Rania A Tohme1, Jocelyne Andre-Alboth2, Alexandra Tejada-Strop3, Ran Shi4, Jacques Boncy2, Jeannot François5, Jean Wysler Domercant6, Mark Griswold7, Erlantz Hyppolite8, Paul Adrien9, Saleem Kamili3. 1. US Centers for Disease Control and Prevention, Atlanta, GA,USA. Electronic address: rtohme@cdc.gov. 2. National Public Health Laboratory, Ministry of Public Health and Population, Haiti. 3. US Centers for Disease Control and Prevention, Atlanta, GA,USA. 4. Emory University, Atlanta, GA, USA. 5. Expanded Program of Immunization, Ministry of Public Health and Population, Port-au-Prince, Haiti. 6. Haiti Country Office, Centers for Disease Control and Prevention, Port-au-Prince, Haiti. 7. Global Program, National Alliance of State and Territorial AIDS Directors, Washington DC, USA. 8. National Alliance of State and Territorial AIDS Directors, Port-au-Prince, Haiti. 9. Directorate of Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Port-au-Prince, Haiti.
Abstract
BACKGROUND: Hepatitis B vaccine administered shortly after birth is highly effective in preventing mother to child transmission (MTCT) of infection. While hepatitis B vaccine was introduced in Haiti as part of a combined pentavalent vaccine in 2012, a birth dose is not yet included in the immunization schedule. OBJECTIVES: Determine the seroprevalence of hepatitis B virus (HBV) infection among pregnant women to evaluate the risk of MTCT. STUDY DESIGN: We selected 1364 residual serum specimens collected during a 2012 human immunodeficiency virus (HIV) sentinel serosurvey among pregnant women attending antenatal care clinics. Haiti was stratified into two regions: West, which includes metropolitan Port-au-Prince, and non-West, which includes all other departments. We evaluated the association between demographic and socioeconomic characteristics and HIV infection with HBV infection. RESULTS: Of 1364 selected specimens, 1307 (96%) were available for testing. A total of 422 specimens (32.7%) tested positive for total anti-HBc (38.2% in West vs. 27% in non-West, p<0.001), and 33 specimens (2.5%) were HBsAg positive (2.1% in West vs. 3% in non-West, p=0.4). Of HBsAg positive specimens, 79% had detectable HBV DNA. Women aged 30 and older had more than double the odds of positive total anti-HBc than women aged 15-19 years (p<0.001). Women with secondary (adjusted odds ratio (aOR)=0.54; 95% CI: 0.36-0.81) and post-secondary education (aOR=0.40, 95% CI: 0.19-0.79) had lower odds of total anti-HBc positivity compared with women with no education. HIV-status was not associated with HBV infection. CONCLUSIONS: Haiti has an intermediate endemicity of chronic HBV infection with high prevalence of positive HBV DNA among chronically infected women. Introduction of a universal birth dose of hepatitis B vaccine might help prevent perinatal HBV transmission. Published by Elsevier B.V.
BACKGROUND:Hepatitis B vaccine administered shortly after birth is highly effective in preventing mother to child transmission (MTCT) of infection. While hepatitis B vaccine was introduced in Haiti as part of a combined pentavalent vaccine in 2012, a birth dose is not yet included in the immunization schedule. OBJECTIVES: Determine the seroprevalence of hepatitis B virus (HBV) infection among pregnant women to evaluate the risk of MTCT. STUDY DESIGN: We selected 1364 residual serum specimens collected during a 2012 humanimmunodeficiency virus (HIV) sentinel serosurvey among pregnant women attending antenatal care clinics. Haiti was stratified into two regions: West, which includes metropolitan Port-au-Prince, and non-West, which includes all other departments. We evaluated the association between demographic and socioeconomic characteristics and HIV infection with HBV infection. RESULTS: Of 1364 selected specimens, 1307 (96%) were available for testing. A total of 422 specimens (32.7%) tested positive for total anti-HBc (38.2% in West vs. 27% in non-West, p<0.001), and 33 specimens (2.5%) were HBsAg positive (2.1% in West vs. 3% in non-West, p=0.4). Of HBsAg positive specimens, 79% had detectable HBV DNA. Women aged 30 and older had more than double the odds of positive total anti-HBc than women aged 15-19 years (p<0.001). Women with secondary (adjusted odds ratio (aOR)=0.54; 95% CI: 0.36-0.81) and post-secondary education (aOR=0.40, 95% CI: 0.19-0.79) had lower odds of total anti-HBc positivity compared with women with no education. HIV-status was not associated with HBV infection. CONCLUSIONS: Haiti has an intermediate endemicity of chronic HBV infection with high prevalence of positive HBV DNA among chronically infected women. Introduction of a universal birth dose of hepatitis B vaccine might help prevent perinatal HBV transmission. Published by Elsevier B.V.
Entities:
Keywords:
Haiti; Hepatitis B; Hepatitis B vaccines; Pregnant women; Serosurvey
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