Hepatitis B and human immunodeficiency virus co-infection among pregnant women in resource-limited high endemic setting, Addis Ababa, Ethiopia: implications for prevention and control measures

Abstract

BackgroundHepatitis, a highly contagious viral infection, is one of the leading killer diseases globally caused by hepatitis virus. Among the existing viral causes for hepatic failure, hepatitis B virus (HBV) plays a significant role with devastating implications, especially when combined with other viral infections such as human immunodeficiency virus (HIV). Co-infection with hepatitis B virus and HIV leads to increased morbidity and mortality as compared to independent HIV and HBV infections. In this study, we aimed to assess the seroprevalence of HBV and HIV coinfection and associated risk factors among pregnant women in a selected hospital facility around Addis Ababa, Ethiopia.MethodsA total of 215 pregnant women were recruited between July and October 2014 from Tirunesh Beijing General Hospital. A pretested and structured questionnaire was used to collect socio-demographic characteristics and possible risk factors. In addition, 5 ml venous blood was collected and centrifuged to estimate the seroprevalence of HBV and HIV. Descriptive statistics and logistic regression analysis were done and a P value less than 0.05 was considered statistically significant.ResultsThe overall prevalence of hepatitis B virus infection was 13 (6 %). This positivity was different across different age categories: 1 (11.1 %), 3 (4.5 %), 6 (6 %), 1 (3.2 %), and 2 (25 %) among those between 15–19, 20–24, 25–29, 30–34, and 35–39 years, respectively. However, a statistically significant association was not established between age and HBV. Among the total, 9 (4.2 %) of the positive cases were detected among primary school completed. Multivariate analyses indicated that history of abortion (p = 0.003), history of surgery (p = 0.0.022), and tattooing (p = 0.033) were significantly associated with HBV infection. A total of 9 (4.2 %) women were found to be HIV seropositive, of whom 2 (22.2 %) were co-infected with HBV.ConclusionsWe observed a relatively higher seroprevalence of HBV infection among pregnant women in the study area, in which majority of the cases had underlying risk factors for acquiring the infection. Since none of the mothers were vaccinated for HBV, the possibility of perinatal transmission is inevitable. Hence, routine screening and immunization against HBV during pregnancy and health education are highly warranted to alleviate the situation.

Hepatitis B Virus Infections and Associated Factors among Pregnant Women Attending Antenatal Care Clinic at Deder Hospital, Eastern Ethiopia

“…Women with a history of abortion had a chance of 11 times (AOR10.9, 95%CI 2.2–53.9) to develop HBV infection compared to their counterpart. Similar results were reported from Jimma [27], Arba Minch [22], Addis Ababa [20] and Dessie, Ethiopia [14]. This high incidence of infection could be attributed to poor practices of infection prevention control during abortion and related activities.…”

“…According to established criterion, the prevalence of HBsAg among pregnant women in this study area can be classified as “high inter-mediate” endemicity area [1]. This finding is similar with a prevalence of 6.1% reported in Southern Ethiopia [19], 6% in Addis Ababa [20] and 7.3% in Gondar, Northwest Ethiopia [16]. But, relatively it is higher than 4.9%, 4.4%, 4.3% and 3.8% of prevalence which were reported from Dessie [14], Felege Hiwot [21], Arba Minch [22] and Bahir Dar city [15], respectively.…”

“…Other possible causes for these huge statistical results such as confounding effects, multicollinearity and the validity of regression model were addressed at the stage of study design and during data analysis. Likewise, similar numerical problems were reported in other comparable studies [14, 20]. For the purpose of this study, only HBsAg was determined which tells about active infection rather than total prevalence.…”

Seroepidemiological patterns and predictors of hepatitis B, C and HIV viruses among pregnant women attending antenatal care clinic of Atat Hospital, Southern Ethiopia

“…History of abortion, blood transfusion, home delivery by TBA, alcohol taking, surgical procedure (CS) and polysexual partners were significant predictors of HBV infections. Like other studies conducted in Jimma, 32 Arba Minch, 33 Addis Ababa 42 and Dessie, 2 pregnant women with abortion history have increased the risk of having HBV infection more than nearly nine times (AOR = 8.643; 95% CI = 0.502-30.361, p = 0.034) as compared with those who had no such practices. Deliberate termination of pregnancy is the result of unwanted pregnancy which in turn could be because of unwanted sexual contact.…”

Hepatitis B and C viruses’ infection and associated factors among pregnant women in the Amhara region, Ethiopia: implications for prevention of vertical transmission.

“…Globally, less than 5% of people are aware of infected by hepatitis virus infection [1]. The majority of hepatitis infected individuals remain asymptomatic or apparently healthy, transmit the virus to other persons, and die of the infection without notice; it is a silent killer [4].…”