Prevalence, risk factors and virological profile of chronic hepatitis b virus infection in pregnant women in India

Abstract

A large program was conducted by the Government of India to study the prevalence and profile of chronic hepatitis B virus (HBV) infection and its risk factors in pregnant women attending a tertiary care hospital in India. From September 2004 to December 2008 consecutive pregnant women attending the antenatal clinic were screened and those found positive for HBsAg were enrolled. Healthy non-pregnant women of child-bearing age, who presented for blood donation during the same period, served as controls. Women with symptoms of liver disease or those aware of their HBsAg status were excluded. Of the 20,104 pregnant women screened, 224 (1.1%) and of the 658 controls, 8 (1.2%) were HBsAg positive (P = ns). Previous blood transfusions and surgery were significant risk factors for infection with HBV. Of the women who were HBsAg positive, the ALT levels were normal in 54% of the women and HBV DNA levels were above 2,000 IU/ml in 71% of women. The median HBV DNA levels were higher in women who were HBeAg positive compared to the HBeAg negative group. The most common HBV genotype was D (84%) followed by A + D and A (8% each). In conclusion, the prevalence of HBsAg positivity among asymptomatic pregnant women in North India is 1.1% with 71% having high HBV DNA levels. These women may have a high risk of transmitting infection to their newborns.

Tackling the Hepatitis B Disease Burden in India

“…[49][50][51][52] A large study involving 8575 pregnant women from Northern India, documented HBsAg carrier rate in antenatal mothers to be 3.7%, HBeAg carrier rate 7.8% and vertical transmission was observed in 18.6%. 53 However, a recent study by Dwivedi et al 54 has shown a lower prevalence rate of 0.9%.…”

Chronic Hepatitis B Virus Infection and Pregnancy

“…5 In India, the prevalence rate of HBsAg positivity in pregnant women in studies before 1990s varies from 2.6 to 9.5%, [6][7][8][9][10][11] whereas more recent studies have reported HBsAg positivity among pregnant women ranging from 0.8 to 1.1%. [12][13][14] The HBeAg positivity among HBsAg positive pregnant women have varied widely from 4.8% to 68.7%. 6,14 In a recent study from Delhi, which found HBsAg prevalence of 1.1% among pregnant women, it was found that the alanine aminotransferase (ALT) levels were normal in 54% of the women and HBV DNA levels were above 10,000 copies/mL (2000 IU/ml) in 71% of women.…”

“…[12][13][14] The HBeAg positivity among HBsAg positive pregnant women have varied widely from 4.8% to 68.7%. 6,14 In a recent study from Delhi, which found HBsAg prevalence of 1.1% among pregnant women, it was found that the alanine aminotransferase (ALT) levels were normal in 54% of the women and HBV DNA levels were above 10,000 copies/mL (2000 IU/ml) in 71% of women. The median HBV DNA levels were higher inHBeAg-negative group.…”

Evaluation of Hepatitis B virus infection in pregnant women

“…Other studies demonstrate that percentages of HBsAgs were 0.9%, 16% and 84% due to tattooing in 78.4% [7]. Other study showed that 1.1% of healthy non pregnant women were positive for HBsAgs and ALT level were elevated in 54% of those women and HBV DNA levels were above 2000 IU/ml in 71% of women and had a higher risk of transmission infection to their newborn [8]. HBsAgs traced in 0.5% of pregnant women in other study [9].…”