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J Viral Hepat. 2014 Jun;21(6):381-96. doi: 10.1111/jvh.12263.

Prevention of materno-foetal transmission of hepatitis B in sub-Saharan Africa: the evidence, current practice and future challenges.

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1
Department of Medicine, Imperial College London, London, UK; Department of Hepatology, St Mary's Hospital, London, UK; The Macfarlane-Burnet Institute, Melbourne, Vic., Australia; Department of Medicine, The University of Melbourne, Melbourne, Vic., Australia.

Abstract

Hepatitis B (HBV) infection is highly endemic in sub-Saharan Africa (SSA), where more than 8% of the population remain chronic HBV carriers. SSA has one of the highest HBV-related liver cancer rates in the world (CA Cancer J Clin, 55, 2005, 74) and HBV-related liver cancer is the most common cause of premature death in West Africa (Lancet Oncol, 9, 2008, 683; Hepatology, 39, 2004, 211). As such, HBV represents a significant global threat to health in the African continent. Most SSA countries have elected to vaccinate all children against HBV through the WHO-sponsored Expanded Program of Immunization and the current recommendation from WHO-AFRO is for birth-dose HBV vaccination to prevent maternal/child transmission (MFT) and early horizontal transmission of HBV. However, in Africa, HBV vaccine coverage remains low and HBV birth-dose vaccination has not been implemented. HBV transmission from mother to child in the early perinatal period therefore remains a significant contributor to the burden of HBV-related disease in SSA. This review explores the evidence for materno-foetal transmission of HBV in SSA, outlining current practice for HBV MFT prevention and identifying the significant challenges to implementation of HBV prevention in SSA.

KEYWORDS:

HIV; antenatal screening; immunization; liver disease; pregnancy; preventive health; vertical transmission; viral hepatitis

PMID:
24827901
DOI:
10.1111/jvh.12263
[Indexed for MEDLINE]
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