Charles S Chasela1, Athena P Kourtis2, Patrick Wall3, Jan Drobeniuc4, Caroline C King5, Hong Thai4, Eyasu H Teshale4, Mina Hosseinipour6, Sascha Ellington5, Mary B Codd3, Denise J Jamieson5, Rod Knight7, Patricia Fitzpatrick3, Saleem Kamili4, Irving Hoffman8, Dumbani Kayira9, Noel Mumba9, Deborah D Kamwendo9, Francis Martinson9, William Powderly3, Chong-Gee Teo4, Charles van der Horst8. 1. UNC Project, P/Bag A-104, Lilongwe, Malawi; School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield Dublin 4, Ireland. 2. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: apk3@cdc.gov. 3. School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield Dublin 4, Ireland. 4. Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. 5. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. 6. UNC Project, P/Bag A-104, Lilongwe, Malawi; School of Medicine, University of North Carolina, Chapel Hill, NC, USA. 7. Westat, Rockville, MD, USA. 8. School of Medicine, University of North Carolina, Chapel Hill, NC, USA. 9. UNC Project, P/Bag A-104, Lilongwe, Malawi.
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. Published by Elsevier B.V.
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-coinfectedwomen. Antenatal testing for HIV and HBV, if instituted, can facilitate implementation of prophylactic measures against infantinfection by both viruses. Published by Elsevier B.V.
Entities:
Keywords:
Antiviral therapy; HIV; Hepatitis; Mother-to-child transmission; Sub-Saharan Africa
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