High Endemicity and Low Molecular Diversity of Hepatitis B Virus Infections in Pregnant Women in a Rural District of North Cameroon

Abstract

BackgroundA program, supported by the GEMHEP (Groupe d'étude Moléculaire des Hépatites), was established in 2007 in the sanitary district of Tokombéré, to prevent perinatal transmission of hepatitis B virus (HBV). It comprises screening for HBV surface antigen (HBsAg) in all pregnant women and vaccinating the newborn if tests are positive.Methods/Principal Findings1276 women were enrolled in the study after providing informed consent. Demographic data and blood samples were available for 1267 of the enrolled patients. HBsAg was determined locally using a rapid test (Vikia HBsAg, Biomerieux). Tests for HBV and HDV virological markers (HBeAg, anti-HDV antibodies (Ab), HBV-DNA, HDV-RNA, HBV and HDV genotypes) were performed on the confirmed HBsAg-positive samples in the virology unit of the Angers University Hospital (France). HBsAg was found in 259 of the 1267 pregnant women (20.4%) between January 2009 and April 2010, of whom 59 were HBeAg-positive (22.7%) with high levels of HBV-DNA. Anti-HDV Ab were found in 19 (7.3%) of the HBsAg-positive women. The prevalence rates of HBsAg and HDV were not age-dependent whereas HBeAg carriers were statistically younger than non carriers. Basal core promoter (BCP) and precore (PC) mutations and genotypes were determined by sequencing. Of 120 amplified sequences, 119 belonged to HBV genotype E (HBV/E) and the 9 HDV strains belonged to HDV clade 1. In the PC region, 83/228 patients (36.4%) harbored a G1896A mutant or mixed phenotype virus. In the BCP region, the double mutation A1762T/G1764A and the G1757A substitution were detected respectively in 26/228 patients (11.4%) and 189/228 patients (82.8%).ConclusionsOur results confirm the high prevalence and low molecular diversity of HBV in Far Northern Cameroon; more than 20% of the infected women were highly viremic, suggesting a high rate of HBV perinatal transmission and supporting the WHO recommendation to vaccinate at birth against hepatitis B.

Prevalence of HBs Antigen, and HCV and HIV Antibodies in a Young Male Population in Cameroon

“…These results differed from those obtained by Ducancelle et al in 2013 in the North among pregnant women (20.4%) and those obtained by Foupouapouognigni et al in the East, in 2011, among the Baka and Bakola Pygmies (11.8%). We recorded the lowest prevalence rate in the South Region, followed by the West with 5.22% and 7.72% respectively.…”

A decision analytic model for prevention of hepatitis B virus infection in Sub‐Saharan Africa using birth‐dose vaccination

“…Although HBV is endemic in much of Sub-Saharan Africa (defined as an HBV surface antigen positive test result rate of >8%), and most studies show high rates of positive test results for HBV e antigen [7, 8], a few pediatric studies have suggested that, in Africa, there is a higher HBV acquisition risk after—instead of during—the perinatal period [4,17]. Owing to this gap in the literature, the present study estimated rates of vertical and horizontal transmission on the basis of the available data [4,7], and assumed a broad range of horizontal transmission (5%–30%). However, the results obtained were not sensitive to this wide range.…”

A prominent role of Hepatitis D Virus in liver cancers documented in Central Africa

“…Furthermore, almost all of our patients had a serological marker of previous HBV infection. The high prevalence of HBV infection was consistently reported in various groups of patients in Cameroon: 10.1 % in blood donors [12], 20.4 % in pregnant women [10], 23.6 % in health care workers [11] and 33 % in the Bantus enrolled in Central, South, North West and East part of the country [13]. Our findings regarding HBV prevalence in HCC is in keeping with data reported for decades in Gabon (40.5 %) and many studies conducted in West African countries like Niger (73 %), Senegal and Mali (63 %), Gambia (60 %) and Nigeria 61 % [26, 34–36].…”