Prevalence of Hepatitis B Virus infection among Pregnant Women in Iran: A Systematic Review and Meta-analysis

Abstract

Background: Hepatitis B infection can be transmitted both vertically and horizontally. Although the universal neonatal vaccination and catch up vaccination of teenagers along with targeted vaccination of at risk population have decreased the prevalence of HBV infection in Iran dramatically, there is still risk of vertical transmission with subsequent chronic liver disease and hepatocellular carcinoma. This study aims to estimate the prevalence of latent HBV infection among Iranian pregnant women using metaanalysis method.Data Sources: Papers written in Persian or English were identified during a comprehensive search within five national and four international main databases. Study Eligibility Criteria and Participants:Studies reported the HBV infection prevalence among Iranian pregnant women and provided enough quality scores were selected for this meta-analysis. Methods:After a systematic review of national and international databases, duplicated and irrelevant studies were excluded. Standard error of the infection prevalence was calculated based on the binomial distribution. Because of the significant heterogeneity observed among the results, random effects model was applied to combine the results of the primary studies. Moreover, sensitivity analysis and meta-regression models were used to detect the sources of this heterogeneity.Results: At final step of the systematic search, 18 papers entered into the meta-analysis investigating 24853 pregnant women. Prevalence of HBV infection among Iranian pregnant women was estimated as 1.2% (95% confidence interval: 0.9 -1.6). Among different risk factors assessed, only familial history in four studies out of five relevant evidences was statistically significant. Conclusions:HBV infection prevalence among Iranian pregnant women is low and familial history is its major determinant.

An updated systematic review and meta-analysis of the prevalence of hepatitis B virus in Ethiopia

“…Concerning HBV among pregnant women, a high (5%) prevalence was noted that require prompt screening of pregnant women during their antenatal care visit and provide proper treatment to decrease the rate of mother to child transmission of the virus. Though the result was far higher than recent findings from India 1.01% [102] and Iran (1.18 and 1.25%) conducted at different time periods [103, 104], it was significantly lower compared to the findings from Nigeria 14.1%, Cameroon 11.11%, Burkina Faso 9.8%, and Ghana 13.1% [96–99]. Most probability this variability could be due to the endemicity of the virus among the mentioned countries than Ethiopia or it could be due to the increased attention of the Ethiopian government in providing care and follow-up for the pregnant women which could significantly reduce the transmission and prevalence of HBV among the pregnant women.…”

An updated systematic review and meta-analysis of the prevalence of hepatitis B virus in Ethiopia

“…Concerning HBV among pregnant women, a high (5%) prevalence was noted that require prompt screening of pregnant women during their antenatal care visit and provide proper treatment to decrease the rate of mother to child transmission of the virus. Though the result was far higher than recent findings from India 1.01% [102] and Iran (1.18% and 1.25%) conducted at different time periods [103,104], it was significantly lower compared to the findings from Nigeria 14.1%, Cameroon 11.11%, Burkina Faso 9.8%, and Ghana 13.1% [96][97][98][99]. Most probability this variability could be due to the endemicity of the virus among the mentioned countries than Ethiopia or it could be due to the increased attention of the Ethiopian government in providing care and followup for the pregnant women which could significantly reduce the transmission and prevalence of HBV among the pregnant women.…”

A qualitative study on individual experiences of chronic hepatitis B patients

“…The inclusion criteria were, living with family members; undergoing a confirmatory HBS Ag test; being an inactive carrier of chronic HBV; and absence of other chronic diseases such as diabetes, renal failure, AIDS and hepatitis C. Referring to many studies conducted in Iran, Hepatitis B is mainly transmitted through intra‐familial transmission (Salehi et al., ). Based on the results of quantitative studies, infection of hepatitis B is mainly through vertical transmission (mother to child), marital relationships, household contacts with Iranian families (Moghaddasifar, Lankarani, Moosazadeh, Afshari, & Malary, ). Regarding these factors, we considered living with family as a main inclusion criteria for participants.…”