Prevalence and Genetic Diversity of Hepatitis B and C Viruses Among Couples Attending Antenatal Care in a Rural Community in Rwanda

Abstract

Background: Globally, over 325 and 170 million people are infected with hepatitis B virus (HBV) and hepatitis C virus (HCV), respectively. If untreated, these infections can progress to cirrhosis or hepatocellular carcinoma. The primary aim of this study was to determine the prevalence, genetic diversity, and factors associated with HBV and HCV among couples attending antenatal care in rural Rwanda. Methods: This was a cross-sectional survey of HBV and HCV seroprevalence. Study participants were administered a brief structured questionnaire to obtain information on sociodemographic and behavioural risk factors for HBV and HCV. Participant blood samples were screened for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies (anti-HCV) using rapid diagnostic kits; confirmatory testing was done by enzyme immunoassay and nucleic acid tests. HBV genotypes were determined using nested polymerase chain reaction; HCV genotypes were determined by reverse transcriptase PCR followed by hybridisation with sequence-specific oligonucleotides. Statistical associations between risk factors and infection status were determined using Chi-square tests and bivariate logistic regression. Results: In total, 220 individuals participated in the study. This includes 110 pregnant women and 110 male partners who were attending antenatal care at Gitare and Cyanika health centres. Two participants (0.9%) had serological evidence of HBV infection, and 4 participants (1.8%) were infected with HCV. HBV genotype A accounted for all HBV infections; HCV genotype 4 accounted for all HCV infections. None of the assessed factors were associated with HBV infection while occupation type and scarification were significantly associated with HCV infection (P values were .03 and <.01 respectively). All cases of infection were discordant with their respective partners. Conclusion: Prevalence rates of HBsAg and anti-HCV are low in couples attending antenatal clinics in rural Rwanda. Consideration should be given to interventions aimed at reducing the risk of transmission in discordant couples and infants of infected mothers.