Screening for Hepatitis B in partners and children of women positive for surface antigen, Burkina Faso

Guingané, Alice Nanelin; Kaboré, Rémi; Shimakawa, Yusuke; Somé, Eric Nagaonlé; Kania, Dramane; Pisoni, Amandine; Nagot, Nicolas; King, Rachel; Sombié, Roger; Méda, Nicolas; Perre, Philippe Van de; Tuaillon, Edouard

doi:10.2471/blt.21.287015

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…Rollout of infant HBV vaccination within the pentavalent series starting at 6 weeks of age is one possible explanation for the HBV prevalence among children in index-positive households, which was >13 times as high for those who were aged >13 years compared to those who were aged ≤13 years in 2022. Our findings are consistent with results of a study conducted in Burkina Faso, which also reported lower HBsAg positivity among children born to 215 HBsAg-positive mothers after HBV vaccine rollout but before birth dose [ 33 ]. We observed relatively few HBsAg-positive offspring of HBsAg-positive mothers, suggestive of infrequent perinatal transmission given that PMTCT measures have not been implemented in DRC.…”

Section: Discussionsupporting

confidence: 93%

Hepatitis B Virus Prevalence and Transmission in the Households of Pregnant Women in Kinshasa, Democratic Republic of Congo

Morgan,

Ngimbi,

Boisson-Walsh

et al. 2024

Open Forum Infectious Diseases

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Background The World Health Organization Africa region has high regional hepatitis B virus (HBV) prevalence and evidence suggests more frequent horizontal HBV transmission than other regions. Context-specific epidemiological studies are needed to inform additional HBV prevention measures. . Methods In the cross-sectional Horizontal and Vertical Transmission of Hepatitis B (HOVER-HBV) study, we introduced HBV surface antigen (HBsAg) screening alongside existing HIV screening as part of routine antenatal care (ANC) in high-volume maternity clinics in Kinshasa, Democratic Republic of Congo. We recruited households of pregnant women (“index mothers”) who were HBsAg-positive and HBsAg-negative, defining households as “index+” and “index-,” respectively. Household members underwent HBsAg testing and an epidemiological survey. We evaluated HBsAg prevalence and potential transmission correlates. Results We enrolled 1,006 participants from 200 households (100 index+, 100 index-) across Kinshasa. HBsAg prevalence was more than twice as high in index+ households (5.0%; 95% CI: 2.8%-7.1%) as in index- households (1.9%; 0.6%-3.2%). HBsAg prevalence was 3.3 (0.9, 11.8) times as high among direct offspring in index+ vs index- households. Factors associated with HBsAg-positivity included older age, marriage, and having multiple recent partners or any new sexual partners among index mothers; and older age, lower household wealth, sharing nail clippers, and using street salons among offspring in index+ households. Conclusions Vertical and horizontal HBV transmission within households is ongoing in Kinshasa. Factors associated with infection reveal opportunities for HBV prevention efforts, including perinatal prevention, protection during sexual contact, and sanitation of shared personal items.

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Section: Discussionsupporting

confidence: 93%

Hepatitis B Virus Prevalence and Transmission in the Households of Pregnant Women in Kinshasa, Democratic Republic of Congo

Morgan,

Ngimbi,

Boisson-Walsh

et al. 2024

Open Forum Infectious Diseases

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“…Based on the findings of this study, 19.1% of pregnant women met the criterion of high viral load, while 22.6% were HBeAg-positive. However, a number of HBeAg-positive women had low DNA levels, whereas some with high viral load were HBeAg-negative, as reported in a previous study in Burkina Faso that used rapid test for HBeAg identifcation 21 .…”

Section: Discussionmentioning

confidence: 60%

Intermediate hepatitis B virus infection prevalence among 1622 pregnant women in rural Burkina Faso and implications for mother-to-child transmission

Ouoba

Lingani

et al. 2023

Sci Rep

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In highly endemic countries for hepatitis B virus (HBV) infection, childhood infection, including mother-to-child transmission (MTCT), represents the primary transmission route. High maternal DNA level (viral load ≥ 200,000 IU/mL) is a significant factor for MTCT. We investigated the prevalence of HBsAg, HBeAg, and high HBV DNA among pregnant women in three hospitals in Burkina Faso and assessed the performance of HBeAg to predict high viral load. Consenting pregnant women were interviewed on their sociodemographic characteristics and tested for HBsAg by a rapid diagnostic test, and dried blood spot (DBS) samples were collected for laboratory analyses. Of the 1622 participants, HBsAg prevalence was 6.5% (95% CI, 5.4–7.8%). Among 102 HBsAg-positive pregnant women in DBS samples, HBeAg was positive in 22.6% (95% CI, 14.9–31.9%), and viral load was quantified in 94 cases, with 19.1% having HBV DNA ≥ 200,000 IU/mL. HBV genotypes were identified in 63 samples and predominant genotypes were E (58.7%) and A (36.5%). The sensitivity of HBeAg by using DBS samples to identify high viral load in the 94 cases was 55.6%, and the specificity was 86.8%. These findings highlight the need to implement routine HBV screening and effective MTCT risk assessment for all pregnant women in Burkina Faso to enable early interventions that can effectively reduce MTCT.

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“…Our findings are consistent with results of a study conducted in Burkina Faso, which also reported lower HBsAg positivity among children born to 215 HBsAg-positive mothers after HBV vaccine rollout but before birth dose. 32 We observed relatively few HBsAg-positive offspring, suggestive of infrequent perinatal transmission given that proven PMTCT measures have not been implemented in DRC. Our observation of incident and cleared infections among mothers further suggests recent HBV exposures and that horizontal transmission is occurring.…”

Section: Discussionmentioning

confidence: 76%

Hepatitis B virus prevalence and transmission in the households of pregnant women in Kinshasa, Democratic Republic of Congo

Morgan,

Ngimbi,

Boisson-Walsh

et al. 2023

Preprint

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BackgroundDespite routine infant vaccination and blood donor screening, the Democratic Republic of Congo (DRC) has high hepatitis B virus (HBV) prevalence compared to the United States and Europe. Through the cross-sectional Horizontal and Vertical Transmission of Hepatitis B (HOVER-HBV) study, we characterized household prevalence in DRC’s capital, Kinshasa, to inform additional prevention efforts.MethodsWe introduced HBV surface antigen (HBsAg) screening alongside existing HIV screening as part of routine antenatal care (ANC) in high-volume maternity clinics in Kinshasa. We recruited households of pregnant women who were HBsAg-positive and HBsAg-negative, defining households as “exposed” and “unexposed,” respectively. Household members underwent HBsAg testing and an epidemiological survey. We evaluated HBsAg prevalence and potential transmission correlates.ResultsWe enrolled 1,006 participants from 200 households (100 exposed, 100 unexposed) across Kinshasa. HBsAg prevalence was more than twice as high in exposed households (5.0%; 95% CI: 2.8%-7.1%) as in unexposed households (1.9%; 0.6%-3.2%). Exposed direct offspring had 3.3 (0.9, 11.8) times the prevalence of unexposed direct offspring. Factors associated with HBsAg-positivity included older age, marriage, and having multiple recent partners or any new sexual partners among index mothers; and older age, lower household wealth, sharing nail clippers, and using street salons among exposed offspring.ConclusionsVertical and horizontal HBV transmission within households is ongoing in Kinshasa. Factors associated with infection reveal opportunities for HBV prevention efforts, including perinatal prevention, protection during sexual contact, and sanitation of shared personal items.

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Screening for Hepatitis B in partners and children of women positive for surface antigen, Burkina Faso

Cited by 7 publications

References 22 publications

Hepatitis B Virus Prevalence and Transmission in the Households of Pregnant Women in Kinshasa, Democratic Republic of Congo

Hepatitis B Virus Prevalence and Transmission in the Households of Pregnant Women in Kinshasa, Democratic Republic of Congo

Intermediate hepatitis B virus infection prevalence among 1622 pregnant women in rural Burkina Faso and implications for mother-to-child transmission

Hepatitis B virus prevalence and transmission in the households of pregnant women in Kinshasa, Democratic Republic of Congo

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