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Genes (Basel). 2018 May 17;9(5). pii: E259. doi: 10.3390/genes9050259.

Chronic and Occult Hepatitis B Virus Infection in Pregnant Women in Botswana.

Author information

1
Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana. mbangiwat@gmail.com.
2
Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Botswana, Gaborone 0022, Botswana. mbangiwat@gmail.com.
3
Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Botswana, Gaborone 0022, Botswana. kasvosvei@ub.ac.bw.
4
Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana. manderson@bhp.org.bw.
5
Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone 0022, Botswana. manderson@bhp.org.bw.
6
Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana. pthami@bhp.org.bw.
7
Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone 0022, Botswana. pthami@bhp.org.bw.
8
Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana. wtchoga@gmail.com.
9
Harvard College, Cambridge, MA 02138, USA. aneedleman@college.harvard.edu.
10
Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana. bphinius@gmail.com.
11
Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana. smoyo@bhp.org.bw.
12
Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA. smoyo@bhp.org.bw.
13
Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone 0022, Botswana. LETEANEM@mopipi.ub.bw.
14
Goodtables Data Consulting, Norman, OK 73019, USA. jeanleid@gmail.com.
15
University of Cincinnati College of Medicine, Cincinnati, OH 45627, USA. blackajt@ucmail.uc.edu.
16
Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana. gmayondi@bhp.org.bw.
17
Department of Psychiatry, Boston Children's Hospital, Boston, MA 02115, USA. Betsy.Kammerer@childrens.harvard.edu.
18
Brigham and Women's Hospital, Boston, MA 02115, USA. Betsy.Kammerer@childrens.harvard.edu.
19
Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana. rmusonda@bhp.org.bw.
20
Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana. messex@hsph.harvard.edu.
21
Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA. messex@hsph.harvard.edu.
22
Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana. shahin.lockman@gmail.com.
23
Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA. shahin.lockman@gmail.com.
24
Brigham and Women's Hospital, Boston, MA 02115, USA. shahin.lockman@gmail.com.
25
Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana. sgaseitsiwe@bhp.org.bw.
26
Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA. sgaseitsiwe@bhp.org.bw.

Abstract

The hepatitis B virus (HBV) is a global problem; however, the burden of HBV infection in pregnant women in Botswana is unknown. We sought to determine the prevalence of chronic and occult HBV infection in human immunodeficiency virus (HIV)-infected and -uninfected pregnant women in Botswana. Samples from 752 pregnant women were tested for hepatitis B surface antigen (HBsAg), and HBsAg-positive samples were tested for hepatitis B e antigen (HBeAg) and HBV DNA load. Samples that were HBsAg negative were screened for occult HBV infection by determining the HBV DNA load. HBV genotypes were determined based on a 415-base-pair fragment of the surface gene. Among the 752 women tested during pregnancy or early postpartum, 16 (2.1%) (95% confidence interval (CI): 2.0⁻2.2) were HBsAg-positive. The prevalence of chronic HBV infection was higher (3.1%) among HIV-infected (95% CI: 3.0⁻3.2) compared with HIV-uninfected women (1.1%) (95% CI: 1.07⁻1.1, p = 0.057). Among the 622 HBsAg-negative women, the prevalence of occult HBV infection was 6.6% (95% CI: 6.5⁻6.7). Three of thirteen HBsAg-positive participants were HBeAg-positive, and all were HIV-negative. Of the 11 maternal samples successfully genotyped, five (45.5%) were genotype D3, five (45.5%) were genotype A1, and one was genotype E (9%). Low and similar proportions of HIV-infected and -uninfected pregnant women in Botswana had occult or chronic HBV infection. We identified a subset of HIV-negative pregnant women who had high HBV DNA levels and were HBeAg-positive, and thus likely to transmit HBV to their infants.

KEYWORDS:

Botswana; hepatitis B virus (HBV); human immunodeficiency virus (HIV); pregnant women

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