Hepatitis B Virus Infection In Pregnant Women Research Articles

Seroprevalence and Associated Factors of HBV and HCV among Pregnant Women Attending Antenatal Care at Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia: A Cross-Sectional Study.

Infections with the hepatitis B virus (HBV) and the hepatitis C virus (HCV) are worldwide problems that particularly place a heavy burden on developing nations. HBV and HCV infections during pregnancy have a high rate of vertical transmission and harmful consequences for both the mother and the child. Therefore, this study was carried out to assess the seroprevalence and associated factors of HBV and HCV infections among pregnant women attending antenatal care at Debre Tabor Comprehensive Specialized Hospital in Ethiopia. A cross-sectional study was conducted from March 15th to September 16th, 2022, at the Debre Tabor Comprehensive Specialized Hospital antenatal care clinic. Five milliliters of venous blood were collected from 422 pregnant women selected using a simple random sampling method. Data on sociodemographic characteristics and risk factors were collected using a prestructured questionnaire. A chi-square test, bivariate, and multivariate analyses were used to evaluate the association between dependent and independent variables. p values less than 0.05 were considered statistically significant. The seroprevalence of HBV and HCV infections was found to be 13% and 0.5%, respectively. Undertaking blood transfusion (AOR = 14.2, CI = 5.81-34.526, p = 0.001), tattooing (AOR = 3.99, CI = 1.1-14.36, p = 0.034), and dental therapy (AOR = 4.9, CI = 1.41-17.025, p = 0.012) were significantly associated with HBV infection. HBV infection in pregnant women was shown to have a high endemicity (13%) in this investigation, whereas the seroprevalence of HCV infection was low (0.5%). HBV infection was significantly associated with a history of blood transfusions, tattooing, and dental therapy. Screening pregnant women for HBV and HCV infections and providing effective therapy would ensure better outcomes for the newborn. In addition, health education must be used to increase knowledge of screening and modes of transmission.

Husband’s behavior and early marriage as risk factors for hepatitis B virus infection among pregnant women in Karangasem, Bali, Indonesia

Background and purpose: Indonesia is categorized as a country with moderate level of hepatitis B virus (HBV) infection, where the majority of HBV transmissions occur from mother to child, horizontal transmission during childhood and adulthood, and transmission in health services. This study aims to determine factors associated with HBV infection among pregnant women. Methods: A case control study was conducted among 80 pregnant women with sero-positive HBsAg as cases and 80 pregnant women with sero-negative HBsAg as controls. The sources of cases and controls were the registers of pregnant women at 12 public health centers (PHCs) and Karangasem District Hospital from June 2017 to December 2018. Cases were selected by systematic random sampling from 129 pregnant women with sero-positive HBsAg and controls were selected through the same method from 1,408 pregnant women with sero-negative HBsAg. They were then matched based on village or residence. Data collected were including history of marriage, pregnancy, childbirth and abortion, history of health services relevant to HBV infection, use of contraception, mobility, permanent tattoos and history of injecting drug use. Data collection was carried out from June to August 2019 through face-to-face interviews with pregnant women as respondents in their respective homes using a pre-tested questionnaire. Bivariate data analysis was conducted with chi square test and multivariate analysis with logistic regression. Results: The case and control groups were similar in terms of age, number of pregnancy and parity. Risk factors which found to be significantly associated with HBV infection in pregnant women were age at first marriage <19 years with AOR=2.51 (95%CI: 1.13-5.60), history of husband’s mobility with AOR=3.07 (95%CI: 1.13-8.34), husband has a permanent tattoo with AOR=2.77 (95%CI: 1.04-7.44) and low level of maternal education with AOR=2.47 (95%CI: 1.06-5.73). Conclusion: Young marital age, low education, husband’s mobility and husband with permanent tattoos increase the likelihood of HBV infection among pregnant women. The coverage of HBV examination among pregnant women and early detection of HBV among husbands ought to be increased, especially among those with associated risk factors.

Progress towards the elimination of hepatitis B in children in Colombia: A novel two-phase study approach.

The World Health Organization (WHO) has established a target to eliminate mother-to-child-transmission (EMTCT) of hepatitis B virus (HBV), defined as a prevalence of hepatitis B surface antigen (HBsAg) of ≤0.1% among children, by 2030. Using nationally representative serosurveys to verify achievement of this target requires large sample sizes and significant resources. We assessed the feasibility of a potentially more efficient two-phase method to verify EMTCT of HBV in Colombia. In the first phase, we conducted a risk assessment to identify municipalities at the highest risk of ongoing HBV transmission. We ranked the 1122 municipalities of Colombia based on the reports of HBV infection in pregnant women per 1000 population. Municipalities with ≥0.3 reports per 1000 persons (equating to the top quartile) were further assessed based on health facility birth rates, coverage with three doses of hepatitis B vaccine (HepB3) and seroprevalence data. Hepatitis B risk was considered to be further increased for municipalities with HepB3 coverage or health facility birth rate <90%. In the second phase, we conducted a multistage household serosurvey of children aged 5-10 years in 36 municipalities with the highest assessed HBV risk. HBsAg was not detected in any of 3203 children tested, yielding a 90% upper confidence bound of <0.1% prevalence. Coverage with HepB3 and hepatitis B birth dose was high at 97.5% and 95.6%, respectively. These results support the conclusion that Colombia has likely achieved EMTCT of HBV.

Prevention, control, and management of HBV infection among pregnant women in China: from a life-cycle perspective.

Hepatitis B virus (HBV) infection is a global public health problem, causing a high disease burden worldwide.[1] As a country previously with a high burden of hepatitis, about 70 million people in China are infected with HBV now, and mother-to-child transmission (MTCT) is still a predominant mode of HBV infection in China.[2] Preventing mother-to-child transmission is the key to eliminating HBV infection, and standardized management of HBV-infected pregnant women and their newborns can effectively cut off the mother-to-child transmission.[3] Neonatal hepatitis B immune globulin and hepatitis B vaccine can effectively reduce neonatal HBV infection in infants of HBV-positive pregnant women. Peripartum antiviral prophylaxis after 28 pregnant weeks is proved to be highly effective at reducing the risk of HBV (MTCT).[4] Furthermore, controlling hepatitis B infection in pregnant women not only reduces the risk of transmission within the family and vertical transmission from mother to child,[5] but also might reduce the risk of adverse pregnancy outcomes.[6] Therefore, understanding the epidemiological characteristics of HBV infection in pregnant women in China and better regulating the prevention, diagnosis, and treatment of this population is of great significance for realizing the goal of “eliminating viral hepatitis as a major public health threat by 2030” proposed by World Health Organization (WHO). Based on recent data from the first nationwide observational study on HBV infection among pregnant women in China, the prevalence of HBV infection among pregnant women in China continued to decline from 2015 to 2020.[7] Data were obtained from the National Integrated Prevention of Mother-to-Child Transmission of HIV, Syphilis, and Hepatitis B (iPMTCT) Program. From 2015 to 2020, a total of 90.87 million pregnant women in 2853 counties of China were tested for HBV, of which about 5.6 million tested positive for HBV infection (defined as a positive outcome for hepatitis B surface antigen). The prevalence of HBV infection among pregnant women decreased from 7.30% in 2015 to 5.44% in 2020, which is at the moderate epidemic level defined by WHO.[7] It reflected the effectiveness of comprehensive prevention and control measures, mainly hepatitis B vaccination for newborns, in reducing the prevalence of HBV infection among adults in China.[7] Compared with 2015, the prevalence of HBV infection among pregnant women in eastern, central, and western China all decreased, from 8.72% to 6.04% (a relative decline of 30.73%) in eastern China and from 6.76% to 4.93% (a relative decline of 20.07%) in central China. In the west, it dropped from 6.40% to 5.43% with a relative decline of 14.48%. The regional gap also narrowed, and the prevalence of HBV infection decreased in most provinces (90.30%) and counties (76.96%) from 2015 to 2020.[7] The study suggests that provinces with a relatively high burden of HBV infection should be given more investment in health resources and more attention in the future. This is the first study on the status quo and trend of HBV infection among pregnant women in China at the national level, which is of great significance.[7] The results provide important basic data for understanding the current burden of hepatitis B among pregnant women in China and realizing the goal of eliminating hepatitis B. The findings also prove the great achievements of hepatitis B prevention and control in China over the years. The results of this study provide scientific evidence for China to better achieve the 2030 goal of eliminating hepatitis B as a public health threat proposed by WHO. How to achieve the WHO 2030 goal of eliminating the public health threat caused by hepatitis B on time is a global common concern.[1,2] From the perspective of life-cycle management, countries can integrate existing public health and medical services to establish a comprehensive prevention and control system covering the whole life cycle of HBV infection prevention, screening, diagnosis, and treatment.[2,7] For example, the integration of the National Free Pre-Pregnancy Health Examination Project and the iPMTCT Program provides a unique opportunity and management platform to better achieve the goal of eliminating hepatitis B by 2030. Through this platform, we can recognize the HBV infection in reproductive women and their family members at risk in the early stages of the disease. The life-cycle management of HBV prevention and control could be implemented in positive families, that is, prevention and treatment management of HBV infection and disease is carried out from pre-pregnancy, during pregnancy, infanthood, childhood, adolescent, child-bearing age, and old age, to achieve the goal of reducing the incidence and mortality of hepatitis B infection, and contribute to China's achievement goal of eliminating the public health threat posed by hepatitis B by 2030. Funding This study was supported by grants from the National Natural Science Foundation of China (Nos. 71874003, 72122001, and 71934002). Conflicts of interest None.

The effects of hepatitis B virus infection on natural and IVF pregnancy: A meta-analysis study.

Hepatitis B virus (HBV) has been considered a significant cause of human reproductive failure in different studies; however, there is a considerable disagreement on the true impacts of HBV on female reproduction. This study has evaluated the impact of HBV infection on pregnancy complications in natural pregnancy and also on pregnancy outcomes in women undergoing in vitro fertilization(IVF) treatment. We searched Embase, Web of Science, PubMed and Google Scholar databases to identify the potentially relevant studies. Summary odds ratio (OR) or standardized mean difference (SMD) with 95% confidence interval (CI) was applied to assess the relationship. Heterogeneity testing, sensitivity analysis and publication bias testing were also performed. A total of 42studies concerning the effect of HBV infection on the natural and IVF pregnancy were included in this study. Our meta-analysis results revealed that HBV infection had a positive correlation to gestational diabetes mellitus (GDM) [OR=1.32 (1.17-1.48) (p<0.01)] and preterm birth [OR=1.26 (1.14-1.40) (p<0.01)] in natural pregnancy; however, HBV infection was not significantly associated with decreased fertility rates among the patients who underwent IVF. This study revealed a strong association of GDM and preterm birth with higher rates of HBV infection in pregnant women. Also, our results suggested that HBV infection in patients undergoing IVF may not negatively influence the pregnancy outcome. It may be rational to conclude that IVF might be rather a safe and effective method for HBV+ females who desire to have children.

Husband's behavior and early marriage as risk factors for hepatitis B virus infection among pregnant women in Karangasem, Bali, Indonesia

Background and purpose: Indonesia is categorized as a country with moderate level of hepatitis B virus (HBV) infection, where the majority of HBV transmissions occur from mother to child, horizontal transmission during childhood and adulthood, and transmission in health services. This study aims to determine factors associated with HBV infection among pregnant women.Methods: A case control study was conducted among 80 pregnant women with sero-positive HBsAg as cases and 80 pregnant women with sero-negative HBsAg as controls. The sources of cases and controls were the registers of pregnant women at 12 public health centers (PHCs) and Karangasem District Hospital from June 2017 to December 2018. Cases were selected by systematic random sampling from 129 pregnant women with sero-positive HBsAg and controls were selected through the same method from 1,408 pregnant women with sero-negative HBsAg. They were then matched based on village or residence. Data collected were including history of marriage, pregnancy, childbirth and abortion, history of health services relevant to HBV infection, use of contraception, mobility, permanent tattoos and history of injecting drug use. Data collection was carried out from June to August 2019 through face-to-face interviews with pregnant women as respondents in their respective homes using a pre-tested questionnaire. Bivariate data analysis was conducted with chi square test and multivariate analysis with logistic regression.Results: The case and control groups were similar in terms of age, number of pregnancy and parity. Risk factors which found to be significantly associated with HBV infection in pregnant women were age at first marriage &lt;19 years with AOR=2.51 (95%CI: 1.13-5.60), history of husband’s mobility with AOR=3.07 (95%CI: 1.13-8.34), husband has a permanent tattoo with AOR=2.77 (95%CI: 1.04-7.44) and low level of maternal education with AOR=2.47 (95%CI: 1.06-5.73).Conclusion: Young marital age, low education, husband's mobility and husband with permanent tattoos increase the likelihood of HBV infection among pregnant women. The coverage of HBV examination among pregnant women and early detection of HBV among husbands ought to be increased, especially among those with associated risk factors.

The influence of hepatitis B virus infection in pregnant women

We carried out the investigation to evaluate hepatitis B virus (HBV) infection status and the influence of HBV infection in pregnant women in Tianjin of China. We founded that the prevalence of HBsAg was 3.77% (69/1829). 88.57% (1620/1829) pregnant women conducted HBsAg screening in last pregnancy. Spontaneous abortion and premature delivery did not show significant differences between HBV infected and uninfected pregnant women. But ALT and AST levels were significantly higher in infected women. And 56.65% of participants (997/1760) were anti-HBs positive. In conclusion, HBsAg prevalence was moderate in pregnant women in this region, which was consistent with the total population in western Pacific regions. And HBV infection did not influence spontaneous abortion and premature delivery. But the HBsAg screening was conducted mostly in the last pregnancy. Early screening and intervention were suggested in pregnant women within countries of moderately endemic regions.

Development of a New Psychometric Assessment Tool for Predicting Hepatitis B Virus Infection in Pregnant Women

Objectives: Hepatitis B virus (HBV) infection in pregnant women can lead to the development of serious complications in neonates. Therefore, this study aimed to develop a new tool for predicting this infection in pregnant women and to assess the psychometric properties of this scale. Materials and Methods:This methodological study was carried out on 220 pregnant women visiting Al-Zahra and Taleghani hospitals of Tabriz, Iran in 2019. First, the relevant items were formulated and the respective questionnaire was developed and then, the validity (i.e., face, content, and construct) and reliability of the questionnaire were assessed as well. The data were analyzed in SPSS 21 using descriptive statistics, exploratory factor analysis (EFA), dependent t test, and Cronbach alpha coefficient. Results: A 22-item questionnaire was designed and the items were scored using a five-point Likert-type scale (Min=22, Max=120). Finally, the Kaiser-Meyer-Olkin value, Bartlett’s test of the Sphericity value, the internal consistency of the tool based on Cronbach’s alpha coefficient, and the intra-cluster correlation coefficient were 0.801, 4035.810, 0.811, and 0.81, respectively. Conclusions: In general, the present tool can reliably predict HBV infection in pregnant women thus its application is recommended in preventing relevant complications.

Seroprevalence of hepatitis B surface antigen and associated risk factors among pregnant women.

Hepatitis B infection is a serious global public health problem. The aim of the study was to assess the seroprevalance of hepatitis B surface antigen (HBsAg), as well as the risk factors associated with hepatitis B virus (HBV) infection among pregnant women attending antenatal care clinics of the University Hospital in Antioch, Turkey. This descriptive cross-sectional study was carried out between May 2016 and December 2016. The Chi-squared was utilized to estimate the statistical significance of the association between socio-demographic variables and HBsAg status. The results were generated as proportions odds ratio (OR) with their 95% confidence intervals (Cl) and calculated by using both univariate and multivariate logistic regression analysis. The seroprevalence of HBsAg was found to be 2.1%. A significant association was observed between age and HBsAg seropositivity (p = 0.027). History of blood transfusion (AOR = 9.51, 95% CI = 1.92-46.80, p = 0.006), history of hepatitis (AOR = 11.13, 95% CI = 2.02-61.28, p = 0.006), tattooing (AOR = 13.64, 95% CI = 2.52-73.76, p = 0.002) and a history of household/close contact (AOR = 11.10, 95% CI = 1.56-78.65, p = 0.016) were significantly associated with the risk of HBV infection. Data regarding the seroprevalence of HBsAg and risk factors associated with HBV infection in pregnant women plays a crucial role in evaluating the effectiveness of the public health protection policies and the strategies to control the disease.

Efficacy of tenofovir in preventing perinatal transmission of HBV infection in pregnant women with high viral loads

Mother-to-child transmission is the major cause of chronic hepatitis B virus (HBV) infection. This double-blind trial tested the effect of tenofovir disoproxil fumarate (TDF) in preventing vertical transmission. Pregnant women who were HBsAg/HBeAg-positive with a HBV DNA titer ≥ 2×106 IU/mL were randomly assigned to the control (n = 60) and TDF-treated (n = 60) groups. TDF treatment (oral dose 300 mg/day) was initiated at 24 weeks of gestation and continued to 4 weeks after delivery. The subjects were followed up to 28 weeks postpartum. The effects of TDF on vertical transmission, outcomes of the mothers and infants and virological changes were monitored. TDF dynamically reduced the serum HBV DNA level of the mothers, particularly during the first 4 weeks of treatment. The lower viral loads were maintained in the pregnancies until delivery. Approximately 90% and 33.9% of the TDF-treated mothers had viral loads ≤2000 IU/mL after delivery and at 28 weeks postpartum, respectively. No cervical transmission or adverse effects were observed in the TDF-treated individuals, whereas 13.5% of the infants were infected with HBV in the control group. We conclude that TDF treatment initiated at 24 weeks of gestation in high-viremia, HBsAg/HBeAg-positive mothers efficiently prevents mother-to-child HBV transmission without adverse events in mothers and infants.

Chronic and Occult Hepatitis B Virus Infection in Pregnant Women in Botswana.

The hepatitis B virus (HBV) is a global problem; however, the burden of HBV infection in pregnant women in Botswana is unknown. We sought to determine the prevalence of chronic and occult HBV infection in human immunodeficiency virus (HIV)-infected and -uninfected pregnant women in Botswana. Samples from 752 pregnant women were tested for hepatitis B surface antigen (HBsAg), and HBsAg-positive samples were tested for hepatitis B e antigen (HBeAg) and HBV DNA load. Samples that were HBsAg negative were screened for occult HBV infection by determining the HBV DNA load. HBV genotypes were determined based on a 415-base-pair fragment of the surface gene. Among the 752 women tested during pregnancy or early postpartum, 16 (2.1%) (95% confidence interval (CI): 2.0–2.2) were HBsAg-positive. The prevalence of chronic HBV infection was higher (3.1%) among HIV-infected (95% CI: 3.0–3.2) compared with HIV-uninfected women (1.1%) (95% CI: 1.07–1.1, p = 0.057). Among the 622 HBsAg-negative women, the prevalence of occult HBV infection was 6.6% (95% CI: 6.5–6.7). Three of thirteen HBsAg-positive participants were HBeAg-positive, and all were HIV-negative. Of the 11 maternal samples successfully genotyped, five (45.5%) were genotype D3, five (45.5%) were genotype A1, and one was genotype E (9%). Low and similar proportions of HIV-infected and -uninfected pregnant women in Botswana had occult or chronic HBV infection. We identified a subset of HIV-negative pregnant women who had high HBV DNA levels and were HBeAg-positive, and thus likely to transmit HBV to their infants.

Postpartum Laboratory Follow-up in Women With Hepatitis B in Massachusetts From 2007 to 2012.

To determine postpartum hepatitis B virus (HBV) laboratory testing rates and identify factors associated with a lack of follow-up testing in Massachusetts. Screening for HBV infection in pregnant women is standard of care. Guidelines recommend that patients with chronic HBV have ongoing care and laboratory testing, but little is known about postpartum maternal HBV care outcomes. We conducted a retrospective cohort study using Massachusetts Virtual Epidemiologic Network, an electronic public health surveillance system maintained by the Massachusetts Department of Public Health. We identified women who tested hepatitis B surface antigen positive during their first reported (index) pregnancy in Massachusetts from 2007 to 2012 and measured HBV-related laboratory tests reported to Massachusetts Department of Public Health during and after pregnancy. We identified 983 hepatitis B surface antigen positive pregnant women. Half (492/983) did not have evidence of additional postpartum HBV laboratory testing following their index pregnancy. Women who had postpartum laboratory tests reported were younger [mean age (SD): 29 (5.3) vs. 31 (5.5) y, P=0.0001] and more likely to have >1 pregnancy during the study period (41% vs. 1%, P<0.0001). There were no differences in race, ethnicity, and US born status. On multivariable logistic regression, older age predicted a lower likelihood of having postpartum laboratory testing (odds ratio, 0.77; 95% confidence interval, 0.70-0.90). Postpartum maternal HBV follow-up laboratory testing occurred in only half of Massachusetts women and did not vary by race, ethnicity, or US born status. Our results were limited to a single state surveillance database, which likely underestimates the number of tests ordered.

Changes in the prevalence of HBV infection in pregnant women in Turkey between 1995 and 2015: a 20-year evaluation

ObjectiveTo determine changes in hepatitis B virus (HBV) prevalence across three different time periods in pregnant women.MethodsThis was a retrospective study of pregnant women attending four healthcare centres between January...

Seroprevalence of hepatitis B surface antigen and anti HCV antibody and its associated risk factors among pregnant women attending maternity ward of Felege Hiwot Referral Hospital, northwest Ethiopia: a cross-sectional study.

BackgroundViral hepatitis is a life-threatening liver disease that has become important public health issue in developing countries including Ethiopia. This study was undertaken to determine the seroprevalence of HBsAgs and anti-HCV antibodies and what socio-demographic factors are associated with sero-positivity of Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infections among pregnant women attending maternity ward of Felege Hiwot Referral Hospital, northwest, Ethiopia.MethodsHospital based cross-sectional study was conducted from November 2013 to January 2014. Blood samples were randomly collected from 384 pregnant women. Data on socio-demographic characteristics, obstetric and potential risk factors were collected using semi-structured questionnaire. Chromatographic kits were used to detect the presence of HBsAg and antibodies against HCV in serum samples of the studied subjects. Chi-square test was used for assessing the association between socio-demographic variables and HBV and HCV status. Logistic regression analysis was done to determine the strength of association between risk factors and HBV or HCV infection. P-values less than 0.05 were considered as significant.ResultsSeroprevalnce of hepatitis B and C virus infections were found to be 4.4 and 0.26 %, respectively. None of the pregnant women were co-infected by these two viruses. Amongst the potential risk factors, previous history of dental procedure (AOR = 4.104, CI = 1.276–13.201, P = 0.018), house hold contact (AOR = 5.475, CI = 1.472–20.368, P = 0.011), multiple sexual exposure (AOR = 5.041, CI = 1.580–16.076, P = 0.006), and delivery at traditional birth attendants (AOR = 4.100, CI = 0.195-86.129, P = 0.024) were significantly associated with and important predictors of hepatitis B infection.ConclusionsThis study found an intermediate endemicity (4.4 %) of HBV infection in pregnant women whereas seroprevalence of anti-HCV antibody was very small, but this needs to be confirmed by other similar studies with larger sample size. Thus, scaling up of the screening of pregnant women for HBV and HCV infections and provision of health education about the risk factors, the mode of transmissions and prevention is recommended.

High HBV Viral Loads in HIV-Infected Pregnant Women at a Tertiary Hospital, South Africa

High HBV Viral Loads in HIV-Infected Pregnant Women at a Tertiary Hospital, South Africa

Differences in hepatitis B infection rate between ethnic groups in antenatal women in Birmingham, United Kingdom, May 2004 to December 2008

Hepatitis B virus (HBV) is a major cause of morbidity and mortality worldwide. Although the United Kingdom (UK) prevalence of HBV is low, it is increasing. There is some evidence that the rate of infection is much higher in some populations living in Britain of non-white ethnicity or who were not born in Britain, compared with the British-born white population. We examined the prevalence of HBV infection in pregnant women through hepatitis B surface antigen (HBsAg) or e-antigen (HBeAg) in Birmingham UK between May 2004 and December 2008 and the effect of ethnicity on the relative risk of infection. There was a significant increase in the number of antenatal HBV infections detected over the study period from 106 cases in 2005 to 161 cases in 2008 (p=0.037). Women who define themselves as of black African, non-British white and Pakistani ethnicity had a markedly elevated rate of HBV infection (relative risk (RR): 11.25, 5.87 and 2.33 respectively) compared to the England average. Health organisations that serve populations with a high or increasing proportion of women originating from intermediate and high HBV prevalence areas of the world such as Africa, some parts of Europe and Asia, should anticipate a need for perinatal and postnatal prophylaxis to children born to HBV infected mothers.

Hepatitis C and Hepatitis B Virus Infection: Epidemiology and Risk Factors in a Large Cohort of Pregnant Women in Lorestan, West of Iran

: Background: There are little data on the prevalence of serological markers of hepatitis B and hepatitis C viruses in pregnant women in Iran.Objectives: This study was designed to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among pregnant women in Lorestan, west of Iran.Patients and Methods: Serum samples of 827 pregnant women who lived in rural (36.8%) and urban areas (63.2%) of Lorestan were collected during 2007-2008. Data were obtained through questionnaires. Samples were first screened for anti-HCV and anti-HBc by ELISA. Those who were positive for anti-HBc were tested for HBsAg.Results: Anti-HBc was found in 28 of 827 pregnant women (overall prevalence, 3.4%; 14 of 523 in urban areas, 2.7%; 14 of 304 in rural areas, 4.6%). Of the 28 positive samples, 6 (0.7%) were positive for HBs-Ag. Only 2 samples (0.2%) were anti-HCV-positive.Conclusions: These results underscore the need for prenatal screening for HBV infection in pregnant women and treatment of newborns from HBsAg-positive mothers. More studies are needed to identify risk factors of HCV infection and highlight the importance of HCV screening and treatment programs. Implication for health policy/practice/research/medical education:The authors mentioned that low prevalence of HBV and HCV in this region establish a national program for regular screening of all pregnant women. Most pregnant women are asymptomatic and clinically disease free and they might not be aware that they are infected and can transmit their infection to newborns. Therefore, prenatal screening for HBV infection in pregnant women and treatment of newborns from HBsAg-positive mothers and also identify risk factors of HCV infection is nessecerry. Please cite this paper as:Mohebbi SR, Sanati A, Cheraghipour K, Rostami Nejad M, Mohaghegh Shalmani H, Zali MR. Hepatitis C and Hepatitis B Virus Infection: Epidemiology and Risk Factors in a Large Cohort of Pregnant Women in Lorestan, West of Iran. Hepat Mon. 2011; 11(9):736-9. DOI: 10.5812/kowsar. 1735143X.749 ©2011 Kowsar M.P.Co. All rights reserved.

Hepatitis C and Hepatitis B Virus Infection: Epidemiology and Risk Factors in a Large Cohort of Pregnant Women in Lorestan, West of Iran

There are little data on the prevalence of serological markers of hepatitis B and hepatitis C viruses in pregnant women in Iran. This study was designed to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among pregnant women in Lorestan, west of Iran. Serum samples of 827 pregnant women who lived in rural (36.8%) and urban areas (63.2%) of Lorestan were collected during 2007-2008. Data were obtained through questionnaires. Samples were first screened for anti-HCV and anti-HBc by ELISA. Those who were positive for anti-HBc were tested for HBsAg. Anti-HBc was found in 28 of 827 pregnant women (overall prevalence, 3.4%; 14 of 523 in urban areas, 2.7%; 14 of 304 in rural areas, 4.6%). Of the 28 positive samples, 6(0.7%) were positive for HBs-Ag. Only 2 samples (0.2%) were anti-HCV-positive. These results underscore the need for prenatal screening for HBV infection in pregnant women and treatment of newborns from HBsAg-positive mothers.More studies are needed to identify risk factors of HCV infection and highlight the importance of HCV screening and treatment programs.

The Presence of Hepatitis B Surface Antigen in the Ova of Pregnant Women and Its Relationship with Intra-Uterine Infection by Hepatitis B Virus

Vertical transmission of hepatitis B virus (HBV) has been proposed to play an important role in mother-to-child transmission, although the extent to which vertical transmission via oocytes contributes to neonatal HBV infection remains unknown. Ovarian biopsies were collected during caesarean sections in 68 clinically asymptomatic pregnant women who were carriers of HBV. The presence of hepatitis B surface antigen (HBsAg) in the ova of pregnant women was determined by immunohistochemistry. Serum markers of HBV infection in pregnant women and their neonates were analysed. It was found that, of 68 women, the ova were positive for HBsAg in only one woman and her neonate was negative for any serum HBV markers 3 days after birth. Of 68 neonates, one was positive for serum HBV markers 3 days after birth and his mother's ova were negative for HBsAg. These findings indicate that vertical transmission via oocytes may not be the major route of HBV intra-uterine infection.

Screening for Hepatitis B Virus Infection in Pregnant Women: Evidence for the U.S. Preventive Services Task Force Reaffirmation Recommendation Statement

Screening for hepatitis B virus (HBV) infection in pregnant women to identify newborns who will require prophylaxis against perinatal infection is a well-established, evidence-based standard of current medical practice. In 2004, the U.S. Preventive Services Task Force (USPSTF) recommended universal screening of pregnant women for HBV infection at the first prenatal visit. To search for large, high-quality studies related to hepatitis B screening in pregnancy that have been published since the 2004 USPSTF recommendation. English-language studies indexed in PubMed and the Cochrane Database of Systematic Reviews and published between 1 January 2001 and 5 March 2008. For benefits of screening and newborn prophylaxis, we included systematic reviews; meta-analyses; and randomized, controlled trials. For harms of screening, we included systematic reviews; meta-analyses; randomized, controlled trials; cohort studies; case-control studies; and case series of large, multisite databases. Abstracts and full articles were independently reviewed for inclusion by both reviewers. Data on the benefits of screening, including benefits of hepatitis B immune globulin and hepatitis B vaccine prophylaxis of newborns of hepatitis B surface antigen-positive mothers, were extracted by 1 reviewer. No new studies met inclusion criteria. A 2006 systematic review of randomized, controlled trials found that newborn prophylaxis reduced perinatal transmission of HBV infection; all relevant trials were published in 1996 or earlier. The focused search strategy, which was restricted to English-language articles, may have missed some smaller studies or new research published in languages other than English. No new evidence was found on the benefits or harms of screening for HBV infection in pregnant women. Previously published randomized trials support the 2004 USPSTF recommendation for screening.