Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Dec:85:71-74.
doi: 10.1016/j.jcv.2016.10.017. Epub 2016 Oct 31.

Screening, characterisation and prevention of Hepatitis B virus (HBV) co-infection in HIV-positive children in South Africa

Pieter Jooste  1 , Anriette van Zyl  1 , Emily Adland  2 , Samantha Daniels  1 , Louise Hattingh  1 , Alethea Brits  1 , Susan Wareing  3 , Dominique Goedhals  4 , Katie Jeffery  3 , Monique Andersson  3 , Philip Goulder  2 , Philippa C Matthews  5
Affiliations

Screening, characterisation and prevention of Hepatitis B virus (HBV) co-infection in HIV-positive children in South Africa

Pieter Jooste et al. J Clin Virol. 2016 Dec.

Abstract

Background: In South Africa, the first HBV vaccine dose is administered at age 6 weeks, leaving a potential window for vertical transmission. Insights into HBV seroprevalence in the vulnerable HIV-infected group are important to drive improvements in surveillance, treatment and prevention.

Objectives: We set out to implement a screening program for HBV among HIV-infected children and adolescents in Kimberley, South Africa. Our aims were to demonstrate that screening is feasible and sustainable, to establish the prevalence of HBV, to characterise the HBV cases we identified, and to inform discussion about the infant vaccination schedule.

Study design: We tested all HIV positive children (age 0-16) for Hepatitis B surface antigen (HBsAg), delivering this testing as part of routine state-funded care. We followed up HBsAg-positive cases with an extended panel of HBV serology tests, and HBV DNA viral load quantification.

Results: Our screening campaign was successfully incorporated into routine out-patient care. Among 625 patients tested, we found five positive for HBsAg (0.8%), of whom three were Hepatitis B e-antigen positive. Two additional children initially tested HBsAg-positive but were negative on repeat testing. Antiviral therapy in the HBsAg children was reviewed and adjusted if required.

Conclusions: The results testify to the overall success of the HBV vaccine campaign. However, we have demonstrated that ongoing vigilance is required to detect cases and prevent transmission events. Further evaluation of the optimum timing of the first vaccine HBV vaccine dose is required; a vaccine dose at birth could reduce prevalence further.

Keywords: Epidemiology; HIV; Hepatitis B; South Africa; Vaccination; Viral hepatitis.

PubMed Disclaimer

References

    1. Ott J.J., Stevens G.A., Groeger J., Wiersma S.T. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine. 2012;30:2212–2219. - PubMed
    1. WHO . WHO; 2012. Hepatitis B Fact Sheet Number 204.http://wwwwhoint/mediacentre/factsheets/fs204/en/
    1. Burnett R.J., Kramvis A., Dochez C., Meheus A. An update after 16 years of hepatitis B vaccination in South Africa. Vaccine. 2012;30(Suppl. 3):C45–51. - PubMed
    1. Chotun N., Nel E., Cotton M.F., Preiser W., Andersson M.I. Hepatitis B virus infection in HIV-exposed infants in the Western Cape, South Africa. Vaccine. 2015;33:4618–46222. - PubMed
    1. Beghin J.C., Ruelle J., Sokal E., Bachy A., Krishna M., Hall L. Effectiveness of the South African expanded program of immunization against hepatitis B in children infected with human immunodeficiency virus-1 living in a resource-limited setting of Kwazulu-Natal. J. Med. Virol. 2017;89:182–185. - PubMed

Publication types

MeSH terms