Hepatitis B virus infection among HIV-infected pregnant women in Malawi and transmission to infants
Chasela, C.S.; Kourtis, A.P.; Wall, P.; Drobeniuc, J.; King, C.C.; Thai, H.; Teshale, E.H.; Hosseinipour, M.; Ellington, S.; Codd, M.B.; Jamieson, D.J.; Knight, R.; Fitzpatrick, P.; Kamili, S.; Hoffman, I.; Kayira, D.; Mumba, N.; Kamwendo, D.D.; Martinson, F.; Powderly, W.; Teo, C.-G.; van der Horst, C.; Adair, L.; Ahmed, Y.; Ait-Khaled, M.; Albrecht, S.; Bangdiwala, S.; Bayer, R.; Bentley, M.; Bramson, B.; Bobrow, E.; Boyle, N.; Butera, S.; Chasela, C.; Chavula, C.; Chimerang'ambe, J.; Chi
Journal of Hepatology 60(3): 508-514
2014
ISSN/ISBN: 1600-0641 PMID: 24211737 DOI: 10.1016/j.jhep.2013.10.029Document Number: 580066
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. 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. 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. 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.
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