Mother‐to‐child transmission of hepatitis B: What more needs to be done to eliminate it around the world?

Nayagam, Shevanthi; Shimakawa, Yusuke; Lemoine, Maud

doi:10.1111/jvh.13231

Cited by 27 publications

(37 citation statements)

References 62 publications

(118 reference statements)

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“…Mother-to-child transmission of HBV is known to be associated with a high risk of developing chronic HBV infection, and also progressing towards chronic liver diseases including cirrhosis and liver cancer [50,51]. Since the majority of mother-to-child transmission occurs perinatally through contact with maternal body fluid, HepB-BD needs to be given as soon as possible after birth [52]. In addition to failing to receive timely protection from these preventable diseases, infants not vaccinated according to the recommended schedule may have an increased risk of never fully completing a whole series of the subsequent vaccines [53].…”

Section: Discussionmentioning

confidence: 99%

Coverage and Timeliness of Birth Dose Vaccination in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

et al. 2020

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Background: Depending on the epidemiological context of each country, three vaccines are recommended by the World Health Organization (WHO) to be administered as soon as possible after birth (birth vaccines); namely, BCG, zero dose of oral polio vaccine (OPV0), and birth dose of hepatitis B vaccine (HepB-BD). The timely administration of these vaccines immediately after birth might pose significant challenges in sub-Saharan Africa, where about half of childbirths occur outside health facilities. We therefore conducted a systematic review and meta-analysis to estimate the coverage rate of these vaccines at a specific timing in neonates in sub-Saharan Africa. Methods: We searched PubMed, Embase, CINAHL, and Web of Science for studies conducted in sub-Saharan Africa and published up to March 31, 2017, which provided a coverage rate of the birth vaccines at any specific time points within 28 days after birth. Two investigators independently screened the titles and abstracts and extracted data from the eligible full-text articles. This study was registered in PROSPERO (CRD42017071269). Results: Of 7283 articles identified, we finally included 31 studies with 204,111 infants in the meta-analysis. The pooled coverage rates at day 0–1 after birth were 14.2% (95% CI: 10.1–18.9) for BCG and 1.3% (0.0–4.5) for HepB-BD. No data were available for OPV0 at day 0–1. The coverage at day 28 was 71.7% (63.7–79.2) for BCG, 60.8% (45.8–74.7) for HepB-BD, and 76.1% (67.1–84.0) for OPV0. No significant difference in the vaccine coverage was observed between infants born in healthcare facilities and those born outside facilities. Conclusions: The rates of vaccine coverage immediately after birth were very low for BCG and HepB-BD, and no data for OPV0. We need additional data to better define barriers and facilitators for the timely administration of the birth vaccines in sub-Saharan Africa, since the delay in its provision may increase the burden of these vaccine-preventable diseases.

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Section: Discussionmentioning

confidence: 99%

Coverage and Timeliness of Birth Dose Vaccination in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

et al. 2020

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“…Regarding HBV infection, major progress has been made in terms of immunization coverage; by the end of 2018, hepatitis B infant vaccine was introduced in 189 countries/regions and the global coverage with three doses of vaccine was estimated at 84% 18 . However, the estimates remain insufficient (76%) in Africa, and HBV birth-dose vaccine coverage globally is still very low (38%), especially in Africa, where only 11% of newborn babies receive the HBV birth dose within 24 h of birth as recommended 18 . Progress has been made in terms of public and political awareness.…”

Section: MLmentioning

confidence: 99%

Progress towards elimination goals for viral hepatitis

Cox

El-Sayed

Kao

et al. 2020

Nat Rev Gastroenterol Hepatol

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Is elimination of viral hepatitis by 2030 feasible? Andrea L. Cox. Hepatitis B virus (HBV) and hepatitis C virus (HCV) combined are among the top four global infectious disease killers alongside tuberculosis, malaria and HIV 1. Although the number of people in the world dying from HIV, tuberculosis and malaria have all declined since 2008, global deaths from chronic HBV and HCV infection continue to rise, with more than 1.4 million deaths each year 1. Globally, HBV-related liver disease represents the seventh highest cause of mortality worldwide 2. Given this burden, viral hepatitis elimination should be a priority. However, available evidence demonstrates that global viral hepatitis elimination by 2030 is highly unlikely. Rates of hepatitis B and C diagnosis are very low, averaging 8% and 18%, respectively, globally 1. Although some regions are approaching prophylaxis and prevalence targets for HBV infection, studies suggest that all regions must substantially scale up rates of diagnosis and access to treatment to meet the global targets 3-5. For HCV infection, 80% of high-income countries are not on track to meet HCV elimination targets by 2030, and 67% will

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“…Twenty-three percent of HBsAg-positive women were HBeAg positive, and 13.1% had a HBV DNA load (>200,000 IU/mL) higher than the threshold above which the majority of MTCT is known to occur [8,27]. The presence of HBeAg in HBsAg-positive pregnant women is an indicator of active viral replication; it increases the risk of perinatal transmission of HBV.…”

Section: Biomed Research Internationalmentioning

confidence: 99%

“…Different studies found that despite implementation of appropriate immunization programs, about 8-30% vertical transmission still occurs in infants born to HBeAg-positive women [27,44,45]. Infant scheduled vaccination interrupts horizontal (child-to-child) HBV transmission but does not effectively control HBV MTCT [8]. In China, despite the fact that 94% of children have received three doses of the hepatitis B vaccine, MTCT still accounts for 40-50% of new HBV infections [46].…”

Section: Biomed Research Internationalmentioning

confidence: 99%

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Hepatitis B Infection and Mother-to-Child Transmission in Haiphong, Vietnam: A Cohort Study with Implications for Interventions

Khue

Linh

Hai³

et al. 2020

BioMed Research International

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Background. There is little data available on HBV infection and mother-to-child transmission (MTCT) in Vietnam. Objective. This study is aimed at assessing the prevalence of HBV infection and the current situation of MTCT in Haiphong, Vietnam. Methods. A transversal survey of 1721 pregnant women followed by an observational prospective cohort study of 183 HBV-infected women was conducted at Haiphong Gyneco-Obstetric Hospital. Women were followed up up to 12-month postpartum; use of prevention measures and the MTCT rate were evaluated. HBV infection in children was defined by a HBsAg-positive test at 12 months of age. Results. At baseline, 183 of 1721 pregnant women (10.6%) tested HBsAg positive. Among them, 23.0% were HBeAg positive, 26.2% had a detectable load of HBV DNA, and 13.1% had a HBV DNA load≥200,000 IU/mL. All women underwent MTCT prevention antiviral therapy. At delivery, 98.9% of newborns receive a HBV vaccine birth dose, and 82% received HBIG. At 12 months of age, 94.7% have received the scheduled HBV vaccines. Eight percent of infants born from followed-up women were HBsAg positive. The mother’s HBeAg-positive status was associated with a higher risk of HBV infection in infants. Conclusion. The HBV prevalence and MTCT rates are high in Haiphong. A strong national plan to increase the access to preventive measures and to monitor results is needed in order to decrease this prevalence.

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Mother‐to‐child transmission of hepatitis B: What more needs to be done to eliminate it around the world?

Cited by 27 publications

References 62 publications

Coverage and Timeliness of Birth Dose Vaccination in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Coverage and Timeliness of Birth Dose Vaccination in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Progress towards elimination goals for viral hepatitis

Hepatitis B Infection and Mother-to-Child Transmission in Haiphong, Vietnam: A Cohort Study with Implications for Interventions

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