A low proportion of HBeAg among HBsAg-positive pregnant women with known HIV status could suggest low perinatal transmission of HBV in Cameroon

Abstract

BackgroundTransmission of hepatitis B virus (HBV) from HBV-positive mothers to their infants is common and usually occurs when the mother is hepatitis B e antigen (HBeAg) positive and/or has a high HBV DNA load. In this study, we determined the prevalence of hepatitis B surface antigen (HBsAg) and HBeAg among pregnant women with known HIV status.FindingsA total of 650 pregnant women with a mean age of 26.2 years including 301 HIV-positives and 349 HIV-negatives were screened for HBsAg (Monolisa AgHBs Plus Biorad, France). Among the HBsAg-positives, HBeAg and anti-HBe were tested (Monolisa Ag HBe Plus Biorad, France). Overall, 51 (7.85%) were positive for HBsAg. The prevalence of HBsAg was not statistically different between HIV-positive and HIV-negative pregnant women [28/301 (9.3%) vs 23/349 (6.59%); p = 0.2]. None of the 45 HBsAg-positive samples was reactive for HBeAg.ConclusionsOur study indicates a high prevalence of HBsAg with very low proportion of HBeAg in Cameroonian pregnant women. Since perinatal transmission of HBV is mostly effective when the mother is also HBeAg-positive, our data could suggest that perinatal transmissions play a minor role in HBV prevalence in Cameroon. In line with previous African studies, these findings further suggests that horizontal transmission could be the most common mechanism of HBV infections in Cameroon.

Seroprevalence of Hepatitis B Surface Antigen among Pregnant Women in a Tertiary Care Health Center of North India

“…The HBeAg-positive women are known to have a high viral load and transmit HBV to their offspring. 26 In our study, among 42 HBsAg-positive women, 11 were available for HBeAg testing, and among these, 4 tested positive for HBeAg. This is indicative that the proportion of the women was highly infectious, and therefore likely to transmit the virus to their offspring.…”

“…The hepatitis status and the HBV viral load are both factors known to be associated with vertical HBV transmission. 26 We did not evaluate the vertical transmission in our study, but used the presence of HBeAg which is a marker of high infecivity. The HBeAg-positive women are known to have a high viral load and transmit HBV to their offspring.…”

Global Epidemiology of Hepatitis B Virus (HBV) Infection

“…However, vertical transmission accounts for only a minority of HBV infections. This is largely attributable to the low proportion of HBeAg positivity, a known risk factor associated with perinatal transmission [57]. Conversely, horizontal transmission trough unexplained routes during early childhood (<5 years) is considered to represent the major mode of HBV transmission in Africa [58].…”

HIV/HBV coinfection in children and antiviral therapy

“…Recently, with the availability of nationally approved combination antiretroviral therapy (cART) programs, there has been increased concern regarding the potentially high prevalence of HBV coinfection in HIV-positive pregnant women. This concern has spawned further evaluations into the true seroprevalence of HBV infection on a national level, including in African countries that were previously underrepresented (TABLE 1) [10–22]. As demonstrated in TABLE 1 , prevalence of HBV monoinfection among pregnant women in Africa ranges from 4.0 to 17.1%, and prevalence of HBV/HIV-coinfected pregnant women in Africa is variable with a range from 0.4 to 7.1%.…”