High prevalence of hepatitis B and HIV among women survivors of sexual violence in South Kivu province, eastern Democratic Republic of Congo

Abstract

Introduction: Limited data are available on the prevalence rates of hepatitis B and acquired immunodeficiency syndrome (AIDS) among women survivors of sexual violence (WSSV) in South Kivu province, in the eastern part of the Democratic Republic of Congo (DRC), where armed conflicts persist. Here, we aimed to assess the prevalence of these two diseases in this vulnerable local population. Methods: A total of 1002 WSSV, aged from 18 to 70 years old were enrolled from May 2018 to May 2020 at three one-stop centers, set up at the Panzi, Mulamba and Bulenga hospitals. Blood samples were collected and tested for hepatitis B virus (HBV) and human immunodeficiency virus (HIV) antigens and antibodies using enzyme-linked immunoassay (ELISA) methods. Viral load quantification for HBV and HIV were performed using the GeneXpert. Results: For HBV, overall prevalence was 8.9% (95% CI [7.2–10.8%]), 32.1% [29.3–35.0%], and 14.5% [12.3–16.8%] for HBsAg, anti-HBc and anti-HBs antibodies, respectively. Among the 89 HBsAg-positive patients, 17 (19.1%) were HBeAg-positive. The mean age was 40.57±14.99 years in the HBsAg-positive group (p=0.025). Risk factors for HBV infection were age (≥35 years) (AOR=1.83 [1.02-3.32]; p=0.041), having no schooling (AOR=4.14 [1.35-12.62]; p=0.012) or only primary school-level (AOR=4.88 [1.61-14.75]; p=0.005), and multiple aggressors (AOR=1.76 [1.09-2.84], p=0.019). The prevalence of HIV was 4.3% [3.1–5.7%]. HIV/HBV co-infection occurred only in 5 individuals (0.5%). The HBV viral load was detectable (>2,000 copies/mL) in 61.8% of HBsAg-positive subjects and 64.8% HIV-positive subjects had a high viral load (>1,000 copies/mL). Conclusion: This study revealed a high prevalence of HBV and HIV infections among WSSV in South Kivu. These results highlight the urgent need for systematic screening of HBV and HIV by integrating fourth-generation ELISA tests in HIV and HBV control programs

Hepatitis B Virus Prevalence and Transmission in the Households of Pregnant Women in Kinshasa, Democratic Republic of Congo

“…National HBV prevalence in the DRC is estimated to be 3.3% by HBV surface antigen (HBsAg) testing [ 11 ], translating to approximately 2.5 million chronic infections in a country where advanced hepatology care is essentially inaccessible [ 12 ]. Estimated prevalence is higher among blood donors [ 13 ], women with human immunodeficiency virus (HIV) presenting to urban antenatal care (ANC) settings [ 14 ], pregnant women in rural areas [ 15 , 16 ], healthcare workers [ 17 ], and survivors of sexual violence [ 18 ]. Blood donor screening and the 3-dose infant pentavalent vaccine series are the only HBV prevention measures implemented nationally in DRC, but complete infant HBV vaccination coverage is <70% [ 19 ].…”

Hepatitis B virus prevalence and transmission in the households of pregnant women in Kinshasa, Democratic Republic of Congo

“…12 Estimated prevalence is higher among blood donors, 13 women with HIV presenting to urban antenatal care (ANC) settings, 14 pregnant women in rural areas, 15,16 healthcare workers, 17 and survivors of sexual violence. 18 Blood donor screening and the three-dose infant pentavalent vaccine series are the only HBV prevention measures implemented nationally in DRC, but complete infant HBV vaccination coverage is <70%. 19 For prevention of mother-to-child transmission, the World Health Organization recommends ANC HBsAg screening, maternal antiviral prophylaxis, and infant birth-dose vaccination to prevent perinatal transmission.…”