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Background: Knowledge of factors associated with seroprevalence of Hepatitis B in pregnancy is important in informing policies towards prevention of vertical transmission of Hepatitis B Virus (HBV) infection, since in-utero and perinatal infection lead to chronic carrier state with severe long-term sequela. In addition, adequate and timely immunization plays a major role in the prevention of transmission. Objective: To determine the factors associated with HBs Ag seroprevalence in pregnant women from various geographical regions in Kenya. Methods and Subjects: This was a cross-sectional survey amongst all pregnant women attending antenatal clinics in Kenyatta National Hospital and 8 other hospitals from different regions of Kenya in their third trimester of pregnancy among June 2001 to June 2002. For each pregnant woman, age, history of intravenous drug use, sexually transmitted disease (STD), liver diseases, alcohol intake, blood transfusion (BT) and presence of traditional scarification were documented. HBs Ag serology was assayed at the Kenya Medical Research Institute (KEMRI) laboratory. Results: A total of 2241 pregnant women were enrolled in the study, 2196 consented, of whom 205 (9.3%) tested positive for HBs Ag. A significant association was found between HBs Ag seroprevalence and traditional scarification (p = 0.029), history of blood transfusion (p = 0.0024) and alcohol intake (p = 0.05). There was no significant association between Hbs Ag seroprevalence and sexually transmitted disease (p = 0.64). It was not possible to evaluate the association of HBs Ag seroprevalence with history of hospitalization for any liver disease including Hepatitis A, B or C, history of intravenous drug use or contact with sex partHow to cite this paper: Gatheru, Z., Murila, F., Mbuthia, J., Okoth, F., Kanyingi, F., Mugo, F., Esamai, F., Alavi, Z., Otieno, J., Kiambati, H. ners previously hospitalised for any liver disease including Hepatitis A, B or C as the numbers with these attributes were small. Conclusions: We found 9.3% of pregnant women were HBs Ag positive, significantly higher than previously observed. The high seropositivity was associated with traditional scarification, history of blood transfusion and alcohol intake. Proper screening of blood transfusion products, immunization and control of scarification and alcohol use should be considered by health policy experts.

Background: Children infected with HIV have been reported to show poor primary immune responses to vaccination. Additionally, their immune responses to vaccination wane more rapidly when compared to HIV uninfected children. This study was designed to evaluate presence of protective antibody levels against hepatitis B surface antigen (anti-HBs) in HIV infected children compared to HIV uninfected children.Methods and materials: This was a cross-sectional study at the Gertrude's Garden Children's Hospital, Kenya. A total of 531 children who had received the three doses of hepatitis B vaccine during infancy according to the recommendation by the Ministry of Health, Kenya were enrolled into the study. Anti-HBs levels were evaluated in serum samples on a Gemini Compact Microplate Processor while HIV sero-status was confirmed retrospectively from the individual hospital records.Results: Study participants were aged between 0.3 and 15 years with a mean age of 1.9 years for HIV infected children and 0.9 years in the HIV uninfected group; 191 were HIV infected and 340, HIV uninfected. A total of 18.3% (35/191) from the HIV infected group and 74.4% (253/340) from the HIV uninfected group had protective levels of anti-HBs above 10mIU/L. This difference was statistically significant (p < 0.0001) and was observed across all age groups.Conclusion: Majority (72%) of HIV infected children aged up to 15 years had no protective antibodies to HBV following immunization in infancy. There is need to review and develop an effective (HBV) immunization program for HIV infected children in this setting.

To evaluate protective antibody levels against hepatitis B surface antigen in HIV-infected and HIV-uninfected Kenyan children, this study enrolled 531 children. In the HIV-infected group, only 18.3% had protective hepatitis B surface antigen compared with 74.4% in the HIV-uninfected group (P < 0.0001). Perhaps HIV-infected children should be immunized differently.