Hepatitis C virus and HIV co-infection among pregnant women in Rwanda

Mutagoma, Mwumvaneza; Balisanga, Helene; Sebuhoro, Dieudonné; Mbituyumuremyi, Aimable; Remera, Eric; Malamba, Samuel; Riedel, David J.; Nsanzimana, Sabin

doi:10.1186/s12879-017-2269-0

Cited by 38 publications

(30 citation statements)

References 17 publications

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“…This overall prevalence among pregnant women in our setting was relatively higher compared to retrospective findings published by Kopilovic et al [4] in some European countries. On the other hand, our findings for HCV prevalence among pregnant women at our setting is higher than findings reported from Nigeria (1.5%), Malawi (2.0%), United Kingdom (0.8%), Brazil (0.2%) and Central African region (2.0%), however, lower than overall estimated prevalence for sub-Saharan African countries (3.0%) [3]. The explanation for these variations could be due to differences in geographical patterns and varying physician test ordering practices, care-seeking and disclosure behaviors of pregnant women, or factors that are related to HCV risk [10].…”

Section: Discussioncontrasting

confidence: 93%

“…Following the identification of the hepatitis C virus in 1989 [2], and the development of specific diagnostic assays, hepatitis C infection is now recognized as a worldwide public health problem which affect 1.3 -8.0% of the world's population. Globally, the prevalence of hepatitis C virus (HCV) infection was estimated to be between 1.2 and 3.8% according to World Health Organization (WHO) Global Burden of Disease, with more than 185 million people infected worldwide [3].…”

Section: Introductionmentioning

confidence: 99%

“…Women infected with HCV have a 2-8% risk of viral transmission to their infant but the mechanism and timing of mother to child transmission (MTCT) are not well understood, J Microbiol Infect Dis www.jmidonline.org Vol 10, No 1, March 2020 nor is the natural history of the illness in pregnant women and their offspring [4]. A study conducted among pregnant women in Nigeria, found the prevalence of HCV to be between 1.4% for women aged between 20 and 35 years old and 11.1% for women aged less than 20 years old [3]. In Ghana, there exist no clear data for HCV prevalence among pregnant women, however, a recent systematic review conducted by Agyemang et al [5], mainly among low risk individuals found a prevalence rate of 3.0%.…”

Section: Introductionmentioning

confidence: 99%

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Hepatitis C Sentinel Seroprevalence, Cape Coast, Ghana

Tetteh¹,

Aglagoh²,

Baffe³

et al. 2020

Journal of Microbiology and Infectious Diseases

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Objectives: Sentinel studies have targeted prenatal women as they are largely descriptive of the reproductive bracket, and prevalence data may be extended to the general population. This study determined the seroprevalence of hepatitis C virus (HCV) infection among pregnant women attending antenatal clinic at the Cape Coast Metropolitan Hospital.Methods: Whole blood samples were collected from 258 pregnant women aged between 15-45 years, from September 1st through December 31st, 2018. Separated plasma was stored and later screened for HCV antibodies.Results: Out of the total, 2.7% (7/258) tested seropositive for HCV antibodies. The 20 -29 years age group recorded the highest prevalence of 1.6% (4/258, χ 2 = 4.260, p = 0.513). According to the 2018 HIV Sentinel Surveillance report, the prevalence of HIV infection in the Cape Coast Metropolitan Area was 3.4% (17/500). Also, the prevalence of HIV among the 20-29 years age group was 1.8% (9/500). The 15-24 years, proxy group for new infections recorded 0.8% (2/258) for HCV and 0.2% (1/500) for HIV infection. Conclusions:The seroprevalence determined in this study is classified 'intermediate,' according to the WHO guidelines for the care and treatment of persons diagnosed with chronic hepatitis C virus infection.The WHO currently does not recommend routine HCV testing for pregnant women; however, this study highlights the need for urgent public health interventions aimed at reducing the infection rate. J Microbiol Infect Dis 2020; 10(1):52-55.

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Section: Discussioncontrasting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hepatitis C Sentinel Seroprevalence, Cape Coast, Ghana

Tetteh¹,

Aglagoh²,

Baffe³

et al. 2020

Journal of Microbiology and Infectious Diseases

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“…The prevalence of HCV and HIV co‐infection among pregnant women varies across settings. One study in Rwanda reported that 3.9% of pregnant women with HCV were co‐infected with HIV . In a Western/Central European cohort of pregnant women living with HIV, 12% were co‐infected with HCV .…”

Section: Introductionmentioning

confidence: 99%

Review article: direct‐acting antivirals for the treatment of HCV during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child

Freriksen

Seyen²,

Judd

et al. 2019

Aliment Pharmacol Ther

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Summary Background With the global efforts to eradicate hepatitis C virus (HCV), treatment during pregnancy is becoming a priority for research as this, and maternal cure should reduce vertical transmission. However, as information on the efficacy and safety of direct‐acting antivirals (DAAs) in pregnancy is generally lacking, treatment of HCV infection during pregnancy is not currently recommended. Aim To provide an overview of current knowledge regarding maternal exposure, placental handling and safety of DAAs during pregnancy and lactation Methods A literature search was performed focusing on the effect of pregnancy on maternal exposure to DAAs, the placental handling of DAAs, the safety of DAAs for mother and child during pregnancy and the safety of DAAs during lactation. Results Exposure to all DAAs studied is likely to be altered during pregnancy, mostly related to pregnancy‐induced effects on drug absorption and metabolism. Although animal studies show that most DAAs are reported to cross the placenta and transfer into breast milk, most DAA combinations show a favourable safety profile. Because of the rapid viral decline after treatment initiation, and to avoid the critical period of organogenesis, treatment may be started at the end of the second trimester or early third trimester. Conclusions Treatment of HCV infection during pregnancy is realistic, as DAAs are highly effective and treatment duration is relatively short. There is an urgent need to study DAAs during pregnancy and lactation to contribute to the goal of HCV elimination.

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“…In Rwanda, the prevalence of HCV is not well known among the general population. Recent studies conducted in specific population groups have found the prevalence of anti-HCV (HCVAb), a marker for exposure to HCV, to be between 4.3-4.7% among people living with HIV(PLHIV) and 2.6% among pregnant women 9,10 . Among these studies none have assessed risk factors for HCV in Rwanda.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for viral hepatitis C infection in Rwanda: Results from a Nationwide Screening Program

Makuza

Liu

Ntihabose

et al. 2019

Preprint

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Background: The epidemiology and risk factors for hepatitis C virus (HCV) infection in Rwanda are not well known; however, this information is crucial to shaping the country's public health approach to hepatitis C control. Methods: A HCV screening campaign was conducted in the general population in 24 districts previously identified to have a high HCV disease burden. At the time of sample collection, sociodemographic information and self-reported risk factors were collected. Bivariate and multivariate logistic regressions were conducted to assess risk factors independently associated with hepatitis C antibodies (HCVAb) seroprevalence. Results: Out of a total of 326,263 individuals screened for HCVAb, 22,183 (6.8%) were positive. In multivariate analysis, risk factors identified as statistically associated with HCVAb Seroprevalence include history of traditional operation or scarification (OR=1.09, 95% CI:1.05-1.14), presence of viral hepatitis in the family (OR=1.27, 95% CI: 1.15-1.40), widowed or separated/divorced (OR=1.36, 95% CI: 1.26-1.47), Southern province (OR=1.98, 95% CI: 1.88-2.08) and aged 65 years and older (OR=4.86, 95% CI: 4.62-5.11). Ubudehe category 3 (OR=0.97, 95% CI: 0.93-1.01) and participants using RAMA (Health insurances for employees of public and private sectors) insurance (OR=0.76, 95% CI: 0.70-0.85) had lower odds of HCV seroprevalence. Conclusions:Our findings provide important information for Rwanda's strategy on prevention and case-finding.Future prevention interventions should aim to reduce transmission through targeted messaging around traditional healing practices and case-finding targeting individuals with a history of exposure or advanced age.

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Hepatitis C virus and HIV co-infection among pregnant women in Rwanda

Cited by 38 publications

References 17 publications

Hepatitis C Sentinel Seroprevalence, Cape Coast, Ghana

Hepatitis C Sentinel Seroprevalence, Cape Coast, Ghana

Review article: direct‐acting antivirals for the treatment of HCV during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child

Risk factors for viral hepatitis C infection in Rwanda: Results from a Nationwide Screening Program

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