting that immunity is incomplete and supporting previous research. The authors therefore suggest public health campaigns may help to inform people who inject drugs about the risk of reinfection.
For more hepatitis research and information, have a look at some of our other articles here.
- Flickr image: all in a day’s work by Dawn Huczek
- Image of hepatitis virions by E.H. Cook, Jr. from the CDC Public Health Image Library is in the public domain.
- Flickr image: Hepatitis C Cell Embroidery Art by Hey Paul Studios
Doedée AMCM, Boland GJ, Pennings JLA, de Klerk A, Berbers GAM, et al. (2014) Effects of Prophylactic and Therapeutic Paracetamol Treatment during Vaccination on Hepatitis B Antibody Levels in Adults: Two Open-Label, Randomized Controlled Trials. PLoS ONE 9(6): e98175. doi:10.1371/journal.pone.0098175
Ducancelle A, Abgueguen P, Birguel J, Mansour W, Pivert A, et al. (2013) High Endemicity and Low Molecular Diversity of Hepatitis B Virus Infections in Pregnant Women in a Rural District of North Cameroon. PLoS ONE 8(11): e80346. doi:10.1371/journal.pone.0080346
Sacks-Davis R, Aitken CK, Higgs P, Spelman T, Pedrana AE, et al. (2013) High Rates of Hepatitis C Virus Reinfection and Spontaneous Clearance of Reinfection in People Who Inject Drugs: A Prospective Cohort Study. PLoS ONE 8(11): e80216. doi:10.1371/journal.pone.0080216