E Keane1,2, A L Funk3, Y Shimakawa4. 1. École Pasteur/CNAM de Santé Publique, Paris, France. 2. Mater Misercicordiae University Hospital, Dublin, Ireland. 3. Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France. 4. Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France. yusuke.shimakawa@gmail.com.
Abstract
BACKGROUND: The risk of mother-to-child transmission of hepatitis B virus (HBV) has been quoted as 70-90% among women positive for hepatitis B surface antigen (HBsAg) and e antigen (HBeAg), and 5-30% among HBsAg-positive HBeAg-negative women. These risks are derived from Asia; little is known about sub-Saharan Africa. AIM: To determine the risk of mother-to-child transmission in sub-Saharan Africa, according to maternal HBeAg and type of prophylaxis. METHODS: We searched Medline, Global Health, Embase, African Journals Online and African Index Medicus. We included observational or interventional studies that enrolled infants of HBV-infected women, and that tested for HBsAg or HBV DNA between 3 and 12 months of age. RESULTS: Fifteen articles from 11 African countries were included. Among HBeAg-positive women, the pooled risk was 38.3% (95% CI: 7.0-74.4%) without prophylaxis, which was significantly lower than the lower bound of 70-90% risk in the literature (P = 0.007). Among HBeAg-negative women, the pooled risk was 4.8% (95% CI: 0.1-13.3%) without prophylaxis, which lays within the lower range of the 5-30% risk in Asia. By extrapolating the pooled transmission risks to the number of births to infectious mothers, an estimated 1% of newborns (n = 367 250) are annually infected with HBV at birth in sub-Saharan Africa. CONCLUSIONS: Compared to Asia, the risk of mother-to-child transmission is low in sub-Saharan Africa. However, the annual number of infants perinatally infected with HBV is twice the number of incident paediatric HIV infections in sub-Saharan Africa (n = 190 000). This highlights the importance of preventing mother-to-child transmission of HBV in sub-Saharan Africa, which has been long neglected.
BACKGROUND: The risk of mother-to-child transmission of hepatitis B virus (HBV) has been quoted as 70-90% among women positive for hepatitis B surface antigen (HBsAg) and e antigen (HBeAg), and 5-30% among HBsAg-positive HBeAg-negative women. These risks are derived from Asia; little is known about sub-Saharan Africa. AIM: To determine the risk of mother-to-child transmission in sub-Saharan Africa, according to maternal HBeAg and type of prophylaxis. METHODS: We searched Medline, Global Health, Embase, African Journals Online and African Index Medicus. We included observational or interventional studies that enrolled infants of HBV-infectedwomen, and that tested for HBsAg or HBV DNA between 3 and 12 months of age. RESULTS: Fifteen articles from 11 African countries were included. Among HBeAg-positive women, the pooled risk was 38.3% (95% CI: 7.0-74.4%) without prophylaxis, which was significantly lower than the lower bound of 70-90% risk in the literature (P = 0.007). Among HBeAg-negative women, the pooled risk was 4.8% (95% CI: 0.1-13.3%) without prophylaxis, which lays within the lower range of the 5-30% risk in Asia. By extrapolating the pooled transmission risks to the number of births to infectious mothers, an estimated 1% of newborns (n = 367 250) are annually infected with HBV at birth in sub-Saharan Africa. CONCLUSIONS: Compared to Asia, the risk of mother-to-child transmission is low in sub-Saharan Africa. However, the annual number of infants perinatally infected with HBV is twice the number of incident paediatric HIV infections in sub-Saharan Africa (n = 190 000). This highlights the importance of preventing mother-to-child transmission of HBV in sub-Saharan Africa, which has been long neglected.
Authors: Jodie Dionne-Odom; Andrew O Westfall; Divine Nzuobontane; Michael J Vinikoor; Gregory Halle-Ekane; Thomas Welty; Alan T N Tita Journal: Pediatr Infect Dis J Date: 2018-01 Impact factor: 2.129
Authors: Jaspreet Toor; Susy Echeverria-Londono; Xiang Li; Kaja Abbas; Emily D Carter; Hannah E Clapham; Andrew Clark; Margaret J de Villiers; Kirsten Eilertson; Matthew Ferrari; Ivane Gamkrelidze; Timothy B Hallett; Wes R Hinsley; Daniel Hogan; John H Huber; Michael L Jackson; Kevin Jean; Mark Jit; Andromachi Karachaliou; Petra Klepac; Alicia Kraay; Justin Lessler; Xi Li; Benjamin A Lopman; Tewodaj Mengistu; C Jessica E Metcalf; Sean M Moore; Shevanthi Nayagam; Timos Papadopoulos; T Alex Perkins; Allison Portnoy; Homie Razavi; Devin Razavi-Shearer; Stephen Resch; Colin Sanderson; Steven Sweet; Yvonne Tam; Hira Tanvir; Quan Tran Minh; Caroline L Trotter; Shaun A Truelove; Emilia Vynnycky; Neff Walker; Amy Winter; Kim Woodruff; Neil M Ferguson; Katy Am Gaythorpe Journal: Elife Date: 2021-07-13 Impact factor: 8.140