Frequency of Occult Hepatitis B in Pregnant Women Attending Antenatal Care Unit of a Tertiary Care Hospital

Abstract

Introduction: Occult infections (OBIs) caused by hepatitis B virus (HBV) are detected by the presence of HBV DNA without surface antigens. The prevalence of HBsAg in general population of Pakistan is around 3%, but there is no data regarding the occurrence of OBIs. Aims & Objectives: The goal of this research was to assess the frequency of occult hepatitis B infection in pregnant females presenting to antenatal care unit of Shaikh Zayed Hospital, Lahore. Place and duration of study: These samples were handled at the Microbiology Department of Shaikh Zayed Hospital, Lahore. The duration of study was one year after the approval of synopsis. Material & Methods: Four hundred and sixty three pregnant women were included in this research. Serum was separated from their blood samples. HBsAg, Anti-HBcand Anti-HBs tests were performed using the ELISA technique on all the samples. Real time PCR was performed to find HBV DNA. Results: The frequency of occult hepatitis B was < 0.25 in this research. Among the 463 women tested during pregnancy, hepatitis B surface antigen was positive in 2 (0.4%) women. These two were excluded from the study. Out of 461 samples, hepatitis B surface antibody was positive in 61 (13.2%) samples and they were negative for hepatitis B core antibody. These 61 samples were also omitted from the research. 25 (5%) samples were positive for both Anti-HBc and Anti-HBs. 11 samples (2%) were Anti-HBc positive and Anti-HBs negative. In 364 (79%) samples, both Anti-HBs and Anti-HBc were absent. Polymerase Chain Reaction was performed on 400 samples. Conclusion: The frequency of occult hepatitis B is very low < 0.25% in pregnant women. It is not recommended to routinely screen pregnant women for hepatitis B virus DNA.

Effect of obligatory Hepatitis B vaccination program on the prevalence of occult hepatitis B among pregnant women in Egypt: A cross sectional study

“…15 Our data showed that the frequency of positive total HBc Ab in the studied cases was 4.2%, and the frequency was statistically significantly increased in unvaccinated group when compared to the vaccinated group. Our results are consistent with those reported by Mbangiwa et al, 2018, 16 and Ali et al, 2020, 17 they found that the prevalence of OBI in was 6•6% and 5% in pregnant women, respectively. Moreover, Chang et al, 2010 14 also reported an increase in frequency of OBI cases among pregnant women which could be explained by immunosuppressive status of pregnancy.…”

“…HBc Ab and/or HBs Ab were detected in 17•1% of pregnant women, 15•8% in the vaccinated group and 14•5% in the unvaccinated group. These findings agreed with those reported by Ali et al, 2020, 17 who found that the frequency of anti HBs was 13•2% in pregnant women and with data of Mak et al, 2020, 23 who reported that the serum markers were used to define different OBI types, which can be classified as seropositive or seronegative. In seropositive anti-HBc and/or anti-HBs were detectable in the serum.…”