Prevalence, risk factors, and molecular epidemiology of hepatitis B and hepatitis delta virus in pregnant women and in patients in Mauritania

Abstract

No recent data are available on hepatitis B virus (HBV) and hepatitis Delta virus (HDV) prevalence in Mauritania. One thousand twenty pregnant women and 946 patients visiting for routine checkups were screened for HBV and HDV infection. Demographic, epidemiological, ethnic, clinical, and biological data were recorded. HBV and HDV genotypes were determined by sequencing and phylogenetic analyses. In the pregnant women and patients cohorts, respectively, the prevalence of HBsAg (10.7% and 18.3%) and anti‐HBcAb (66.3% and 76.5%) indicated high HBV endemicity. In pregnant women, exposure to HBV was significantly associated in multivariate analysis with education level, ethnicity, blood transfusion, and occupation. HDV antibodies (HDVAb) were found in 14.7% of pregnant women. In patients, HBsAg was found less frequently in females than in males. Again in multivariate analysis, exposure to HBV was significantly correlated with gender (males), and HDVAb positivity with age and gender. The HBV DNA viral load was >3 log IU/ml in only 10.1% of pregnant women and in 17.3% of patients. HDV‐RNA was detectable in 21 (67.7%) of the 31 patients positive for HDVAb, and in 11 of the 16 pregnant women positive for HDVAb (68.8%). The most frequent HBV genotypes were: HBV/D, 53%; HBV/E, 35%; and HBV/A, 12%. Sub‐genotyping revealed HBV/D1,/D7, and the recently described/D8. HDV genotypes were: HDV‐1, 90.3% and HDV‐5, 9.7%. This study confirms the high prevalence of HBV and HDV infections in Mauritania and demonstrates the high genetic diversity of HBV in this country. J. Med. Virol. 84: 1186–1198, 2012. © 2012 Wiley Periodicals, Inc.

Hepatitis B and C virus infections among pregnant women in Arab and African countries

“…Medical and surgical risk factors such as surgical procedures, home delivery, dental procedures, and history of jaundice were all found not to be significant [24,30,39,100,101].…”

“…Several other studies have reported higher prevalence among those dependent on blood and blood products, especially when compared with reports of a decline in seroprevalence [96][97][98][99][100][101]. In contrast to the above-mentioned findings, studies of HBV infection in pregnant women in Sudan, Yemen, and Mauritania have failed to show any evidence of blood transfusion being a risk factor for virus transmission [24,30,39]. This difference might be explained by better safety precautions being taken for blood donation, where screening for the virus is regularly undertaken.…”

“…Sociodemographic factors such as age, education level, and gravidity have been found not to be significant factors associated with transmission of HBV [24,30,39,100,101]; however, some reports have stated that becoming sexually active at an early age is a risk factor as has been found by Rabiu et al among Nigerian pregnant women [100]. Other important sociodemographic risk factors for HBV infection that cannot be ignored are history of intravenous drug abuse, imprisonment, and history of multiple partners.…”

“…D is the most common genotype among the different settings throughout the previously mentioned Arab states [37][38][39][40][41][42][43][44][45][46].…”

Molecular and Immunological Study of Hepatitis B virus infection in Samara City, Iraq.

“…In Mosul, Iraq, Shafiq [12] [2013] reported that genotype D is the predominant genotype in HBV acute and chronic infections. In addition, another study found that D genotype is the predominant among Mosul blood donors [11].In Arab countries the predominant genotype was D in Saudi Arabia [13], United Arab Emirates [14], Yemen [15], Lebanon [16], Jordan [17], Egypt [25], Libya [18] Mauritania [19], Morocco [20], and Syria [21].…”