Screening program on hepatitis B in young Albanian population: The Greek-Albanian collaborative study on the prevention of hepatitis B (the HEPAGA project)

Abstract

SUMMARY
Aim: The aim of the study was to screen for hepatitis B
virus (HBV) in a well-defined, young, population in the area
of Tirana, Albania (the HEPAGA project).
Patients-Method: This study was conducted under the
auspices and with grants from the Greek Ministry of
Development and the Albanian Ministry of Education and
science. This collaborative study lasted for two years (2001-
2002) and was successfully completed on both sides. Serum
samples from the non-vaccinated, young population (ages
14-20) living in a well-defined area of Tirana were collected
during the period from September 2001 to February 2002
and were stored at -20o C until assayed at the Blood Bank of
the Ioannina University Hospital. Every sample was
examined for HBV immunology profile using routine
methods. In case of gray zone results double testing was
performed. In cases of insufficient serum we tested, in
priority, HBsAg, then HBcore antibody (anti-) and then anti-
HBs. Results were then sent back to Albania where Albanian Results: The Greek part received 412 serum samples. Two
samples could not be evaluated for technical reasons, while
the remaining 410 were analyzed for the HBV immunology
parameters as shown below.
Parameter tested No of %
samples
Hepatitis B virus not detected 226 54.88
HBsAg(+) 49 11.89
HBcore(+)/anti-HBs over 10 UI/ml 87 21.19
HBcore(+)/anti-HBs less than 10 UI/ml 14 3.49
Only HBcore(+) 14 3.49
HBcore(+) not enough serum for anti-HBs 8 1.97
HBsAg(-) not enough serum for HBcore 12 3.09
TOTAL 410 100.00
Conclusions: The HEPAGA Study showed that public health
projects between Balkan countries are realistic. Albania is
a paradigm of public health prevention strategy directed at
the elimination of hepatitis B through an expanded,
obligatory vaccination programme.
Key words: hepatitis, HBsAg, Albania, Greece, screening,
population study