High seroprevalence and associated risk factors for hepatitis B virus infection among pregnant women living with HIV in Mtwara region, Tanzania

Abstract

Background Hepatitis B virus (HBV) infection continues to be a global public health problem. As of 2019, there were 296 million people chronically infected with HBV, resulting in nearly 1 million deaths from decompensated cirrhosis or hepatocellular carcinoma. The seroprevalence of HBV infection among pregnant women in Tanzania was reported to range between 3.8 and 8.03%. However, data on HBV infection in HIV-infected pregnant women is limited. We aimed to determine the seroprevalence and associated risk factors for HBV infection among HIV-infected pregnant women in selected health facilities in the Mtwara region. This was a health facility-based quantitative cross-sectional study conducted for three months (from February to April 2022). A structured questionnaire was used to collect information from the study participants. A total of 4 ml of blood was collected for HBV screening and confirmatory tests using rapid diagnostic tests and automated Enzyme-Linked Immunosorbent Assay (ELISA) tests, respectively. The logistic regression model was used to identify significant variables for HBV infection. Results Two hundred and twenty (n = 220) pregnant women living with HIV were enrolled in this study, with a median age of 32.7 years (Interquartile range (IQR) 27.6–37.6). The seroprevalence of HBV, chronic, and acute HBV infections were 10.5%, 10.0%, and 0.5%, respectively. We found that the multiparous women [aOR 11.99: 95% CI 1.11–129.01, p = 0.040], being infected with syphilis [aOR 27.65: 95% CI 9.07–84.30, p < 0.001], and having HIV viral load of 1000 copies/ml and above [aOR 16.00: 95% CI 1.70–150.63, p = 0.015], are factors independently associated with HBV infection. Conclusions The overall seroprevalence of HBV infection among pregnant women was 10.5%, which is high endemicity. Furthermore, the study revealed that having more than four children, a high HIV-1 viral load of ≥ 1000cp/ml, and being infected with syphilis are significant risk factors associated with HBV infection among pregnant women living with HIV in the Mtwara region.

Prevalence of Hepatitis B Infection Among Pregnant Women in Gombe, Gombe State, Nigeria

“…The result of our findings were in agreement with the report of Ndako et al (2021), that women in their second trimester of pregnancy had a highest prevalence of 22.2%. According to Shedura et al 2023 in Tanzania highest prevalence of hepatitis B 19.1% was observed in second trimester, followed by 9.8% in third trimester and no infection in first trimester. The report by Mac, Suleiman and Airiohuodion, (2019) was not in agreement with the finding of this work by reporting that women in the third trimester of their gestational period (39.2%) had the highest prevalence of HBsAg compared to those in first trimester (18.2%) and second trimester (15.3%).…”

“…The seroprevalence of hepatitis B virus infection among pregnant women living with HIV attending Prevention of mother-to-child transmission (PMTCT) clinics in the Mtwara region Tanzania was 10.5% (Shedura, Mchau and Kamori, 2023). A prevalence of 9.20% amongst pregnant women in the Gambia (Bittaye et al, 2019).…”

Prevalence of Hepatitis B Virus Infection in Tanzania: A Systematic Review and Meta‐Analysis

“…As for the southern, Zanzibar, and central regions, it is challenging to determine the overall prevalence of HBV due to the limited number of studies conducted in each area, with different populations and timeframes. In the southern region, Shedura et al [ 39 ] analyzed the prevalence of HBV among pregnant women attending antenatal clinics in 2022. In Zanzibar [ 26 ], febrile outpatients were analyzed in 2007 while the analyzed population in the central region included all outpatients attending districts and regional hospitals from 1991 to 1992 [ 14 ].…”

“…Only one study [ 30 ] focused on the population of infants who are particularly susceptible to HBV infection through maternal transmission. Similarly, only one study was available for some geographical zones such as southern [ 39 ], central [ 14 ], and Zanzibar [ 26 ]. Therefore, it is important to be cautious when interpreting the overall findings of our study.…”

Incongruity Between Knowledge and Preventive Practices on Hepatitis B Infection Among University Students in North-eastern, Tanzania

“…Sample size was estimated by the “Epitools” online sample size (ss) calculator based on the formula ss= Z 2 (P) (1-P)/ε 2 , where ‘Z’ is the value (1.96 for 95% confidence level [CI]), ‘P’ represents prevalence (0.08), 27 and ‘ε’ is the minimal tolerable error at 95% CI, expressed as a decimal (0.05). These estimations gave a minimum sample size of 114.…”