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. 2014 Mar;60(3):508-14.
doi: 10.1016/j.jhep.2013.10.029. Epub 2013 Nov 6.

Hepatitis B virus infection among HIV-infected pregnant women in Malawi and transmission to infants

Charles S Chasela  1 , Athena P Kourtis  2 , Patrick Wall  3 , Jan Drobeniuc  4 , Caroline C King  5 , Hong Thai  4 , Eyasu H Teshale  4 , Mina Hosseinipour  6 , Sascha Ellington  5 , Mary B Codd  3 , Denise J Jamieson  5 , Rod Knight  7 , Patricia Fitzpatrick  3 , Saleem Kamili  4 , Irving Hoffman  8 , Dumbani Kayira  9 , Noel Mumba  9 , Deborah D Kamwendo  9 , Francis Martinson  9 , William Powderly  3 , Chong-Gee Teo  4 , Charles van der Horst  8 ; BAN Study Team
Collaborators, Affiliations

Hepatitis B virus infection among HIV-infected pregnant women in Malawi and transmission to infants

Charles S Chasela et al. J Hepatol. 2014 Mar.

Abstract

Background & aims: The extent of HBV infection to infants of HBV/HIV-coinfected pregnant women in sub-Saharan Africa is unknown. The aim of this study was to assess prevalence of HBV infection among antiretroviral-naïve, HIV-infected pregnant women in Malawi and examine HBV transmission to their infants.

Methods: Plasma from 2048 HIV-infected, Malawian women and their infants were tested for markers of HBV infection. Study participants were provided standard-of-care health services, which included administration of pentavalent vaccine to infants at 6, 10, and 14 weeks of age.

Results: One-hundred and three women (5%) were HBsAg-positive; 70 of these HBsAg-positive women were also HBV-DNA-positive. Sixteen women (0.8%) were HBV-DNA-positive but HBsAg-negative. Five of 51 infants (9.8%) born to HBsAg-positive and/or HBV-DNA-positive women were HBV-DNA-positive by 48 weeks of age.HBV DNA concentrations of two infants of mothers who received extended lamivudine-containing anti-HIV prophylaxis were <4 log10 IU/ml compared to ⩾ 8 log10 IU/ml in three infants of mothers who did not.

Conclusions: HBV DNA was detected in nearly 10% of infants born to HBV/HIV-coinfected women. Antenatal testing for HIV and HBV, if instituted, can facilitate implementation of prophylactic measures against infant infection by both viruses.

Keywords: Antiviral therapy; HIV; Hepatitis; Mother-to-child transmission; Sub-Saharan Africa.

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Conflict of interest statement

Conflict of interest

The authors who have taken part in this study declared that they do not have anything to disclose regarding funding or conflict of interest with respect to this manuscript.

Figures

Fig. 1
Fig. 1. Flowchart of HBV testing on 2048 HIV-infected, pregnant women screened for the Breastfeeding, Antiretrovirals, and Nutrition study
aInfant testing for hepatitis B was limited to infants born to HBsAg-positive (n = 103) or HBsAg-negative and HBV-DNA-positive (n = 16) mothers at the screening visit who enrolled in BAN at delivery (n = 95) and whose infants remained HIV-negative at 2 weeks of life (n = 79) and had plasma specimens available for HBV testing at 2 weeks (n = 57) and/or 48 weeks (n = 51) of age for a total of 72 infants tested for hepatitis B. These infants were included in the analysis of HBV infection among infants (Table 1). bVolume insufficient for HBeAg testing of one mother and for determining HBV DNA concentration in another mother.
See this image and copyright information in PMC

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