Zaw Zaw Aung

Myanmar Liver Foundation, Mandalay, Myanmar



Biography

Zaw Zaw Aung got his MBBS from University of Medicine, Mandalay in 2017. Just after graduation, he volunterred in intergrated HIV care services in govenment hospitals as medical officer. Now he is working as a sub-investigator in the demonstration project on assessment of  simplified antiviral  treatment strategy for Hepatitis C in Myanmar.

Abstract

Background Nearly 5 million of Myanmar people are living with hepatitis B. HBV/HCV coinfected patients are increased risk of cirrhosis, hepatic decompensation and hepatocellular carcinoma. There is currently no data for hepatitis B vaccine utilization in HCV positive patients and their antibody response.

Methodology From February 2018 to May 2018, consented participants at or above 18 years were tested with anti-HCV RDT. Those who tested HCV positive (n=165) were further tested with hepatitis B profile and asked about their hepatitis B vaccination history and risk factors.

Results HCV positive participants (n=165) were categorized into previously vaccinated 64% (n=106) and unvaccinated 36% (n=59) There were three characteristics groups- PWID monoinfected (n=77), GP monoinfected (n=22) and HIV/HCV coinfected participants (n=66). Unvaccinated participants were highest in HIV/HCV, with 68%(n=45) followed by GP (23%, n=5) and PWID (12%, n=9) . Among previously vaccinated participants, the highest percentage was PWID (88%, n=68), the second highest was GP (77%, n=17) and lowest in HIV/HCV patients (32%, n=21). 53% of participants who completed 3 dose of hepatitis B were non-responders (n=34): PWID (47%, n=16), HIV/HCV (35%, n=12) and GP (18%, n=6)

Conclusion Even in the presence of effective and safe hepatitis B vaccine, uptake is low among high risk groups especially PLHIV that needs to be improved. Integration or collaboration of hepatitis B vaccination program, ARV and hepatitis C treatment centers is desirable. Half of vaccinated participants were non-responders so that optimal doses, schedule and follow-up testing need to be addressed carefully for those groups.