Concerns on the mother-to-child transmission of hepatitis B virus reported in Ethiopia

Abstract

Introduction: Taye and colleagues reported that the rate of mother-to-child transmission (MTCT) of hepatitis B virus (HBV) was as high as 20.7% in Ethiopia based on their meta-analysis of three studies [1]. However, numerous studies demonstrate that the overall rate of MTCT is below 5% after timely neonatal administration of hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine after birth. Concerns: The reports on which the meta-analysis was conducted appear to be problematic. The infants of HBV-infected mothers were not vaccinated against HBV at all, in one report. In another report, MTCT was defined based on positive hepatitis B surface antigen (HBsAg) in the umbilical cord blood, which is not correct because vast majority (> 95%) of positive HBsAg in umbilical cord blood is not infected with, but exposed to, HBV. Thus, MTCT of HBV calculated to be as high as 20.7% in this meta-analysis was overestimated, and much higher than the reported rate of 1–3% immunoprophylaxis failure in other parts of the world, including in Africa. Conclusions: The rate of MTCT of HBV in Ethiopia in this meta-analysis was overestimated. High-quality investigations are required to understand the real picture of immunoprophylaxis against MTCT of HBV in Ethiopia.