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Ebogo-Belobo JT, Kenmoe S, Mbongue Mikangue CA, Tchatchouang S, Robertine LF, Takuissu GR, Ndzie Ondigui JL, Bowo-Ngandji A, Kenfack-Momo R, Kengne-Ndé C, Mbaga DS, Menkem EZ, Kame-Ngasse GI, Magoudjou-Pekam JN, Kenfack-Zanguim J, Esemu SN, Tagnouokam-Ngoupo PA, Ndip L, Njouom R. Systematic review and meta-analysis of seroprevalence of human immunodeficiency virus serological markers among pregnant women in Africa, 1984-2020. World J Crit Care Med 2023; 12:264-285. [PMID: 38188451 PMCID: PMC10768416 DOI: 10.5492/wjccm.v12.i5.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/19/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) is a major public health concern, particularly in Africa where HIV rates remain substantial. Pregnant women are at an increased risk of acquiring HIV, which has a significant impact on both maternal and child health. AIM To review summarizes HIV seroprevalence among pregnant women in Africa. It also identifies regional and clinical characteristics that contribute to study-specific estimates variation. METHODS The study included pregnant women from any African country or region, irrespective of their symptoms, and any study design conducted in any setting. Using electronic literature searches, articles published until February 2023 were reviewed. The quality of the included studies was evaluated. The DerSimonian and Laird random-effects model was applied to determine HIV pooled seroprevalence among pregnant women in Africa. Subgroup and sensitivity analyses were conducted to identify potential sources of heterogeneity. Heterogeneity was assessed with Cochran's Q test and I2 statistics, and publication bias was assessed with Egger's test. RESULTS A total of 248 studies conducted between 1984 and 2020 were included in the quantitative synthesis (meta-analysis). Out of the total studies, 146 (58.9%) had a low risk of bias and 102 (41.1%) had a moderate risk of bias. No HIV-positive pregnant women died in the included studies. The overall HIV seroprevalence in pregnant women was estimated to be 9.3% [95% confidence interval (CI): 8.3-10.3]. The subgroup analysis showed statistically significant heterogeneity across subgroups (P < 0.001), with the highest seroprevalence observed in Southern Africa (29.4%, 95%CI: 26.5-32.4) and the lowest seroprevalence observed in Northern Africa (0.7%, 95%CI: 0.3-1.3). CONCLUSION The review found that HIV seroprevalence among pregnant women in African countries remains significant, particularly in Southern African countries. This review can inform the development of targeted public health interventions to address high HIV seroprevalence in pregnant women in African countries.
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Affiliation(s)
- Jean Thierry Ebogo-Belobo
- Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
| | | | | | | | - Guy Roussel Takuissu
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | | | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon
| | - Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde 00237, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala 00237, Cameroon
| | - Donatien Serge Mbaga
- Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon
| | | | - Ginette Irma Kame-Ngasse
- Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | | | | | - Seraphine Nkie Esemu
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
| | | | - Lucy Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
| | - Richard Njouom
- Department of Virology, Centre Pasteur du Cameroun, Yaounde 00237, Cameroon
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Assefa A, Kiros T, Delelegn B. Seroprevalence and Associated Factors of HBV and HCV among Pregnant Women Attending Antenatal Care at Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia: A Cross-Sectional Study. Int J Microbiol 2023; 2023:2282673. [PMID: 37576850 PMCID: PMC10413223 DOI: 10.1155/2023/2282673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 05/01/2023] [Accepted: 07/19/2023] [Indexed: 08/15/2023] Open
Abstract
Background Infections with the hepatitis B virus (HBV) and the hepatitis C virus (HCV) are worldwide problems that particularly place a heavy burden on developing nations. HBV and HCV infections during pregnancy have a high rate of vertical transmission and harmful consequences for both the mother and the child. Therefore, this study was carried out to assess the seroprevalence and associated factors of HBV and HCV infections among pregnant women attending antenatal care at Debre Tabor Comprehensive Specialized Hospital in Ethiopia. Methods A cross-sectional study was conducted from March 15th to September 16th, 2022, at the Debre Tabor Comprehensive Specialized Hospital antenatal care clinic. Five milliliters of venous blood were collected from 422 pregnant women selected using a simple random sampling method. Data on sociodemographic characteristics and risk factors were collected using a prestructured questionnaire. A chi-square test, bivariate, and multivariate analyses were used to evaluate the association between dependent and independent variables. p values less than 0.05 were considered statistically significant. Results The seroprevalence of HBV and HCV infections was found to be 13% and 0.5%, respectively. Undertaking blood transfusion (AOR = 14.2, CI = 5.81-34.526, p = 0.001), tattooing (AOR = 3.99, CI = 1.1-14.36, p = 0.034), and dental therapy (AOR = 4.9, CI = 1.41-17.025, p = 0.012) were significantly associated with HBV infection. Conclusion HBV infection in pregnant women was shown to have a high endemicity (13%) in this investigation, whereas the seroprevalence of HCV infection was low (0.5%). HBV infection was significantly associated with a history of blood transfusions, tattooing, and dental therapy. Screening pregnant women for HBV and HCV infections and providing effective therapy would ensure better outcomes for the newborn. In addition, health education must be used to increase knowledge of screening and modes of transmission.
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Affiliation(s)
- Ayenew Assefa
- Unit of Immunology, Department of Medical Laboratory Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Teklehaimanot Kiros
- Unit of Medical Microbiology, Department of Medical Laboratory Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Birtukan Delelegn
- Department of Medical Laboratory Science, Debre Tabor University, Debre Tabor, Ethiopia
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Kafeero HM, Ndagire D, Ocama P, Kato CD, Wampande E, Walusansa A, Kajumbula H, Kateete D, Ssenku JE, Sendagire H. Mapping hepatitis B virus genotypes on the African continent from 1997 to 2021: a systematic review with meta-analysis. Sci Rep 2023; 13:5723. [PMID: 37029173 PMCID: PMC10082212 DOI: 10.1038/s41598-023-32865-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/04/2023] [Indexed: 04/09/2023] Open
Abstract
Hepatitis B virus (HBV) has ten genotypes (A-J) and over 40 sub-genotypes based on the divergence of ≥ 8% and 4 to < 8% in the complete genome respectively. These genotypes and sub-genotypes influence the disease prognosis, response to therapy and route of viral transmission. Besides, infection with mixed genotypes and recombinant genotypes has also been reported. This study aimed at mapping the de novo genotypes and correlate them with the immigration trends in order to inform future research on the underlying reasons for the relative distribution of HBV genotypes from a large sample size pooled from many primary studies. Data was extracted from 59 full research articles obtained from Scopus, PubMed, EMBASE, Willy library, African Journal Online (AJOL) and Google Scholar. Studies that investigated the genotypes, sub-genotypes, mixed genotypes and recombinant were included. The Z-test and regression were used for the analysis. The study protocol is registered with PROSPERO under the registration number CRD42022300220. Overall, genotype E had the highest pooled prevalence significantly higher than all the other genotypes (P < 0.001). By region, genotype A posted the highest pooled prevalence in eastern and southern Africa, E in west Africa and D in north Africa (P < 0.0001). Regarding the emerging genotypes B and C on the African continent, genotype B was significantly higher in south Africa than C (P < 0.001). In contrast, genotype C was significantly higher in east Africa than west Africa (P < 0.0001). The A1 and D/E were the most diverse sub-genotypes and genotype mixtures respectively. Finally, we observed a general progressive decrease in the prevalence of predominant genotypes but a progressive increase in the less dominant by region. Historical and recent continental and intercontinental migrations can provide a plausible explanation for the HBV genotype distribution pattern on the African continent.
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Affiliation(s)
- Hussein Mukasa Kafeero
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda.
- Department of Medical Microbiology, Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda, P. O Box 7689, Kampala, Uganda.
| | - Dorothy Ndagire
- Department of Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Ponsiano Ocama
- Department of Medicine, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Charles Drago Kato
- Department of Biomolecular Resources and Biolab Sciences, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Eddie Wampande
- Department of Biomolecular Resources and Biolab Sciences, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Abdul Walusansa
- Department of Medical Microbiology, Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda, P. O Box 7689, Kampala, Uganda
| | - Henry Kajumbula
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - David Kateete
- Department of Molecular Biology and Immunology, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Jamilu E Ssenku
- Department of Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Hakim Sendagire
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
- Department of Medical Microbiology, Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda, P. O Box 7689, Kampala, Uganda
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Netanel C, Ben-Aharon O, Ben-Ari Z, Chodick G, Anis E, Magnezi R. Evaluation of a universal hepatitis B vaccination program and antenatal screening for hepatitis B surface antigen: Results from a real-world study 2015-2016. Vaccine 2021; 39:7101-7107. [PMID: 34782158 DOI: 10.1016/j.vaccine.2021.09.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/22/2021] [Accepted: 09/28/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Universal vaccination against hepatitis B virus (HBV) in infancy was implemented in Israel in 1992. This population-based study aimed to evaluate the coverage rate and cost-benefit of the HBV vaccination program among infants in Israel and the Hepatitis B surface antigen (HBsAg) status in their mothers. METHODS Using the database of a health maintenance organization with 2 million members, we retrospectively identified, all the infants born in 2015-2016 and their mothers. Maternal data collected included age, ethnicity, country of birth and HBsAg status during pregnancy. HBV vaccination coverage among infants was calculated. A cost-benefit analysis of the HBV vaccination program was conducted based on the actual costs of HBV infection treatments in all HBsAg positive mothers. RESULTS Our cohort included 72,792 mothers who gave birth to 77,572 live infants. A total of 71,107 (97.7%) mothers were screened for HBV during pregnancy, of them 124 (0.2%), who gave birth to 132 infants were HBsAg positive. HBV vaccination coverage rates were 94%, 93% and 89%, for the first, second and third dose, respectively. Birth dose coverage of 95% among infants born to HBsAg positive mothers was significantly higher compared to HBsAg negative or unscreened mothers (p < 0.001). The percentage of HBsAg positivity among mothers who were born in Israel, the Former Soviet Union or Ethiopia, were 0.1%, 0.8% and 5%, respectively (p < 0.001). Ethnic differences were not found between HBsAg positive and HBsAg negative mothers. Calculated benefit-to-cost ratios were 1.24:1 and 4.15:1, with and without antenatal HBsAg screening, respectively. CONCLUSIONS The Israeli vaccination program against HBV infection is epidemiologically and economically justified. High coverage rates among infants born to HBsAg positive mothers reflect very good adherence to the vaccination program and antenatal screening. Higher HBsAg positivity rates among immigrant mothers identify a high-risk population for HBV infection.
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Affiliation(s)
- Carmit Netanel
- Department of Management, Bar-Ilan University, Ramat-Gan, Israel; Liver Disease Center, Sheba Medical Center, Tel Hashomer, Israel.
| | - Omer Ben-Aharon
- Department of Management, Bar-Ilan University, Ramat-Gan, Israel
| | - Ziv Ben-Ari
- Liver Disease Center, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gabriel Chodick
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Maccabi Health Care Services, Maccabi Institute of Health Services Research, Tel Aviv, Israel
| | - Emilia Anis
- Braun School of Public Health and Community Medicine, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel; Division of Epidemiology, Ministry of Health, Jerusalem, Israel
| | - Racheli Magnezi
- Department of Management, Bar-Ilan University, Ramat-Gan, Israel
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Andes A, Ellenberg K, Vakos A, Collins J, Fryer K. Hepatitis C Virus in Pregnancy: A Systematic Review of the Literature. Am J Perinatol 2021; 38:e1-e13. [PMID: 32323289 DOI: 10.1055/s-0040-1709672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The aim of this study was to systematically review the literature to summarize recent demographic characteristics of hepatitis C virus (HCV) infection during pregnancy and the efficacy of risk-based versus universal screening. STUDY DESIGN PubMed, EMBASE, and Cochrane Library were searched to identify relevant studies. Studies that recognized hepatitis C as a primary or secondary outcome, with pregnant women as the population and written in English, were included. Studies were excluded if they were abstracts only, written in foreign language, or published prior to 1992. Two researchers independently screened all the studies by titles, abstracts, and full text. Conflicts were settled by a third researcher. RESULTS A total of 698 studies were identified with 78 fitting inclusion criteria. In total, 69 epidemiologic and 9 comparison studies were found. Identified risk factors for HCV infection include intravenous or illicit drug use, sexually transmitted coinfection, high-risk behaviors in the partners, high parity, and history of miscarriages or abortions. Demographic characteristics associated with HCV include non-Hispanic white race, American Indian or Alaskan Native ethnicity, and increasing age. Providers may fail to adequately screen for each risk factor, and up to two-thirds of women with a known risk factor are not screened under current guidelines. Finally, up to 27% of HCV+ women have no identifiable risk factors for infection. CONCLUSION There is evidence that risk-based screening fails to identify a large proportion of HCV positive women in pregnancy and that pregnant women with HCV risk factors and consistent with current screening guidelines fail to be tested. We urge for the adoption of universal screening to identify these women and offer treatment.
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Affiliation(s)
- Alexandra Andes
- Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Kerry Ellenberg
- Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Amanda Vakos
- Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - James Collins
- Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Kimberly Fryer
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida
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Rizzetto M, Hamid S, Negro F. The changing context of hepatitis D. J Hepatol 2021; 74:1200-1211. [PMID: 33484770 DOI: 10.1016/j.jhep.2021.01.014] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/04/2021] [Accepted: 01/09/2021] [Indexed: 12/18/2022]
Abstract
The global epidemiology of hepatitis D is changing with the widespread implementation of vaccination against hepatitis B. In high-income countries that achieved optimal control of HBV, the epidemiology of hepatitis D is dual, consisting of an ageing cohort of domestic patients with advanced liver fibrosis who represent the end stage of the natural history of HDV, and of a younger generation of immigrants from endemic countries who account for the majority of new infections. As observed in Europe in the 1980s, the distinctive clinical characteristic of chronic hepatitis D in endemic countries is the accelerated progression to cirrhosis and hepatocellular carcinoma. Despite some recent progress, the therapeutic management of HDV remains unsatisfactory, as most patients are not cured of HDV with currently available medicines. This review article describes the current epidemiology and clinical features of chronic hepatitis D, based on the literature published in the last 10 years.
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Affiliation(s)
- Mario Rizzetto
- Department of Medical Sciences, University of Turin, Turin, Italy.
| | - Saeed Hamid
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Franco Negro
- Division of Gastroenterology and Hepatology, Geneva University Hospitals, Geneva, Switzerland; Division of Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland
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Kpossou AR, Paraiso MN, Sokpon CN, Alassan KS, Vignon RK, Keke RK, Bigot C, Domonhédo C, Sossa Gbédo E, Séhonou J, Kodjoh N, Lawin H. [Seroprevalence of viral hepatitis B and its associated factors determined based on data from a screening campaign targeting the general population in Benin]. Pan Afr Med J 2020; 37:247. [PMID: 33552365 PMCID: PMC7847212 DOI: 10.11604/pamj.2020.37.247.26070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/07/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION hepatitis B is a global public health problem. The purpose of this study was to determine the prevalence of hepatitis B virus (HBV) and its associated factors based on data from a mass screening in several localities across Benin. METHOD we conducted a cross-sectional descriptive and analytical study with prospective data collection. Data collection was carried out during voluntary free hepatitis B screening organized by the Rotary Club in 23 localities across Benin from the 20th to 28th July 2019. Rapid test for diagnostic orientation was used for the detection of HBs antigen. RESULTS a total of 9035 volunteers were included in the study. They were mostly of Benin origin (99%), with a mean age of 27 years; 51.1% of them were singles, mainly schoolchildren, pupils or students (37.9%). HBV seroprevalence was 6% (545/9035) [95%CI=5.5%-6.5%]. In univariate analysis, factors associated with HBs Ag colonization were: age, sex, marital status, education level, occupation and a history of diabetes, scarification and hepatitis C, while in multivariate analysis they were: sex, age and education level. CONCLUSION HBV seroprevalence is 6% in the study population. HBV infection mainly affects male subjects over 17 years of age with secondary-level education.
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Affiliation(s)
- Aboudou Raïmi Kpossou
- Faculté des Sciences de la Santé, Université d´Abomey-Calavi, Cotonou, Bénin
- Centre National Hospitalier et Universitaire Hubert Koutoukou Maga de Cotonou, Cotonou, Bénin
| | | | | | - Khadidjatou Saké Alassan
- Service de Médecine Interne, Centre Hospitalier Universitaire Départemental Borgou-Alibori, Parakou, Bénin
| | - Rodolph Koffi Vignon
- Faculté des Sciences de la Santé, Université d´Abomey-Calavi, Cotonou, Bénin
- Centre National Hospitalier et Universitaire Hubert Koutoukou Maga de Cotonou, Cotonou, Bénin
| | - René Kpemahouton Keke
- Laboratoire National de Référence du Programme Santé de Lutte contre le Sida, Cotonou, Bénin
| | - Cédric Bigot
- Faculté des Sciences de la Santé, Université d´Abomey-Calavi, Cotonou, Bénin
| | | | | | - Jean Séhonou
- Faculté des Sciences de la Santé, Université d´Abomey-Calavi, Cotonou, Bénin
- Centre National Hospitalier et Universitaire Hubert Koutoukou Maga de Cotonou, Cotonou, Bénin
| | - Nicolas Kodjoh
- Programme National de Lutte contre les Hépatites (PNLH), Cotonou, Bénin
| | - Hervé Lawin
- Unité d'Enseignement et de Recherche en Santé au Travail et Environnement, Faculté des Sciences de la Santé, Université d´Abomey-Calavi, Cotonou, Bénin
- Chaire EcoSanté, Faculté des Sciences de la Santé, Université d´Abomey-Calavi, Cotonou, Bénin
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Ekouevi DK, Larrouy L, Gbeasor-Komlanvi FA, Mackiewicz V, Tchankoni MK, Bitty-Anderson AM, Gnatou GYS, Sadio A, Salou M, Dagnra CA, Descamps D, Coffie PA. Prevalence of hepatitis B among childbearing women and infant born to HBV-positive mothers in Togo. BMC Infect Dis 2020; 20:839. [PMID: 33183254 PMCID: PMC7664060 DOI: 10.1186/s12879-020-05574-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 10/31/2020] [Indexed: 12/12/2022] Open
Abstract
Background Hepatitis B virus (HBV) infection is a public health problem in Togo and transmission to the child occurs mainly during childbirth. The objective of this study was to estimate the prevalence of HBV among childbearing women and infants born to HBV positive mothers in Togo. Methods A national cross-sectional study was carried out in six cities in Togo in the six health regions in Togo. Mother-child pairs were recruited from immunization centers or pediatric wards in Lomé, Tsévié, Atakpamé, Sokodé, Kara and Dapaong in 2017. Women aged 18 and over with one child of at least 6 months old were included. A standardized questionnaire was used for data collection and HBV screening was performed using Determine® rapid tests. The prevalence of HBV, defined by a positive HBV surface antigen (HBsAg), was estimated in mothers and then in infants of mothers who were positive for HBsAg. Logistic regression model was performed to identify risk factors for HBsAg positivity in mothers. Results A total of 2105 mothers-pairs child were recruited. The median age of mothers and infants was 29 years, interquartile range (IQR) [25–33] and 2.1 years, IQR [1–3] respectively. About 35% of women were screened for HBV during antenatal care and 85% of infants received three doses of HBV immunization. Among mothers, the prevalence of HBV was 10.6, 95% confidence interval (95% CI) [9.4–12.0%], and 177 had detectable HBV viral load (> 10 IU/mL). Among mothers with positive HBsAg, three infants also had positive HBsAg, a prevalence of 1.3, 95% CI [0.2–3.8%]. In multivariable analysis, HIV-infection (aOR = 2.19; p = 0.018), having at least three pregnancies (aOR = 1.46; p = 0.025) and living in Tsévié (aOR = 0.31; p < 0.001) compared to those living in Lomé, were associated to HBV infection in mothers. Conclusion In this study, one out of 10 childbearing women were infected with HBV, but less than 2% of infant born to HBV positive mothers under 5 years’ old who received immunization under the Expanded Program on Immunization were infected. Improving antenatal screening and providing targeted interventions in babies could help eliminate HBV in Togo.
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Affiliation(s)
- Didier K Ekouevi
- Département de Santé Publique, Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo. .,Institut de Santé Publique Epidémiologie Développement (ISPED), Université de Bordeaux, Bordeaux, France. .,Programme PACCI - Site ANRS Côte d'Ivoire, CHU de Treichville, Abidjan, Côte d'Ivoire. .,INSERM U1219 Bordeaux Population Health Research, ISPED, Université de Bordeaux, Bordeaux, France. .,Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo.
| | - Lucile Larrouy
- Université de Paris, INSERM UMR 1137 IAME, F-75018, Paris, France.,Laboratoire de Virologie, AP-HP, Hôpital Bichat-Claude Bernard, F-75018, Paris, France
| | - Fifonsi A Gbeasor-Komlanvi
- Département de Santé Publique, Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo.,Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo
| | - Vincent Mackiewicz
- Laboratoire de Virologie, AP-HP, Hôpital Bichat-Claude Bernard, F-75018, Paris, France
| | - Martin K Tchankoni
- Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo
| | | | - Gatibe Yendu-Suglpak Gnatou
- Département de Santé Publique, Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo.,Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo
| | - Arnold Sadio
- Département de Santé Publique, Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo.,Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo
| | - Mounerou Salou
- Département des Sciences Fondamentales, Laboratoire de Biologie Moléculaire, Université de Lomé, Lomé, Togo
| | - Claver A Dagnra
- Département des Sciences Fondamentales, Laboratoire de Biologie Moléculaire, Université de Lomé, Lomé, Togo.,Programme National de Lutte contre le VIH/Sida, les Hépatites virales et les Infections Sexuellement Transmissibles (PNLS/HV/IST), Lomé, Togo
| | - Diane Descamps
- Université de Paris, INSERM UMR 1137 IAME, F-75018, Paris, France.,Laboratoire de Virologie, AP-HP, Hôpital Bichat-Claude Bernard, F-75018, Paris, France
| | - Patrick A Coffie
- Programme PACCI - Site ANRS Côte d'Ivoire, CHU de Treichville, Abidjan, Côte d'Ivoire.,Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire.,Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
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Aboubakar M, Kpossou AR, Glago BRGH, Aguiah AG, Mboreha ZH, Sehonou J. [Prevention and factors associated with anti-HCV carriage in pregnant women living in Cotonou]. Pan Afr Med J 2020; 36:182. [PMID: 32952826 PMCID: PMC7467609 DOI: 10.11604/pamj.2020.36.182.23122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/08/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction hepatitis C is an infection which can be passed from mother to child. The purpose of this study was to investigate the prevalence of colonization by anti-HCV antibodies in pregnant women living in Cotonou and to identify factors associated with it. Methods we conducted a cross-sectional study of 253 pregnant women admitted for prenatal care in four major maternity hospitals in Cotonou (Benin) from 01/06/2018 to 01/09/2018. Anti-HCV antibodies were detected using rapid diagnostic tests. A venous blood sample was collected from pregnant women tested positive for anti-HCV before confirmatory serological tests and screening tests for gestational diabetes. Results the prevalence of anti-HCV antibodies was 1.2% (3/253 pregnant women). Factors associated with HCV carriage couldn't be identified given the low number of positive cases. However, pregnant women who were carriers of hepatitis C antibodies had higher mean age (32 ± 3) compared to the remainder of the population (29.58 ± 5.5). Potential risk factors for HCV infection were scarifications, piercing, tattooing, sharing of manicure equipment, a history of surgery and blood transfusions. The prevalence of gestational diabetes in our study population was 7.9% (20/253). No association was found between gestational diabetes and hepatitis C. Conclusion the prevalence of anti-HCV antibodies in pregnant women living in Cotonou was low. A national-level study is needed to identify factors associated with this infection.
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Affiliation(s)
- Moufalilou Aboubakar
- Centre Hospitalier Universitaire de la Mère et de l´Enfant Lagune (CHU-MEL), Cotonou, Bénin
| | - Aboudou Raïmi Kpossou
- Clinique Universitaire d´Hépato-gastro-entérologie, Centre National Hospitalier et Universitaire Hubert Koutoukou Maga (CNHU-HKM), Cotonou, Bénin
| | | | - Amel Gildas Aguiah
- Clinique Universitaire de Gynécologie-obstétrique, Centre National Hospitalier et Universitaire Hubert Koutoukou Maga (CNHU-HKM), Cotonou, Bénin
| | - Zafy Hairou Mboreha
- Centre Hospitalier Universitaire de la Mère et de l´Enfant Lagune (CHU-MEL), Cotonou, Bénin
| | - Jean Sehonou
- Clinique Universitaire d´Hépato-gastro-entérologie, Centre National Hospitalier et Universitaire Hubert Koutoukou Maga (CNHU-HKM), Cotonou, Bénin
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10
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Hønge BL, Olesen JS, Jensen MM, Jespersen S, da Silva ZJ, Rodrigues A, Laursen AL, Wejse C, Krarup H, Aaby P, Erikstrup C. Hepatitis B and C in the adult population of Bissau, Guinea-Bissau: a cross-sectional survey. Trop Med Int Health 2019; 25:255-263. [PMID: 31746078 DOI: 10.1111/tmi.13335] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Hepatitis B virus (HBV) and hepatitis C virus (HCV) are prevalent in West Africa. To address the WHO 2030 goals of a 90% reduction in incidence and a 65% reduction in mortality for both infections, we assessed the prevalence of HBV and HCV from surveys in the general population. METHODS Participants in this cross-sectional survey were included from randomly selected houses in a demographic surveillance site in Bissau, Guinea-Bissau. Participants were interviewed and had a blood sample drawn for viral analyses (HBsAg, anti-HBs, anti-HBc, anti-HCV and HCV RNA). Risk factors of HBV and HCV infection were determined by binomial regression adjusted for sex and age. RESULTS A total of 2715 participants were included in this study. The overall HBsAg prevalence was 18.7% (95% CI: 17.3-20.2%). HBsAg was associated with male sex (adjusted risk ratio (aRR): 1.64), and prevalence decreased with age >34 years. HBV exposure was found in 91.9% of participants. Although 72.6% of individuals without sexual debut had been exposed to HBV, ever engaging in a sexual relationship was associated with higher risk of HBV exposure (aRR 1.18). The anti-HCV prevalence was 0.5% (95% CI: 0.3-0.9%), and 78.6% of those had detectable HCV RNA. Risk factors for anti-HCV sero-positivity were age above 55 (aRR 10.60), a history of blood transfusion (aRR 5.07) and being in a polygamous marriage (aRR 3.52). CONCLUSION In Guinea-Bissau initiatives to implement treatment and widespread testing are needed to reach the WHO 2030 goals.
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Affiliation(s)
- Bo Langhoff Hønge
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau.,Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Steen Olesen
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau.,Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Mads Mose Jensen
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau.,Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Sanne Jespersen
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau.,Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Zacarias José da Silva
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau.,National Public Health Laboratory, Bissau, Guinea-Bissau
| | | | - Alex Lund Laursen
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Christian Wejse
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau.,Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.,GloHAU, Center for Global Health, School of Public Health, Aarhus University, Aarhus, Denmark
| | - Henrik Krarup
- Section of Molecular Diagnostics, Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
| | - Peter Aaby
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
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11
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12
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Assih M, Ouattara AK, Diarra B, Yonli AT, Compaore TR, Obiri-Yeboah D, Djigma FW, Karou S, Simpore J. Genetic diversity of hepatitis viruses in West-African countries from 1996 to 2018. World J Hepatol 2018; 10:807-821. [PMID: 30533182 PMCID: PMC6280160 DOI: 10.4254/wjh.v10.i11.807] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/10/2018] [Accepted: 10/23/2018] [Indexed: 02/06/2023] Open
Abstract
The severity of hepatic pathology and the response to treatment depend on the hepatitis virus genotype in the infected host. The objective of this review was to determine the distribution of hepatitis virus genotypes in West African countries. A systematic review of the literature in PubMed, Google Scholar and Science Direct was performed to identify 52 relevant articles reporting hepatitis A, B, C, D, E and G viruses genotypes. Hepatitis B virus (HBV) genotype E with a prevalence of 90.6% (95%CI: 0.891-0.920) found in this review, is characterized by low genetic diversity. Hepatitis C virus (HCV) genotypes 1 and 2 represented 96.4% of HCV infections in West African countries, while hepatitis delta virus, hepatitis A virus, hepatitis G virus genotypes 1 and HEV genotype 3 were reported in some studies in Ghana and Nigeria. HBV genotype E is characterized by high prevalence, low genetic diversity and wide geographical distribution. Further studies on the clinical implications of HBV genotype E and HCV genotypes 1 and 2 are needed for the development of an effective treatment against this viral hepatitis in West African countries. Surveillance of the distribution of different genotypes is also needed to reduce recombination rates and prevent the emergence of more virulent viral strains.
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Affiliation(s)
- Maléki Assih
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
| | - Abdoul Karim Ouattara
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
| | - Birama Diarra
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
| | - Albert Theophane Yonli
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
| | - Tegwindé Rebeca Compaore
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
| | - Dorcas Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast 00233, Ghana
| | - Florencia Wendkuuni Djigma
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
| | - Simplice Karou
- Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA-UL), Universite de Lome, Lome 00229, Togo
| | - Jacques Simpore
- Biochemistry-Microbiology, CERBA/LABIOGENE, Ouagadougou 02006, Burkina Faso
- Laboratory of Molecular Biology and Molecular Genetics (LABIOGENE) UFR/SVT, University Ouaga I Prof Joseph KI-ZERBO, Ouagadougou 00226, Burkina Faso
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13
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Prevalence of hepatitis D virus infection in sub-Saharan Africa: a systematic review and meta-analysis. LANCET GLOBAL HEALTH 2018; 5:e992-e1003. [PMID: 28911765 PMCID: PMC5599428 DOI: 10.1016/s2214-109x(17)30298-x] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 04/26/2017] [Accepted: 07/18/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND Hepatitis D virus (also known as hepatitis delta virus) can establish a persistent infection in people with chronic hepatitis B, leading to accelerated progression of liver disease. In sub-Saharan Africa, where HBsAg prevalence is higher than 8%, hepatitis D virus might represent an important additive cause of chronic liver disease. We aimed to establish the prevalence of hepatitis D virus among HBsAg-positive populations in sub-Saharan Africa. METHODS We systematically reviewed studies of hepatitis D virus prevalence among HBsAg-positive populations in sub-Saharan Africa. We searched PubMed, Embase, and Scopus for papers published between Jan 1, 1995, and Aug 30, 2016, in which patient selection criteria and geographical setting were described. Search strings included sub-Saharan Africa, the countries therein, and permutations of hepatitis D virus. Cohort data were also added from HIV-positive populations in Malawi and Ghana. Populations undergoing assessment in liver disease clinics and those sampled from other populations (defined as general populations) were analysed. We did a meta-analysis with a DerSimonian-Laird random-effects model to calculate a pooled estimate of hepatitis D virus seroprevalence. FINDINGS Of 374 studies identified by our search, 30 were included in our study, only eight of which included detection of hepatitis D virus RNA among anti-hepatitis D virus seropositive participants. In west Africa, the pooled seroprevalence of hepatitis D virus was 7·33% (95% CI 3·55-12·20) in general populations and 9·57% (2·31-20·43) in liver-disease populations. In central Africa, seroprevalence was 25·64% (12·09-42·00) in general populations and 37·77% (12·13-67·54) in liver-disease populations. In east and southern Africa, seroprevalence was 0·05% (0·00-1·78) in general populations. The odds ratio for anti-hepatitis D virus detection among HBsAg-positive patients with liver fibrosis or hepatocellular carcinoma was 5·24 (95% CI 2·74-10·01; p<0·0001) relative to asymptomatic controls. INTERPRETATION Findings suggest localised clusters of hepatitis D virus endemicity across sub-Saharan Africa. Epidemiological data are needed from southern and east Africa, and from patients with established liver disease. Further studies should aim to define the reliability of hepatitis D virus testing methods, identify risk factors for transmission, and characterise the natural history of the infection in the region. FUNDING Wellcome Trust, Royal Society.
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14
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Sanou AM, Benkirane K, Tinto B, Cissé A, Sagna T, Ilboudo AK, Dording C, Tarnagda Z, Muller CP, Hübschen JM. Prevalence of Hepatitis B virus and Hepatitis D virus Coinfection in Western Burkina Faso and molecular characterization of the detected virus strains. Int J Infect Dis 2018; 70:15-19. [PMID: 29432880 DOI: 10.1016/j.ijid.2018.02.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 02/01/2018] [Accepted: 02/02/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES In this study, we monitored the seroprevalence of HBV-HDV co-infection in different population groups in the Western part of Burkina Faso, and described the genetic diversity of the detected virus strains. METHODS Between October 2013 and December 2014, venous blood samples were collected from different cohorts (blood donors, pregnant women, outpatients) in the western region of Burkina Faso. Samples were tested for HBsAg and total anti-HDV antibodies. Positive samples were further analysed for HBV-DNA and HDV-RNA. Genotyping of the detected virus strains was done by nucleotide sequencing and phylogenetic analyses. RESULTS A total of 841 participants were included in this study. The mean age was 27.45 years (range: 7-89 years). HBsAg was found in 117 (13.9%) participants. Of the HBsAg positive samples, 4 (3.4%) were positive for total anti-HDV antibodies and negative for HDV RNA. Phylogenetic analyses based on the HBV complete genome (n=10) and S fragment sequences (n=35) showed that all strains belonged to genotype E. CONCLUSIONS Our study showed a high HBsAg prevalence, but a low rate of HDV co-infection in HBsAg carriers from western Burkina Faso. The predominance of HBV genotype E in the country was confirmed. Our findings contribute to a better understanding of the burden of HBV and HDV infection in western Burkina Faso.
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Affiliation(s)
- Armel M Sanou
- Unité des Maladies à potentiel épidémiques, Maladies émergentes et Zoonoses, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso.
| | - Kenza Benkirane
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
| | - Bachirou Tinto
- Département des Sciences Biomédicales, Laboratoire National de Référence des Fièvres Hémorragiques Virales, Centre Muraz, Bobo-Dioulasso, Burkina Faso.
| | - Assana Cissé
- Unité des Maladies à potentiel épidémiques, Maladies émergentes et Zoonoses, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso.
| | - Tani Sagna
- Unité des Maladies à potentiel épidémiques, Maladies émergentes et Zoonoses, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso.
| | - Abdoul Kader Ilboudo
- Unité des Maladies à potentiel épidémiques, Maladies émergentes et Zoonoses, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso.
| | - Claire Dording
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
| | - Zekiba Tarnagda
- Unité des Maladies à potentiel épidémiques, Maladies émergentes et Zoonoses, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso.
| | - Claude P Muller
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg; Laboratoire national de santé, 1, rue Louis Rech • L-3555 Dudelange, Luxembourg.
| | - Judith M Hübschen
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
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15
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Belyhun Y, Liebert UG, Maier M. Clade homogeneity and low rate of delta virus despite hyperendemicity of hepatitis B virus in Ethiopia. Virol J 2017; 14:176. [PMID: 28899424 PMCID: PMC5596854 DOI: 10.1186/s12985-017-0844-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 09/05/2017] [Indexed: 12/14/2022] Open
Abstract
Background Although hepatitis B virus (HBV) is hyperendemic and heterogeneous in its genetic diversity in Ethiopia, little is known about hepatitis D virus (HDV) circulating genotypes and molecular diversity. Methods A total of 321 hepatitis B surface antigen (HBsAg) positives (125 HIV co-infected, 102 liver disease patients and 94 blood donors) were screened for anti-HDV antibody. The anti-HDV positive sera were subjected to Real time PCR for HDV-RNA confirmation. The non coding genome region (spanning from 467 to 834 nucleotides) commonly used for HDV genotyping as well as complete HDV genome were sequenced for genotyping and molecular analysis. Results The anti-HDV antibody was found to be 3.2% (3) in blood donors, 8.0% (10) in HIV co-infected individuals and 12.7% (13) in liver disease patients. None of the HIV co-infected patients who revealed HBV lamivudine (3TC) resistance at tyrosine-methionine/isoleucine-aspartate-aspartate (YM(I)DD) reverse transcriptase (RT) motif with concomitant vaccine escape gene mutants was positive for anti-HDV antibody. The HDV viremia rate was 33.3%, 30.0% and 23.1% in respect to the above study groups. All the six isolates sequenced were phylogenetically classified as HDV genotype 1 (HDV-1) and grouped into two monophyletic clusters. Amino acid (aa) residues analysis of clathrin heavy chain (CHC) domain and the isoprenylation signal site (Py) at 19 carboxyl (C)-terminal amino acids (aa 196–214) and the HDV RNA binding domain (aa 79–107) were highly conserved and showed a very little nucleotide variations. All the sequenced isolates showed serine at amino acid position 202. The RNA editing targets of the anti-genomic HDV RNA (nt1012) and its corresponding genomic RNA (nt 580) showed nucleotides A and C, respectively. Conclusions The low seroprevalence and viraemic rates of HDV in particular during HIV-confection might be highly affected by HBV drug resistance selected HBsAg mutant variants in this setting, although HDV-1 sequences analysis revealed clade homogeneity and highly conserved structural and functional domains. Thus, the potential role of HBV drug resistance associated polymerase mutations and concomitant HBsAg protein variability on HDV viral assembly, secretion and infectivity needs further investigation.
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Affiliation(s)
- Yeshambel Belyhun
- Institute of Virology, Medical Faculty, Leipzig University, Johannisallee 30, 04103, Leipzig, Germany. .,School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Uwe Gerd Liebert
- Institute of Virology, Medical Faculty, Leipzig University, Johannisallee 30, 04103, Leipzig, Germany
| | - Melanie Maier
- Institute of Virology, Medical Faculty, Leipzig University, Johannisallee 30, 04103, Leipzig, Germany
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16
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Coffie PA, Tchounga BK, Bado G, Kabran M, Minta DK, Wandeler G, Gottlieb GS, Dabis F, Eholie SP, Ekouevi DK. Prevalence of hepatitis B and delta according to HIV-type: a multi-country cross-sectional survey in West Africa. BMC Infect Dis 2017; 17:466. [PMID: 28676076 PMCID: PMC5496401 DOI: 10.1186/s12879-017-2568-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 06/26/2017] [Indexed: 12/22/2022] Open
Abstract
Background In West Africa where HIV-1 and HIV-2 co-circulate, the co-infection with hepatitis B virus (HBV) and hepatitis Delta virus (HDV) is not well described. This study aimed at estimating the prevalence of HBV and HBV/HDV co-infection according to HIV types and risk factors for HBV infection among West African HIV-infected patients. Method A cross-sectional survey was conducted within the IeDEA West Africa cohort from March to December 2012 in Côte d’Ivoire (three sites), Burkina Faso and Mali (one site each). All HIV-infected adult patients on antiretroviral therapy (ART) or not who attended one of the participating HIV clinics during the study period and agreed to participate were included. Blood samples were collected and re-tested for HIV type discrimination, HBV and HDV serology as well as HBV viral load. Logistic regression was used to identify risk factors for HBV infection. Results A total of 791 patients were included: 192 HIV-1, 447 HIV-2 and 152 HIV-1&2 dually reactive. At time of sampling, 555 (70.2%) were on ART and median CD4+ cell count was 472/mm3 (inter-quartile range [IQR]: IQR: 294–644). Sixty-seven (8.5%, 95% CI 6.6–10.6) patients were HBsAg positive without any difference according to HIV type (7.9% in HIV-1, 7.2% in HIV-1&2 dually reactive and 9.4% in HIV-2; p = 0.61). In multivariate logistic analysis, age ≤ 30 years old (adjusted odds ratio [aOR] 5.00, 95% CI 1.96–12.76), age between 31 and 49 years old (aOR 1.78, 95% CI 1.00–2.21) and male gender (aOR 2.15, 95% CI 1.25–3.69) were associated with HBsAg positivity. HBV DNA testing was performed in 36 patients with blood sample available (25 on ART) and 8 (22.2%) had detectable HBV DNA. Among the HBsAg-positive individuals, 14.9% (95% CI 7.4–25.7) were also positive for anti-HDV antibody without any difference according to HIV type (28.6% in HIV-1, 14.3% in HIV-2 and 0.0% in HIV-1&2 dually reactive; p = 0.15). Conclusion HBV and HBV/HDV co-infection are common in West Africa, irrespective of HIV type. Therefore, screening for both viruses should be systematically performed to allow a better management of HIV-infected patients. Follow-up studies are necessary to determine the impact of these two viruses on HIV infection.
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Affiliation(s)
- Patrick A Coffie
- Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Université Félix Houphouët Boigny, BP V3 Abidjan, CHU de Treichville, Abidjan, Côte d'Ivoire. .,Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire. .,Programme PACCI, site de recherche ANRS, Abidjan, Côte d'Ivoire.
| | - Boris K Tchounga
- Programme PACCI, site de recherche ANRS, Abidjan, Côte d'Ivoire.,ISPED, Université de Bordeaux & Centre INSERM U1219 - Bordeaux Population Health, Bordeaux, France
| | - Guillaume Bado
- Hôpital de Jour, Service des Maladies Infectieuses et Tropicales, CHU Souro Sanou, Bobo Dioulasso, Burkina Faso
| | - Mathieu Kabran
- Département d'Hématologie, d'immunologie et de biologie cellulaire, UFR des Sciences Pharmaceutiques, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire
| | - Daouda K Minta
- Centre de Prise en Charge des Personnes vivant avec le VIH, Service de Maladies Infectieuses, Hôpital du Point G, Bamako, Mali
| | - Gilles Wandeler
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Geoffrey S Gottlieb
- Departments of Medicine & Global Health, University of Washington, Seattle, USA
| | - François Dabis
- ISPED, Université de Bordeaux & Centre INSERM U1219 - Bordeaux Population Health, Bordeaux, France
| | - Serge P Eholie
- Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Université Félix Houphouët Boigny, BP V3 Abidjan, CHU de Treichville, Abidjan, Côte d'Ivoire.,Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire.,Programme PACCI, site de recherche ANRS, Abidjan, Côte d'Ivoire
| | - Didier K Ekouevi
- Programme PACCI, site de recherche ANRS, Abidjan, Côte d'Ivoire.,ISPED, Université de Bordeaux & Centre INSERM U1219 - Bordeaux Population Health, Bordeaux, France.,Université de Lomé, Département des Sciences Fondamentales et Santé Publique, Lomé, Togo
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17
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Breakwell L, Tevi-Benissan C, Childs L, Mihigo R, Tohme R. The status of hepatitis B control in the African region. Pan Afr Med J 2017; 27:17. [PMID: 29296152 PMCID: PMC5745934 DOI: 10.11604/pamj.supp.2017.27.3.11981] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/10/2017] [Indexed: 01/05/2023] Open
Abstract
The World Health Organization (WHO) African Region has approximately 100 million people with chronic hepatitis B virus (HBV) infection. This review describes the status of hepatitis B control in the Region. We present hepatitis B vaccine (HepB) coverage data and from available data in the published literature, the impact of HepB vaccination on hepatitis B surface antigen (HBsAg) prevalence, a marker of chronic infection, among children, HBsAg prevalence in pregnant women, and risk of perinatal transmission. Lastly, we describe challenges with HepB birth dose (HepB-BD) introduction reported in the Region, and propose strategies to increase coverage. In 2015, regional three dose HepB coverage was 76%, and 16(34%) of 47 countries reported ≥ 90% coverage. Overall, 11 countries introduced HepB-BD; only nine provide universal HepB-BD, and of these, five reported ≥ 80% coverage. From non-nationally representative serosurveys among children, HBsAg prevalence was lower among children born after HepB introduction compared to those born before HepB introduction. However, some studies still found HBsAg prevalence to be above 2%. From limited surveys among pregnant women, the median HBsAg prevalence varied by country, ranging from 1.9% (Madagascar) to 16.1% (Niger); hepatitis B e antigen (HBeAg) prevalence among HBsAg-positive women ranged from 3.3% (Zimbabwe) to 28.5% (Nigeria). Studies in three countries indicated that the risk of perinatal HBV transmission was associated with HBeAg expression or high HBV DNA viral load. Major challenges for timely HepB-BD administration were poor knowledge of or lack of national HepB-BD vaccination guidelines, high prevalence of home births, and unreliable vaccine supply. Overall, substantial progress has been made in the region. However, countries need to improve HepB3 coverage and some countries might need to consider introducing the HepB-BD to help achieve the regional hepatitis B control goal of < 2% HBsAg prevalence among children < 5 years old by 2020. To facilitate HepB-BD introduction and improve timely coverage, strategies are needed to reach both facility-based and home births. Strong political commitment, clear policy recommendations and staff training on HepB-BD administration are also required. Furthermore, high quality nationally representative serosurveys among children are needed to inform decision makers about progress towards the regional control goal.
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Affiliation(s)
- Lucy Breakwell
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carol Tevi-Benissan
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Lana Childs
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Richard Mihigo
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Rania Tohme
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
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18
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Performance Characteristics of a New Consensus Commercial Kit for Hepatitis D Virus RNA Viral Load Quantification. J Clin Microbiol 2016; 55:431-441. [PMID: 27881614 DOI: 10.1128/jcm.02027-16] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 11/07/2016] [Indexed: 12/16/2022] Open
Abstract
Hepatitis D virus (HDV) is responsible for fulminant hepatitis and liver failure and accelerates evolution toward cirrhosis and hepatocellular carcinoma in hepatitis B virus (HBV)-infected patients. To date, treatment relies upon long-term administration of pegylated alpha-interferon with a sustained virological response in 30% of the patients. Very recently, new, promising anti-HDV therapies have been developed and are already being used in clinical trials. HDV RNA viral load (HDVL) monitoring must be an integral part of the management of the infected patients. However, HDV genus is characterized by a high genetic variability into eight genotypes (HDV-1 to -8), and most available in-house or commercial assays are useful for only a limited subset of genotypes. Results of a comparison of the performance of a new kit for HDVL quantification with the consensus in-house assay of the French National Reference Laboratory for HDV developed in 2005 are reported here. A total of 611 clinical samples of all HDV genotypes with various HDVL values, including several consecutive samples over several years from 36 patients, were studied. A specificity, sensitivity, and reproducibility evaluation was conducted using HDV-positive clinical samples, hepatitis A, B, C and E (HAV, HBV, HCV, and HEV, respectively) and HIV mono-infected samples, and the WHO HDV RNA international standard. Overall results were strictly comparable between the two assays (median difference, 0.07 log IU/ml), with high diagnosis precision and capacity. In summary, this new kit showed high performance in detection/quantification of HDVL, regardless of the genotype of the infecting strain used, and seems to be a suitable tool for patient management.
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19
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Séroprévalence de l’infection par le virus de l’hépatite D dans une population de donneurs de sang porteurs de l’Antigène HBs au Centre régional de transfusion sanguine de Bobo-Dioulasso. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s12157-015-0646-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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20
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Huang QT, Huang Q, Zhong M, Wei SS, Luo W, Li F, Yu YH. Chronic hepatitis C virus infection is associated with increased risk of preterm birth: a meta-analysis of observational studies. J Viral Hepat 2015; 22:1033-42. [PMID: 26081198 DOI: 10.1111/jvh.12430] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 02/03/2015] [Indexed: 02/07/2023]
Abstract
Although several epidemiological studies reported that maternal chronic hepatitis C virus (HCV) infection had significantly increased risk of undergoing adverse obstetrical and perinatal outcomes, studies on the relationship between HCV infection and risk of preterm birth (PTB) have yielded inconclusive and inconsistent results. Therefore, we conducted a meta-analysis to investigate the association between HCV infection and PTB. The electronic database was searched until 1 September 2014. Relevant studies reporting the association between HCV infection and the risk of PTB were included for further evaluation. Statistical analysis was performed using revmen 5.3 and stata 10.0. Nine studies involving 4186698 participants and 5218 HCV infection cases were included. A significant association between HCV infection and PTB was observed (odds ratio = 1.62, 95% CI 1.48-1.76, P < 0.001, fixed-effects model). Stratification according to maternal smoking/alcohol abuse, maternal drug abuse or coinfected with HBV and/or HIV matched groups still demonstrated that women with HCV infection had a high risk for PTB. Findings from our meta-analysis suggested that maternal HCV infection was significantly associated with an increased risk of PTB. In the future, pathophysiological studies are warranted to ascertain the causality and explore the possible biological mechanisms involved.
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Affiliation(s)
- Q-t Huang
- Division of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Q Huang
- Division of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - M Zhong
- Division of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - S-s Wei
- Division of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - W Luo
- Division of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - F Li
- Division of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Y-h Yu
- Division of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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