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J Hepatol. 2014 Mar;60(3):508-14. doi: 10.1016/j.jhep.2013.10.029. Epub 2013 Nov 6.

Hepatitis B virus infection among HIV-infected pregnant women in Malawi and transmission to infants.

Author information

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.

KEYWORDS:

Antiviral therapy; HIV; Hepatitis; Mother-to-child transmission; Sub-Saharan Africa

PMID:
24211737
PMCID:
PMC4411040
DOI:
10.1016/j.jhep.2013.10.029
[Indexed for MEDLINE]
Free PMC Article
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