Insights into hepatitis B virus infection among pregnant women: Assessing seroprevalence, serological, and virological profile at a tertiary care hospital in India

Abstract

ABSTRACT Background: India bears a considerable global burden, hosting over 37 million hepatitis B virus (HBV) carriers, primarily transmitted through the perinatal route. Therefore, this study aimed to determine the prevalence of HBV infection among pregnant women attending the antenatal clinic at a tertiary care hospital. Aims: This study sought to assess the seroprevalence of HBV infection in pregnant women, analyze the serological markers of HBV infection, and ascertain the viral load of HBV DNA. Settings and Design: The study was conducted at the Department of Microbiology and Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. It adopted a hospital-based cross-sectional design. Subjects and Methods: The study spanned from January 2021 to June 2022. HBV infection among pregnant women attending the antenatal clinic of a tertiary care hospital was identified by screening their sera using hepatitis B surface antigen (HBsAg) ELISA. For samples testing positive for HBsAg ELISA, additional tests were administered, including HBeAg, HBeAb, hepatitis B core immunoglobulin M, and total hepatitis B core antibody (immunoglobulin [Ig] M + IgG) by ELISA. In addition, a quantitative assessment of HBV DNA was conducted using real-time reverse transcription-polymerase chain reaction. Statistical Analysis Used: All data underwent coding and entry into an MS Excel spreadsheet, with analysis executed using the Statistical Package for the Social Sciences (SPSS) version 21.0. Ethical approval was obtained from the Institutional Ethics Committee, Vardhman Mahavir Medical College and Safdarjung Hospital. Informed consent was obtained from all pregnant women participating in the study. Results: Among the 1519 pregnant women screened for HBsAg, 15 tested positive, resulting in a seroprevalence of 1% (15/1519). Subsequent examination revealed two women with acute HBV/chronic hepatitis B-acute exacerbation infections (high infectivity) and 13 women with chronic HBV infections (low infectivity). Furthermore, only HBeAg-positive women exhibited HBV DNA levels surpassing 2000 IU/mL. Conclusions: The 1% seroprevalence of HBV among pregnant women implies an approximate count of 4 million infected women of reproductive age, posing a risk of vertical transmission to nearly 4 million newborns annually. With HBeAg-positive mothers, the risk of neonatal transmission ranges from 70% to 90%. Timely interventions for all pregnant women are imperative to mitigate HBV vertical transmission.