HBV and HCV prevalence and viraemia in HIV‐positive and HIV‐negative pregnant women in Abidjan, Côte d'Ivoire: The ANRS 1236 study

Abstract

A retrospective survey estimating the prevalence of hepatitis viruses B (HBV) and C (HCV) was conducted on samples taken in 1,002 African pregnant women (501 diagnosed as HIV-1 positive and 501 HIV-1 negative) participating in a clinical trial program conducted in Abidjan, Côte d'Ivoire (West Africa). Hepatitis B markers studied were HBs antigen (HBsAg), and if positive, HBe antigen/anti-HBe antibodies and HBV DNA. Two third generation (G3) HCV enzyme immunoassays (EIAs) were used for primary HCV screening. All anti-HCV antibody-positive sera were assessed further with supplementary assays (one another G3 EIA, RIBA 3.0, and HCV RNA). HCV genotypes were also determined. HBsAg was found in a similar proportion among HIV-positive (45/499, 9.0%, 95% confidence interval [95% CI], 6.6-11.9) and HIV-negative (40/498, 8.0%, 95% CI, 5.8-10.8) women (P = 0.58). The diagnosis of chronic hepatitis B, based on HBV DNA positive results, was more frequent in HIV-positive women (26.7%), compared to HIV-negative women (9.4%) (P = 0.06). In the case of hepatitis C infection, after supplementary testing allowing the elimination of frequent false-positive screening results, a prevalence rate of about 1% was found, both in HIV-positive (6/501, 1.2%, 95% CI, 0.44-2.59) and HIV-negative (4/501, 0.8%, 95% CI, 0.22-2.03) women (P = 0.53). Of the 10 samples confirmed positive and assessed for HCV RNA, eight (80%) were viraemic and belonged to HCV genotypes 1 or 2. The relative high frequency of HIV/HBV coinfection in Côte d'Ivoire emphasises the need for monitoring the risk of hepatotoxicity by antiretroviral therapy in such patients. We propose an accurate and cost-efficient algorithm for HCV diagnosis in Africa.

Prevalence and virological profiles of hepatitis B infection in human immunodeficiency virus patients

“…Our study results confirm the high prevalence of HBV infection among HIV patients in Côte d'Ivoire, and more generally in sub-Saharan Africa, as evidenced by most studies on the subject [10,13,[15][16][17][18][19][20][21][22] . Indeed, the prevalence of HBsAg and that of anti-HBcAb were respectively 13.4% and 72.9% in our patients.…”

“…Indeed, HIV infection increases chronic HBV infection risk and promotes faster progression to cirrhosis and its complications, especially when HBV replication is important [4][5][6][7][8][9] . If HBV-HIV coinfection is very common in sub-Saharan Africa, there are few data on HBV infection virological aspects in HIV Black African patients [10][11][12][13][14] . This study's aims were to estimate HBV infection prevalence among an adult population, with HIV infection, less than 500 CD4+ T-cell/mm 3 and without antiretroviral therapy (ART), to describe the different profiles of virological B co-infected subjects and to search for HBs antigen (HBsAg) presence associated factors in these HIV patients.…”

Viral Hepatitis Infections in Africa - A Meta-analysis

“…In Cameroun, the high prevalence of HBV has also been linked to the pregnant status among women suggesting that pregnant women serve as a very important reservoir to fuel the HBV epidemic in the general population in Cameroun (Kfutwah et al, 1912). Similar results were obtained in Côte d'Ivoire (Rouet et al, 2004) and Tanzania (Jacobs et al, 1997). The overall 8.3% (17/204) HBV maternofoetal transmission rate observed in Ghana was like the 7% rate reported from Senegal in infants at birth, but was higher than previously reported in other studies from sub-Saharan Africa (Candotti et al, 2007).…”

Prevalence of hepatitis B e antigen among human immunodeficiency virus and hepatitis B virus co-infected patients in Jos, Nigeria

“…On the other hand, the HBeAg prevalence of 15% in the HBV mono-infected control was higher than the rate of 8-10% generally reported in HBV monoinfected individuals in sub-Saharan Africa [18,22,34].This may be due to differences in the characteristics of the study subjects. For example, a study in Enugu, southeastern Nigeria [34] excluded symptomatic patients, compared to the current study, in which symptomatic patients were included.…”

“…A high prevalence of HBeAg in both groups was found; coinfected patients had a significantly higher value than the mono-infected controls. Higher HBeAg prevalence in HIV/HBV co-infected patients than in HBV monoinfected subjects has also been observed in both developed nations and sub-Saharan Africa [4,18,[21][22][23].…”