Circulation of multiple hepatitis B virus genotypes in individual pregnant women seeking antenatal care in northern Ghana

Abstract

Background: Identification and monitoring of HBV genotype variations is important, since that can help forecast the likelihood of developing serious liver disease and how well patients respond to antiviral medication. Given that HBV genotyping tests are not widely available in our healthcare system, this study characterized HBV genotypes in pregnant women seeking prenatal treatment in northern Ghana.

Method: By a cross-sectional approach, 2071 pregnant women seeking antenatal care in health facilities in northern Ghana were screened for HBV infection using hepatitis B surface antigen (HBsAg) rapid diagnostic test kit. The women were aged between 17 and 41 years, were of varying gravidae (primigravidae and multigravidae) and gestational age (first, second and third trimesters). A confirmatory PCR assay was used to detect HBsAg, and the distribution of HBV genotypes was determined using a nested PCR assay.

Results: Three HBV genotypes (A, D and E) were detected among the pregnant women, of which 175 (91.6%) had genotype E, 9 (4.7%) had mixed genotypes A and E, 5 (2.6%) had mixed genotypes D and E, and 2 (1.1) had mixed genotypes A, D and E. The proportions of women with the different HBV genotypes were independent of age (p = 0.925), gravidity (p = 0.193, χ² = 4.729) and gestational age (p = 0.227, χ² = 8.152).

Conclusion: This study for the first-time characterized circulating HBV genotypes in pregnant women in northern Ghana, which reveals genotypes A and D are found in mixed infections with genotype E. The findings have clinical implications on the management of chronic HBV infection among pregnant women in northern Ghana.

Keywords: Antenatal clinic; Chronic hepatitis B; HBV genotypes; Pregnant women.

Fig. 1

Electrophoresis of PCR products for HBV detection in pregnant women. M: 100 bp molecular weight marker (separates by 100 bp); positive samples found in wells 1–11 (98 bp). The analysis was done on 2% agarose gel

Fig. 2

Electrophoresis of PCR products for HBV genotyping. Specific primers for (A) genotypes A, B and C and (B) genotypes D, E and F were used for the genotyping. M: 100 bp ladder (separates by a 100 bp), Wells 1–21: samples from individual pregnant women. The genotypes are identified on the gels by their respective rectangular coloured shapes as shown on the beneath of the figure. Genotypes A and D were identified as co-circulating with genotype E as represented in sample 1 (mixed genotypes A and E) and sample 12 (mixed genotypes A, D and E)