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Ingasia LAO, Wose Kinge C, Kramvis A. Genotype E: The neglected genotype of hepatitis B virus. World J Hepatol 2021; 13:1875-1891. [PMID: 35069995 PMCID: PMC8727212 DOI: 10.4254/wjh.v13.i12.1875] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/15/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B virus (HBV) (sub)genotypes A1, D3 and E circulate in sub-Saharan Africa, the region with one of the highest incidences of HBV-associated hepatocellular carcinoma globally. Although genotype E was identified more than 20 years ago, and is the most widespread genotype in Africa, it has not been extensively studied. The current knowledge status and gaps in its origin and evolution, natural history of infection, disease progression, response to antiviral therapy and vaccination are discussed. Genotype E is an African genotype, with unique molecular characteristics that is found mainly in Western and Central Africa and rarely outside Africa except in individuals of African descent. The low prevalence of this genotype in the African descendant populations in the New World, phylogeographic analyses, the low genetic diversity and evidence of remnants of genotype E in ancient HBV samples suggests the relatively recent re-introduction into the population. There is scarcity of information on the clinical and virological characteristics of genotype E-infected patients, disease progression and outcomes and efficacy of anti-HBV drugs. Individuals infected with genotype E have been characterised with high hepatitis B e antigen-positivity and high viral load with a lower end of treatment response to interferon-alpha. A minority of genotype E-infected participants have been included in studies in which treatment response was monitored. Of concern is that current guidelines do not consider patients infected with genotype E. Thus, there is an urgent need for further large-scale investigations into genotype E, the neglected genotype of HBV.
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Affiliation(s)
- Luicer Anne Olubayo Ingasia
- Hepatitis Virus Diversity Research Unit, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, Gauteng, South Africa
| | - Constance Wose Kinge
- Hepatitis Virus Diversity Research Unit, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, Gauteng, South Africa
- Department of Implementation Science, Right to Care, Johannesburg 0046, Gauteng, South Africa
| | - Anna Kramvis
- Hepatitis Virus Diversity Research Unit, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, Gauteng, South Africa
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2
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Kafeero HM, Ndagire D, Ocama P, Walusansa A, Sendagire H. Sero-prevalence of human immunodeficiency virus-hepatitis B virus (HIV-HBV) co-infection among pregnant women attending antenatal care (ANC) in sub-Saharan Africa (SSA) and the associated risk factors: a systematic review and meta-analysis. Virol J 2020; 17:170. [PMID: 33160386 PMCID: PMC7648981 DOI: 10.1186/s12985-020-01443-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/27/2020] [Indexed: 12/14/2022] Open
Abstract
Background There is plenitude of information on HIV infection among pregnant mothers attending antenatal care (ANC) in sub-Saharan Africa. However, the epidemiology of HBV–HIV co-infections in the same cohort is not clear despite the common route of transmission of both viruses. The aim of our study was to synthesize data on the prevalence of HBV–HIV co-infection among pregnant women attending ANC in Sub-Saharan Africa to assist in the design of public health interventions to mitigate the challenge.
Methods The study was done in tandem with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards and the Cochran’s Q test, I2 statistics for heterogeneity and the prevalence were calculated using commercially available software called MedCalcs (https://www.medcalc.org). A random effect model was used to pool the prevalence since all the heterogeneities were high (≥ 78%) and Phet < 0.05 indicated significant heterogeneities. The risk factors and risk differences for HBV–HIV co-infection were analyzed. Any likely sources of heterogeneity were analyzed through sensitivity analysis, meta-regression and sub-group analysis. All analyses were done at 95% level of significance and a P < 0.05 was considered significant. Results The overall pooled prevalence of HBV–HIV co-infection among pregnant mothers in sub-Saharan Africa was low 3.302% (95%CI = 2.285 to 4.4498%) with heterogeneities (I2) of 97.59% (P > 0.0001). Within regional sub group meta-analyses, West Africa had significantly higher prevalence of 5.155% (95% = 2.671 to 8.392%) with heterogeneity (I2) of 92.25% (P < 0.0001) than any other region (P < 0.001). Articles published from 2004–2010 had significantly higher prevalence of 6.356% (95% = 3.611 to 9.811%) with heterogeneity (I2) 91.15% (P < 0.0001) compared to those published from 2011 to 2019 (P < 0.001). The HIV positive cohort had significantly higher prevalence of HBV–HIV co-infection of 8.312% (95% CI = 5.806 to 11.22%) with heterogeneity (I2)94.90% (P < 0.0001) than the mothers sampled from the general population with a prevalence of 2.152% (95% CI = 1.358 to 3.125%) (P < 0.001). The overall and sub group analyses had high heterogeneities (I2 > 89%, P < 0.0001) but was reduced for South Africa (I2) = 78.4% (P = 0.0314). Age, marital status and employment were independent factors significantly associated with risk of HBV–HIV co-infection (P < 0.001) but not extent of gravidity and education level (P > 0.05). After meta-regression for year of publication and sample size for HBsAg positivity, the results were not significantly associated with HBV pooled prevalence for sample size (P = 0.146) and year of publication (P = 0.560). Following sensitivity analysis, the HBsAg pooled prevalence slightly increased to 3.429% (95% CI = 2.459 to 4.554%) with heterogeneity I2 = 96.59% (95% CI = 95.93 to 97.14%), P < 0.0001 Conclusion There is an urgent need for routine HBV screening among HIV positive pregnant mothers attending antenatal care in sub-Saharan Africa to establish the extent of HBV–HIV co-infection in this cohort. Future studies need to investigate the putative risk factors for HBV–HIV co-infection and prioritize plausible control strategies.
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Affiliation(s)
- Hussein Mukasa Kafeero
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P.O Box 7062, Kampala, Uganda. .,Department of Medical Microbiology, Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda, P.O Box 7689, Kampala, Uganda.
| | - Dorothy Ndagire
- Department of Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Ponsiano Ocama
- Department of Medicine, College of Health Sciences, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Abdul Walusansa
- Department of Medical Microbiology, Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda, P.O Box 7689, Kampala, Uganda
| | - Hakim Sendagire
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P.O Box 7062, Kampala, Uganda.,Department of Medical Microbiology, Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda, P.O Box 7689, Kampala, Uganda
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3
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Platt L, French CE, McGowan CR, Sabin K, Gower E, Trickey A, McDonald B, Ong J, Stone J, Easterbrook P, Vickerman P. Prevalence and burden of HBV co-infection among people living with HIV: A global systematic review and meta-analysis. J Viral Hepat 2020; 27:294-315. [PMID: 31603999 PMCID: PMC7383613 DOI: 10.1111/jvh.13217] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/09/2019] [Indexed: 12/22/2022]
Abstract
Globally, in 2017 35 million people were living with HIV (PLHIV) and 257 million had chronic HBV infection (HBsAg positive). The extent of HIV-HBsAg co-infection is unknown. We undertook a systematic review to estimate the global burden of HBsAg co-infection in PLHIV. We searched MEDLINE, Embase and other databases for published studies (2002-2018) measuring prevalence of HBsAg among PLHIV. The review was registered with PROSPERO (#CRD42019123388). Populations were categorized by HIV-exposure category. The global burden of co-infection was estimated by applying regional co-infection prevalence estimates to UNAIDS estimates of PLHIV. We conducted a meta-analysis to estimate the odds of HBsAg among PLHIV compared to HIV-negative individuals. We identified 506 estimates (475 studies) of HIV-HBsAg co-infection prevalence from 80/195 (41.0%) countries. Globally, the prevalence of HIV-HBsAg co-infection is 7.6% (IQR 5.6%-12.1%) in PLHIV, or 2.7 million HIV-HBsAg co-infections (IQR 2.0-4.2). The greatest burden (69% of cases; 1.9 million) is in sub-Saharan Africa. Globally, there was little difference in prevalence of HIV-HBsAg co-infection by population group (approximately 6%-7%), but it was slightly higher among people who inject drugs (11.8% IQR 6.0%-16.9%). Odds of HBsAg infection were 1.4 times higher among PLHIV compared to HIV-negative individuals. There is therefore, a high global burden of HIV-HBsAg co-infection, especially in sub-Saharan Africa. Key prevention strategies include infant HBV vaccination, including a timely birth-dose. Findings also highlight the importance of targeting PLHIV, especially high-risk groups for testing, catch-up HBV vaccination and other preventative interventions. The global scale-up of antiretroviral therapy (ART) for PLHIV using a tenofovir-based ART regimen provides an opportunity to simultaneously treat those with HBV co-infection, and in pregnant women to also reduce mother-to-child transmission of HBV alongside HIV.
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Affiliation(s)
- Lucy Platt
- Faculty of Public Health & PolicyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Clare E. French
- NIHR Health Protection Research Unit in Evaluation of InterventionsPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Catherine R. McGowan
- Faculty of Public Health & PolicyLondon School of Hygiene & Tropical MedicineLondonUK
- Humanitarian Public Health Technical UnitSave the Children UKLondonUK
| | | | - Erin Gower
- Centre for Disease Control and PreventionAtlantaUSA
| | - Adam Trickey
- NIHR Health Protection Research Unit in Evaluation of InterventionsPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Bethan McDonald
- Oxford School of Public HealthNuffield Department of Population HealthUniversity of OxfordOxfordUK
- Oxford University Hospitals NHS Foundation TrustJohn Radcliffe HospitalOxfordUK
- Department of Clinical ResearchLondon School of Hygiene and Tropical MedicineLondonUK
| | - Jason Ong
- Department of Clinical ResearchLondon School of Hygiene and Tropical MedicineLondonUK
| | - Jack Stone
- NIHR Health Protection Research Unit in Evaluation of InterventionsPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | | | - Peter Vickerman
- NIHR Health Protection Research Unit in Evaluation of InterventionsPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
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Joseph F, Rodrigue KW, Serges T, Salomon NP, Christian TN, Carlos TTM, Samuel F, Anne-Esther NN, Colizzi V, Celine NN. Hepatitis B infection and risk factors among children living with HIV in Yaounde, Cameroon: an integrated management. BMC Pediatr 2019; 19:366. [PMID: 31640616 PMCID: PMC6805430 DOI: 10.1186/s12887-019-1750-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/25/2019] [Indexed: 12/14/2022] Open
Abstract
Background The endemicity of hepatitis B virus (HBV) prompted the systematic immunization of newborns in Cameroon since 2005. In the frame of a considerable burden of HIV/HBV co-infection (17.5%), monitoring HBV among children living with HIV (CLHIV) would guide toward HIV/HBV integrated paediatric care. We sought to ascertain the prevalence and determinants of HBV infection in the population of CLHIV and performance of commonly used rapid diagnosis tests (RDTs). Methods Cross-sectional study conducted from February through June 2017 in a subset of CLHIV ≤15 years old at the Essos Hospital Centre, Yaounde, Cameroon. HBV was tested by HBsAg ELISA sandwich in duplicates for each sample, and the mean optical density was calculated. The Determinants of HBV-prevalencewere evaluated, and p < 0.05 was the significance threshold. The performance of two HBV RDTs (Diaspot vs. HBV-5) was evaluated in comparison to ELISA (used as gold standard). Results Of the 83 CLHIV enrolled (54.2% female, mean age 8.7 [±3.8] years, 60% vaccinated against HBV, all breastfed), HBV-prevalence was 2.41% (2/83). HBV-positivity was significantly associated with unknown maternal HBV status (2.9% [2/69] vs. 0.0% [0/14], p = 0.0097) and vaginal delivery (2.4% [2/82] vs. 0.0% [0/1], p = 0.0018). Moreover, the most likely to be positive were aged 11 and 15 years, and had experienced neither anti-HBV vaccination nor anti-HBV serum administration, and both had not been treated with any antiseptic solution at birth. Regarding the performance of Diaspot vs. HBV-5 respectively, sensitivity was 100% (2/2) vs. 50% (1/2), while specificity was 100% (45/45) vs. 97.8% (44/45); positive and negative predictive values of Diaspot versus HBV-5 were respectively 100% (2/2) and 100% (45/45) versus 50% (1/2) and 97.8% (44/45). Conclusion HBV-infection in the population of CLHIV appears at a moderate prevalence, suggesting a decreased burden likely due to preventive measures including the wide vaccine coverage. Focusing on mothers with unknown HBV status and promoting safer delivery mode (caesarean section) for HBV-positive motherswould contribute toward pediatric HBV elimination. In context of limited resources, Diaspot test appears more reliable to rollout HBV-infection in the population of CLHIV. As findings are limited to a small sample size, studies on a wider population would be relevant.
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Affiliation(s)
- Fokam Joseph
- Chantal BIYA International Reference Centre (CIRCB) for Research on HIV/AIDS prevention and management, Yaounde, Cameroon.,Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1, Yaounde, Cameroon.,National HIV Drug Resistance Working Group, Ministry of Public Health, Yaounde, Cameroon
| | - Kamga Wouambo Rodrigue
- Faculty of Science, Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon. .,Department of Health Sciences, Estuary Academy and Strategic Institute (IUES/INSAM/ISSAS), Higher Institute of Health Applied Sciences, University of Buea, Buea, Cameroon.
| | - Tchatchouang Serges
- Faculty of Science, Department of Biochemistry, University of Yaounde 1, Yaounde, Cameroon
| | - Nguwoh Philippe Salomon
- Department of Health Sciences, Estuary Academy and Strategic Institute (IUES/INSAM/ISSAS), Higher Institute of Health Applied Sciences, University of Buea, Buea, Cameroon.,National Public Health Laboratory, Ministry of Public Health, Yaounde, Cameroon
| | | | - Tommo Tchouaket Michel Carlos
- Chantal BIYA International Reference Centre (CIRCB) for Research on HIV/AIDS prevention and management, Yaounde, Cameroon
| | - Fosso Samuel
- Laboratoire Biosanté International, Yaounde, Cameroon
| | | | - Vittorio Colizzi
- Cameroon Evangelic University, Bandjoun, Cameroon.,UNESCO Board of Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - Nkenfou Nguefeu Celine
- Chantal BIYA International Reference Centre (CIRCB) for Research on HIV/AIDS prevention and management, Yaounde, Cameroon.,Higher Teacher Training College (ENS), University of Yaounde 1, Yaounde, Cameroon
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5
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Ghoma Linguissi LS, Sagna T, Soubeiga ST, Gwom LC, Nkenfou CN, Obiri-Yeboah D, Ouattara AK, Pietra V, Simpore J. Prevention of mother-to-child transmission (PMTCT) of HIV: a review of the achievements and challenges in Burkina-Faso. HIV AIDS (Auckl) 2019; 11:165-177. [PMID: 31440104 PMCID: PMC6664853 DOI: 10.2147/hiv.s204661] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 06/14/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Burkina-Faso's HIV/AIDS program is one of the most successful in Africa, with a declining HIV prevalence and treatment outcomes that rival those of developed countries. Prevention of mother-to-child transmission (PMTCT) guidelines in Burkina-Faso, initiated in the year 2000, were revised in 2004, 2006 and 2010. The guideline document has since undergone several stages of improvement, largely based on recommendations from WHO, with adaptations by local experts in the field. Option B+ adopted since August 2014 in Burkina-Faso has enabled maintenance of mothers on longer treatment and increasing their survival and that of their children. Through this review, we describe the achievements and challenges of HIV PMTCT programs in Burkina-Faso. AIMS OF STUDY This study had the following objectives: 1) describing the historical perspective of PMTCT implementation in Burkina-Faso; 2) presenting the effectiveness of interventions at improving PMTCT service delivery and promoting retention of mothers and babies in care; and 3) determining the impact of male partner involvement on PMTCT in Burkina-Faso. METHODOLOGY A literature search was conducted in PubMed and Google. Search terms included the following keywords: "HIV testing"; "prevention"; "mother"; "child"; "male partner"; "counseling"; "involvement"; "participation"; and the grouped terms "PMTCT and partners"; "VCT"; "barriers and/or factors"; "Male involvement in PMTCT"; and "Burkina-Faso". Data collection took place from May to October 2015. The search was limited to articles published between January 2002 and December 2015. UNICEF and UNAIDS web sites were also used to find relevant abstracts and documents. RESULTS Studies have revealed that with PMTCT, HIV transmission rate moved from 10.4% in 2006 to 0% in 2015. The PMTCT program remains the best way to care for HIV-infected pregnant women and their babies. The current PMTCT policy is based on evidence that male partner involvement is associated with women's completion of PMTCT. CONCLUSION This study shows that the reduction in mother to child transmission of HIV in Burkina-Faso over the years is mainly due to the improvement of PMTCT programs. Efforts still need to be made about the involvement of male partners.
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Affiliation(s)
- Laure Stella Ghoma Linguissi
- Laboratoire de Biologie Moléculaire et de Génétique, Université Ouaga I Pr Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
- Institut National de Recherche en Sciences de la Santé (IRSSA), Brazzaville, Republic of Congo
| | - Tani Sagna
- Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
- Centre de Recherche Biomoleculaire Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Serge Théophile Soubeiga
- Laboratoire de Biologie Moléculaire et de Génétique, Université Ouaga I Pr Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
- Centre de Recherche Biomoleculaire Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Luc Christian Gwom
- “Chantal Biya” International Reference Centre for Research on HIV/Aids Prevention and Management (CBIRC), Yaoundé, Cameroon
| | - Céline Nguefeu Nkenfou
- “Chantal Biya” International Reference Centre for Research on HIV/Aids Prevention and Management (CBIRC), Yaoundé, Cameroon
- Higher Teachers’ Training College, University of Yaoundé I, Yaoundé, Cameroon
| | - Dorcas Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Abdoul Karim Ouattara
- Laboratoire de Biologie Moléculaire et de Génétique, Université Ouaga I Pr Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
- Centre de Recherche Biomoleculaire Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Virginio Pietra
- Centre de Recherche Biomoleculaire Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Jacques Simpore
- Laboratoire de Biologie Moléculaire et de Génétique, Université Ouaga I Pr Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
- Centre de Recherche Biomoleculaire Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
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Wilson P, Parr JB, Jhaveri R, Meshnick SR. Call to Action: Prevention of Mother-to-Child Transmission of Hepatitis B in Africa. J Infect Dis 2019; 217:1180-1183. [PMID: 29351639 DOI: 10.1093/infdis/jiy028] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 01/16/2018] [Indexed: 12/24/2022] Open
Abstract
Hepatitis B virus (HBV) is a significant public health issue that has not been adequately addressed, especially in the high-prevalence region of Africa. Despite the incorporation of HBV vaccines into the Expanded Program on Immunization, children continue to be infected with HBV through maternal-to-child transmission (MTCT). The addition of a birth dose of HBV vaccine would be a cost-effective method to reduce MTCT. Birth-dose HBV vaccine policies have been adopted in the Western Pacific region but not yet in Africa. Even better protection against HBV MTCT can be achieved by treatment of pregnant women with high HBV viral loads with tenofovir. Tenofovir is already widely used in prevention of HIV MTCT (PMTCT) programs. We suggest that existing HIV PMTCT programs could be expanded to deliver care for HBV-infected pregnant women. With appropriate adoption of birth-dose vaccination policies and expansion of PMTCT programs, elimination of HBV MTCT in Africa is achievable.
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Affiliation(s)
- Peyton Wilson
- Department of Pediatrics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Jonathan B Parr
- Department of Medicine, Division of Infectious Diseases, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Ravi Jhaveri
- Department of Pediatrics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Steve R Meshnick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
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Yelemkoure ET, Yonli AT, Montesano C, Ouattara AK, Diarra B, Zohoncon TM, Nadembega CWM, Ouedraogo P, Sombié C, Soubeiga ST, Tao I, Gansane A, Amicosante M, Djigma F, Obiri-Yeboah D, Pietra V, Simpore J, Colizzi V. Prevention of mother-to-child transmission of hepatitis B virus in Burkina Faso: Screening, vaccination and evaluation of post-vaccination antibodies against hepatitis B surface antigen in newborns. J Public Health Afr 2018; 9:816. [PMID: 30687485 PMCID: PMC6326159 DOI: 10.4081/jphia.2018.816] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 08/09/2018] [Indexed: 01/06/2023] Open
Abstract
The low rate of screening for hepatitis B virus (HBV) in pregnant women is a highrisk factor for its vertical transmission. The objectives of this study were: i) to screen pregnant women for HBV infection; ii) vaccinate all children from birth against HBV regardless their mother HBV status; and iii) evaluate after 7 months of birth the level of their AbHBs among babies who received HBV vaccine at birth. Serological markers of HBV (HBsAg, HBeAg, AbHBs, AbHBe, and AbHBc) were determined on venous blood samples from 237 pregnant women and their children using the Abon Biopharm Kit. One hundred and two (102) children received the three doses of the EUVAX B® vaccine respectively at birth, two months and four months of life. Seven months after delivery, venous blood samples were collected from mothers and their children. Antibodies against hepatitis B surface antigen (AbHBs) were measured in vaccinated children using the ELISA Kit AbHBs Quantitative EIA. DNA extraction was performed on samples from HBV-seropositive mothers and their children using the Ribo Virus (HBV Real-TM Qual) Kit and for Real Time PCR, the HBV Real-TM Qual Kit was used. Serological diagnosis in pregnant women revealed 22 (9.28%) hepatitis B surface antigen (HBsAg) positive samples of which 21 were positive for viral DNA by real-time PCR. Among the 22 HBsAg+ women, five (05) transmitted the virus to their children with a vertical transmission rate of 22.73%. A transmission rate of 23.81% (5/21) was found with the PCR method. Analysis of AbHBs levels revealed that 98.31% of the children had an average concentration of 218.07 ± 74.66 IU/L, which is well above the minimum threshold for protection (11 IU/L). This study has confirmed that vertical transmission of HBV is a reality in Burkina Faso and that vaccination at birth would significantly reduce this transmission.
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Affiliation(s)
- Edwige T Yelemkoure
- Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Ouaga, Ouagadougou, Burkina Faso.,Biomolecular Research Center Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Albert T Yonli
- Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Ouaga, Ouagadougou, Burkina Faso.,Biomolecular Research Center Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Carla Montesano
- Department of Biology, Tor Vergata University of Rome, Italy
| | - Abdoul Karim Ouattara
- Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Ouaga, Ouagadougou, Burkina Faso.,Biomolecular Research Center Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Birama Diarra
- Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Ouaga, Ouagadougou, Burkina Faso.,Biomolecular Research Center Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Théodora M Zohoncon
- Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Ouaga, Ouagadougou, Burkina Faso.,Biomolecular Research Center Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Christelle W M Nadembega
- Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Ouaga, Ouagadougou, Burkina Faso
| | - Paul Ouedraogo
- Saint Camille Hospital of Ouagadougou (HOSCO), Burkina Faso
| | - Charles Sombié
- Biomolecular Research Center Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Serge Theophile Soubeiga
- Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Ouaga, Ouagadougou, Burkina Faso.,Biomolecular Research Center Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Issoufou Tao
- Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Ouaga, Ouagadougou, Burkina Faso
| | - Adama Gansane
- Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | | | - Florencia Djigma
- Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Ouaga, Ouagadougou, Burkina Faso.,Biomolecular Research Center Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Dorcas Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Ghana
| | - Virginio Pietra
- Biomolecular Research Center Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso
| | - Jacques Simpore
- Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Ouaga, Ouagadougou, Burkina Faso.,Biomolecular Research Center Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso.,Department of Biology, Tor Vergata University of Rome, Italy
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8
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Insights into the Interplay between KIR Gene Frequencies and Chronic HBV Infection in Burkina Faso. Mediterr J Hematol Infect Dis 2018; 10:e2018060. [PMID: 30416692 PMCID: PMC6223576 DOI: 10.4084/mjhid.2018.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 10/01/2018] [Indexed: 12/13/2022] Open
Abstract
Background/Objective Hepatitis B virus (HBV) infection is the leading risk factor for cirrhosis and hepatocellular carcinoma (HCC). The objective of this investigation was to assess the association between “Killer Cell Immunoglobulin-Like Receptor” (KIR) gene frequencies and chronic HBV infection. Methods Chronic HBV carriers and healthy patients were selected for this study. The viral load for HBV were performed, and SSP-PCR was used to characterize the frequencies of KIR genes. Results The study suggested that inhibitory genes KIR2DL2 (crude OR = 2.82; p < 0.001), KIR2DL3 (crude OR = 2.49; p < 0.001) and activator gene KIR2DS2 (crude OR = 3.95; p< 0.001) might be associated with chronic stages of HBV infection. Conversely the inhibitory genes KIR3DL1 (crude OR = 0.49; p = 0.0018) and KIR3DL2 (crude OR = 0.41; p = 0.005), the activator gene KIR2DS1 (crude OR = 0.48; p = 0.014) and the pseudo gene KIR2DP1 (crude OR = 0.49; p = 0.008) could be associated with immunity against HBV infection. Chronic HBV patients who are carriers for the KIR3DL3 gene (crude OR = 8; p = 0.048) were positive for HBeAg and patients who carried the KIR3DL2 gene (crude OR = 3.21; p = 0.012) had a high HBV viral load compared to the rest of the study population. Conclusion Our data showed evidence of a correlation between the risk of developing chronic HBV infection and certain KIR gene frequencies and also show that KIR3DL1, KIR3DL2, KIR2DS1 might confer a protective status against chronic HBV infection.
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9
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Lingani M, Akita T, Ouoba S, Sanou AM, Sugiyama A, Tarnagda Z, Ohisa M, Tinto H, Mishiro S, Tanaka J. High prevalence of hepatitis B infections in Burkina Faso (1996-2017): a systematic review with meta-analysis of epidemiological studies. BMC Public Health 2018; 18:551. [PMID: 29699534 PMCID: PMC5921387 DOI: 10.1186/s12889-018-5432-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/10/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection was long considered an important public health concern in Burkina Faso and still represents a major cause of liver cancer and cirrhosis in the active population. To counter the problem, a national strategic plan was developed and adopted in July 2017 to coordinate viral hepatitis elimination's efforts. However evidence to support its implementation remains scanty and scattered. The main purpose of this study was to summarize available information from per-reviewed articles published over the last two decades to accurately estimate the prevalence of HBV infection in Burkina Faso. METHODS We conducted a systematic search with meta-analysis of scientific articles using Science-Direct, Web-of-Science, PubMed/Medline, and Google Scholar. We systematically assessed all relevant publications that measured the prevalence of hepatitis B surface antigen and which were published between 1996 and 2017. We estimated the national HBV prevalence and its 95% confident interval. We subsequently adjusted the meta-analysis to possible sources of heterogeneity. RESULTS We retrieved and analyzed a total of 22 full text papers including 99,672 participants. The overall prevalence was 11.21%. The prevalence after adjustment were 9.41%, 11.11%, 11.73% and 12.61% in the general population, pregnant women, blood donors and HIV-positive persons respectively. The prevalence was higher before implementation of HBV universal vaccination and decreased from 12.80% between 1996 and 2001 to 11.11% between 2012 and 2017. The prevalence was also higher in rural area 17.35% than urban area 11.11%. The western regions were more affected with 12.69% than the central regions 10.57%. The prevalence was 14.66% in the boucle of Mouhoun region and 14.59 in the center-west region. Aggregate data were not available for the other regions. CONCLUSIONS HBV has clearly an important burden in Burkina Faso as described by its high prevalence and this problem significantly challenges the national health care system. There is an urgent need for effective public health interventions to eliminate the problem. However, higher quality data are needed to produce reliable epidemiological estimates that will guide control efforts towards the achievement of the national strategic plan's goals.
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Affiliation(s)
- Moussa Lingani
- Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, BP 218 Burkina Faso
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomoyuki Akita
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Serge Ouoba
- Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, BP 218 Burkina Faso
| | - Armel Moumini Sanou
- Unité des Maladies à potentiel épidémiques, Maladies émergentes et Zoonoses, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Aya Sugiyama
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Zekiba Tarnagda
- Unité des Maladies à potentiel épidémiques, Maladies émergentes et Zoonoses, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Masayuki Ohisa
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Halidou Tinto
- Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, BP 218 Burkina Faso
| | - Shunji Mishiro
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Compaore TR, Diarra B, Assih M, Obiri-Yeboah D, Soubeiga ST, Ouattara AK, Tchelougou D, Bisseye C, Bakouan DR, Compaore IP, Dembele A, Djigma WF, Simpore J. HBV/HIV co-infection and APOBEC3G polymorphisms in a population from Burkina Faso. BMC Infect Dis 2016; 16:336. [PMID: 27449138 PMCID: PMC4957463 DOI: 10.1186/s12879-016-1672-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 06/16/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Apolipoprotein B mRNA editing enzyme catalytic polypeptide-like 3G (APOBEC3G) is a potent host defense factor, which interferes with HIV-1 and HBV. Our study had three objectives, to screen a population of HIV-1 infected and uninfected patients in Burkina Faso for HBV, to screen the population for APOBEC3G variants rs6001417, rs8177832, and rs35228531 previously described, and to analyze the effect of these three variants and their haplotypes on HIV-1/HBV co-infection in Burkina Faso. METHODS HBV detection was performed on samples from HIV-1 infected and uninfected subjects using rapid detection tests and real-time PCR. APOBEC3 genotyping was done by the TaqMan allelic discrimination method. Fisher Exact test, Odds ratio (OR), confidence intervals (CI) at 95 %, Linkage disequilibrium (LD) summary statistics and haplotype frequencies were calculated. RESULTS The prevalence of HBV was 56.7 % among HIV-1 positive patients of our study while it was about 12.8 % among HIV-1 seronegative subjects. Genotype E was the genotype of HBV present in our hepatitis B positive samples. Minor allele frequencies of rs6001417, rs8177832, and rs35228531 were higher in seronegative subjects. The T minor allele of variant rs35228531 was protective against HIV-1/HBV co-infection with OR = 0.61, 95 % CI (0.42-0.90), p = 0.013. There was also an association between the GGT haplotype and protection against HIV-1/HBV co-infection, OR = 0.57, 95 % CI (0.33-0.99), p = 0.050. The other haplotypes present in the population were not statistically significant. There minor allele T of the rs35228531 was protective against HIV mono-infection OR = 0.53, 95 % CI (0.3-0.93), P = 0.030. But there was no effect of protection against HBV mono-infection. CONCLUSION APOBEC3G through its variants rs6001417, rs8177832, and rs35228531, in this study interferes with HIV-1/HBV co-infection could be due the HIV-1 mono-infection in a population from Burkina Faso.
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Affiliation(s)
- Tegwinde Rebeca Compaore
- Pietro Annigoni Biomolecular Research Centre (CERBA)/LABIOGENE, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Birama Diarra
- Pietro Annigoni Biomolecular Research Centre (CERBA)/LABIOGENE, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Maleki Assih
- Pietro Annigoni Biomolecular Research Centre (CERBA)/LABIOGENE, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Dorcas Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Serge Theophile Soubeiga
- Pietro Annigoni Biomolecular Research Centre (CERBA)/LABIOGENE, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Abdoul Karim Ouattara
- Pietro Annigoni Biomolecular Research Centre (CERBA)/LABIOGENE, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Damehan Tchelougou
- Pietro Annigoni Biomolecular Research Centre (CERBA)/LABIOGENE, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Cyrille Bisseye
- Pietro Annigoni Biomolecular Research Centre (CERBA)/LABIOGENE, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Didier Romuald Bakouan
- Permanent Secretary against Aids and sexually transmitted diseases, Ouagadougou, Burkina Faso
| | - Issaka Pierre Compaore
- Pietro Annigoni Biomolecular Research Centre (CERBA)/LABIOGENE, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Augustine Dembele
- Permanent Secretary against Aids and sexually transmitted diseases, Ouagadougou, Burkina Faso
| | - Wendkuuni Florencia Djigma
- Pietro Annigoni Biomolecular Research Centre (CERBA)/LABIOGENE, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Jacques Simpore
- Pietro Annigoni Biomolecular Research Centre (CERBA)/LABIOGENE, University of Ouagadougou, Ouagadougou, Burkina Faso.
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Davidson UN, Chidiebele NI, Josephine EI, Olakunle OE, Nnaemeka IA, Chijioke EJ, Kingsley NI. THE PREVALENCE LIVER FUNCTION AND IMMUNOLOGIC STATUS OF CHILDREN WITH HIV AND HEPATITIS B VIRUS COINFECTION IN ENUGU, NIGERIA. Afr J Infect Dis 2016; 10:61-68. [PMID: 28331915 DOI: 10.4314/ajid.v10i2.2986] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Hepatitis B Virus (HBV) co-infection is prevalent among HIV infected individuals because of shared routes and mechanisms of transmission. The multidimensional immunosuppression from HIV infection causes impaired spontaneous recovery from an acute HBV infection, predisposing to chronic infection which is worsened by younger age at infection. Co-infection increases the risk of HBV replication, hepatotoxicity and liver related deaths from Highly Active Antiretroviral Therapy (HAART). The study was undertaken to highlight the burden of co-infection among HIV positive children in Enugu, determine the associated risk factors and compare the effect of co-infection between co-infected and non-co-infected children using liver enzyme and CD4 counts. MATERIALS AND METHODS A cross sectional study was carried out among HIV positive children attending the Paediatric ARV clinic of the University of Nigeria Teaching Hospital, Ituku-Ozalla. A total of 140 HIV infected children aged 18 months to 15 years were recruited. An interviewer questionnaire was administered. Hepatitis B surface antigen (HBsAg) was determined using Determine test Kit. Baseline and recent CD4 counts/CD4% were retrieved from the patients' folders. RESULTS Fourteen (10%) were positive for HBsAg. The highest prevalence of HBsAg was observed among children aged 11- 15 years. The higher the socioeconomic class the less likely the HBsAg positivity. Seven (50%) of the co-infected children had elevated baseline ALT compared with 57 (45.2%) of non-co-infected children though the difference was not statistically significant (t = 0.6, P = 0.56). After the initiation of HAART, 10 (76.9%) of the co-infected and 18 (15.1%) of the non-co-infected children had elevated ALT. The baseline median CD4 count among children ≥ 6 years was 230 cells/mm3 and 360 cells/mm3 respectively among the co-infected and non- co-infected, (P = 0.67). However, in children ≤ 5 years, it was 25% and 15 % respectively (P = 0.06). CONCLUSION HBV co-infection among HIV infected children is common in our environment, and co-infection is associated with impaired immunity and probably liver enzyme derangement.
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Affiliation(s)
| | | | - Emodi Ifeoma Josephine
- Department of Pediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - Obidike Egbuna Olakunle
- Department of Pediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - Ikefuna Anthony Nnaemeka
- Department of Pediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - Eze Jude Chijioke
- Department of Pediatrics, James Cook University Hospital, Middlesborough, England.
| | - Ndu Ikenna Kingsley
- department of Pediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria
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Ouédraogo Yugbaré SO, Zagré N, Koueta F, Dao L, Kam L, Ouattara DY, Simporé J. [Effectiveness of Prevention of Mother to Child Transmission of Human Immunodeficiency Virus by the 2010 protocol of the World Health Organisation at the Medical Center St. Camille of Ouagadougou (Burkina Faso)]. Pan Afr Med J 2015; 22:303. [PMID: 26966499 PMCID: PMC4769039 DOI: 10.11604/pamj.2015.22.303.7720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/04/2015] [Indexed: 11/17/2022] Open
Abstract
L’épidémie du Virus de l'Immunodéficience Humaine en milieu pédiatrique est surtout le résultat de la transmission mère-enfant. Notre étude a pour objectif de décrire l'efficacité de la prévention de la transmission mère-enfant du Virus de l'Immunodéficience Humaine par le protocole OMS 2010 (Option A et trithérapie) au centre médical saint Camille de Ouagadougou. Nous avons mené une étude d'une cohorte d'enfants suivis dans le cadre de la prévention de la transmission mère-enfant du Virus de l'Immunodéficience Humaine au centre médical saint Camille de Ouagadougou sur une période de 2 ans allant du 1er Janvier 2012 au 31 Décembre 2013. Nous avons obtenu l'accord de 4900 femmes enceintes pour le dépistage de l'infection du Virus de l'Immunodéficience Humaine et 238 gestantes ont été diagnostiquées séropositives soit 4,86% de séroprévalence. Les femmes étaient surtout infectées par le Virus de l'Immunodéficience Humaine avec de type I (95,38%)). La majorité était sous trithérapie (74,3%) et (25,7%) sous prophylaxie (option A). Les nouveau-nés (92,5%) ont reçu un traitement antirétroviral à base de névirapine dans les 72 heures après la naissance. L'allaitement sécurisé a été appliquée dans 78% des cas. Le taux global de transmission mère-enfant du VIH était de 3,6% avec 3% de transmission chez les enfants nés de mères sous trithérapie antirétrovirale et 6,3% dans les cas de prophylaxie antirétrovirale. Le facteur de risque de transmission a été le long délai du début d'administration des antirétroviraux chez le nouveau-né. La mortalité infantile à un an était de 3,5%. Cette étude a révélé l'efficacité de l'Option A et conforté celle de la trithérapie, le passage à l'Option B+ serait donc plus bénéfique.
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Affiliation(s)
- Solange Odile Ouédraogo Yugbaré
- Unité de Formation et de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso; Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Burkina Faso
| | - Nikaise Zagré
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Burkina Faso
| | - Fla Koueta
- Unité de Formation et de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso; Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Burkina Faso
| | - Lassina Dao
- Unité de Formation et de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso; Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Burkina Faso
| | - Ludovic Kam
- Unité de Formation et de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso; Service de pédiatrie du Centre Hospitalier Universitaire-Yalgado Ouédraogo
| | - Diarra Yé Ouattara
- Unité de Formation et de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso; Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Burkina Faso
| | - Jacques Simporé
- Unité de Formation et de Recherche en Sciences de la vie et de la terre, Ouagadougou, Burkina Faso; Centre médical saint Camille, Ouagadougou, Burkina Faso
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13
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Sagna T, Bisseye C, Compaore TR, Kagone TS, Djigma FW, Ouermi D, Pirkle CM, Zeba MTA, Bazie VJT, Douamba Z, Moret R, Pietra V, Koama A, Gnoula C, Sia JD, Nikiema JB, Simpore J. Prevention of mother-to-child HIV-1 transmission in Burkina Faso: evaluation of vertical transmission by PCR, molecular characterization of subtypes and determination of antiretroviral drugs resistance. Glob Health Action 2015; 8:26065. [PMID: 25630709 PMCID: PMC4309832 DOI: 10.3402/gha.v8.26065] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 12/20/2014] [Accepted: 12/21/2014] [Indexed: 11/27/2022] Open
Abstract
Background Vertical human immunodeficiency virus (HIV) transmission is a public health problem in Burkina Faso. The main objective of this study on the prevention of mother-to-child HIV-1 transmission was to determine the residual risk of HIV transmission in infants born to mothers receiving highly active antiretroviral therapy (HAART). Moreover, we detect HIV antiretroviral (ARV) drug resistance among mother–infant pairs and identify subtypes and circulating recombinant forms (CRF) in Burkina Faso. Design In this study, 3,215 samples of pregnant women were analyzed for HIV using rapid tests. Vertical transmission was estimated by polymerase chain reaction in 6-month-old infants born to women who tested HIV positive. HIV-1 resistance to ARV, subtypes, and CRFs was determined through ViroSeq kit using the ABI PRISM 3,130 sequencer. Results In this study, 12.26% (394/3,215) of the pregnant women were diagnosed HIV positive. There was 0.52% (2/388) overall vertical transmission of HIV, with rates of 1.75% (2/114) among mothers under prophylaxis and 0.00% (0/274) for those under HAART. Genetic mutations were also isolated that induce resistance to ARV such as M184V, Y115F, K103N, Y181C, V179E, and G190A. There were subtypes and CRF of HIV-1 present, the most common being: CRF06_CPX (58.8%), CRF02_AG (35.3%), and subtype G (5.9%). Conclusions ARV drugs reduce the residual rate of HIV vertical transmission. However, the virus has developed resistance to ARV, which could limit future therapeutic options when treatment is needed. Resistance to ARV therefore requires a permanent interaction between researchers, physicians, and pharmacists, to strengthen the network of monitoring and surveillance of drug resistance in Burkina Faso.
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Affiliation(s)
- Tani Sagna
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa; Institute of Research in Health Sciences, IRSS, Bobo-Dioulasso, Burkina Faso;
| | - Cyrille Bisseye
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa; Laboratory of Molecular and Cellular Biology, University of Sciences and Techniques of Masuku (USTM), Franceville, Gabon
| | - Tegewende R Compaore
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa; Saint Camille Medical Centre, Ouagadougou, Burkina Faso
| | - Therese S Kagone
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa
| | - Florencia W Djigma
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa
| | - Djeneba Ouermi
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa; Saint Camille Medical Centre, Ouagadougou, Burkina Faso
| | - Catherine M Pirkle
- Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre, Quebec, Canada
| | - Moctar T A Zeba
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa
| | - Valerie J T Bazie
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa
| | - Zoenabo Douamba
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa
| | - Remy Moret
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa
| | | | - Adjirita Koama
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa
| | - Charlemagne Gnoula
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa
| | - Joseph D Sia
- Saint Camille Medical Centre, Ouagadougou, Burkina Faso
| | - Jean-Baptiste Nikiema
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa
| | - Jacques Simpore
- Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa; Saint Camille Medical Centre, Ouagadougou, Burkina Faso
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Matthews PC, Geretti AM, Goulder PJR, Klenerman P. Epidemiology and impact of HIV coinfection with hepatitis B and hepatitis C viruses in Sub-Saharan Africa. J Clin Virol 2014; 61:20-33. [PMID: 24973812 DOI: 10.1016/j.jcv.2014.05.018] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 05/22/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023]
Abstract
Human immunodeficiency virus (HIV), Hepatitis B (HBV) and Hepatitis C (HCV) are blood-borne viruses with potentially shared routes of transmission. In high-income settings, the impact of antiretroviral therapy (ART) on survival has unmasked chronic liver disease from viral hepatitis B or hepatitis C as a leading cause of morbidity and mortality in individuals with HIV infection. It is now feared that progressive liver disease may threaten the success of ART programmes in developing countries, where HCV or HBV testing and monitoring are not yet systematic among HIV-infected patients and ART use is generally blind to these co-infections. We set out to review recent data from Sub-Saharan Africa, in order to build a detailed and up-to-date picture of the epidemiology and emerging impact of HBV and HCV coinfection in countries at the heart of the HIV pandemic. There is a preponderance of HIV/HBV coinfection compared to HIV/HCV in this region, and significant caveats exist regarding the accuracy of published HCV seroprevalence surveys. Morbidity and mortality of coinfection is significant, and may be further enhanced in African populations due to the influence of host, viral and environmental factors. Careful scrutiny of the coinfection problem is vital to inform an approach to directing resources, planning public health initiatives, providing clinical care, and guiding future research.
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Affiliation(s)
- Philippa C Matthews
- Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford OX1 3SY, UK; Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK.
| | - Anna Maria Geretti
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool L69 7BE, UK
| | - Philip J R Goulder
- Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford OX1 3SY, UK; Department of Paediatrics, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK
| | - Paul Klenerman
- Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford OX1 3SY, UK; Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK; NIHR Biomedical Research Centre, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK
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15
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Chasela CS, Kourtis AP, Wall P, Drobeniuc J, King CC, Thai H, Teshale EH, Hosseinipour M, Ellington S, Codd MB, Jamieson DJ, Knight R, Fitzpatrick P, Kamili S, Hoffman I, Kayira D, Mumba N, Kamwendo DD, Martinson F, Powderly W, Teo CG, van der Horst C. Hepatitis B virus infection among HIV-infected pregnant women in Malawi and transmission to infants. J Hepatol 2014; 60:508-14. [PMID: 24211737 PMCID: PMC4411040 DOI: 10.1016/j.jhep.2013.10.029] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 10/21/2013] [Accepted: 10/29/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS The extent of HBV infection to infants of HBV/HIV-coinfected pregnant women in sub-Saharan Africa is unknown. The aim of this study was to assess prevalence of HBV infection among antiretroviral-naïve, HIV-infected pregnant women in Malawi and examine HBV transmission to their infants. METHODS Plasma from 2048 HIV-infected, Malawian women and their infants were tested for markers of HBV infection. Study participants were provided standard-of-care health services, which included administration of pentavalent vaccine to infants at 6, 10, and 14 weeks of age. RESULTS One-hundred and three women (5%) were HBsAg-positive; 70 of these HBsAg-positive women were also HBV-DNA-positive. Sixteen women (0.8%) were HBV-DNA-positive but HBsAg-negative. Five of 51 infants (9.8%) born to HBsAg-positive and/or HBV-DNA-positive women were HBV-DNA-positive by 48 weeks of age.HBV DNA concentrations of two infants of mothers who received extended lamivudine-containing anti-HIV prophylaxis were <4 log10 IU/ml compared to ⩾ 8 log10 IU/ml in three infants of mothers who did not. CONCLUSIONS HBV DNA was detected in nearly 10% of infants born to HBV/HIV-coinfected women. Antenatal testing for HIV and HBV, if instituted, can facilitate implementation of prophylactic measures against infant infection by both viruses.
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Affiliation(s)
- Charles S Chasela
- UNC Project, P/Bag A-104, Lilongwe, Malawi; School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield Dublin 4, Ireland
| | - Athena P Kourtis
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Patrick Wall
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield Dublin 4, Ireland
| | - Jan Drobeniuc
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Caroline C King
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hong Thai
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eyasu H Teshale
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mina Hosseinipour
- UNC Project, P/Bag A-104, Lilongwe, Malawi; School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Sascha Ellington
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary B Codd
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield Dublin 4, Ireland
| | - Denise J Jamieson
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Patricia Fitzpatrick
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield Dublin 4, Ireland
| | - Saleem Kamili
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Irving Hoffman
- School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | | | - Noel Mumba
- UNC Project, P/Bag A-104, Lilongwe, Malawi
| | | | | | - William Powderly
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield Dublin 4, Ireland
| | - Chong-Gee Teo
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Ikpeme EE, Etukudo OM, Ekrikpo UE. Seroprevalence of HBV and HIV co-infection in children and outcomes following highly active antiretroviral therapy (HAART) in Uyo, South-South Nigeria. Afr Health Sci 2013; 13:955-61. [PMID: 24940318 PMCID: PMC4056492 DOI: 10.4314/ahs.v13i4.14] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Human Immunodeficiency Virus/Hepatitis B Virus (HIV/HBV) co-infection in Nigerian children has emerged as a major concern with the advent of HAART. Its impact on the immune system and liver has not been extensively studied in children. OBJECTIVES To determine the prevalence of HBV seropositivity among HIV positive children on HAART and its effect on immune response and liver enzymes. METHODS All consecutive HIV positive children aged two months to seventeen years on HAART constituted the study population. Age and gender; CD4+ count, ALT, creatinine and HBsAg were tested and documented at enrolment and 12months. RESULTS One hundred and seventy one patients were seen over this period. Seventy-two (43.4%) were males while 94 (56.6%) were females giving a male: female ratio of 1:1.3. The mean age of the patients was 63±43.4 months. Prevalence of HIV/HBV co-infection was 6.02% (95% CI 2.4-9.7). There was no significant effect of HBV status on elevation of ALT levels with 12 months of HAART. Co-infected patients had an odds ratio of achieving immune response of 0.14 (95% CI 0.02-0.79). CONCLUSION HIV/HBV co-infection rates in our children are comparable to other localities. ALT levels do not worsen with HAART and immune response of the co-infected children on HAART is lower.
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Affiliation(s)
- E E Ikpeme
- Department of Paediatrics, University of Uyo Teaching Hospital -PMB 1136 Uyo Akwa Ibom State, Nigeria
| | - O M Etukudo
- Department of Paediatrics, University of Uyo Teaching Hospital -PMB 1136 Uyo Akwa Ibom State, Nigeria
| | - U E Ekrikpo
- Department of Internal Medicine University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
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Analysis of residual perinatal transmission of hepatitis B virus (HBV) and of genetic variants in human immunodeficiency virus and HBV co-infected women and their offspring. J Clin Virol 2013; 58:415-21. [PMID: 23916828 DOI: 10.1016/j.jcv.2013.06.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 04/16/2013] [Accepted: 06/16/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Despite implementation of universal infant hepatitis B (HB) vaccination, mother-to-child transmission (MTCT) of hepatitis B virus (HBV) still occurs. Limited data are available on the residual MTCT of HBV in human immunodeficiency virus (HIV)-HBV co-infected women. OBJECTIVES We assessed the prevalence of HBV infection among HIV-infected pregnant women and the rate of residual MTCT of HBV from HIV-HBV co-infected women and analyzed the viral determinants in mothers and their HBV-infected children. STUDY DESIGN HIV-1 infected pregnant women enrolled in two nationwide perinatal HIV prevention trials in Thailand were screened for HB surface antigen (HBsAg) and tested for HBeAg and HBV DNA load. Infants born to HBsAg-positive women had HBsAg and HBV DNA tested at 4-6 months. HBV diversity within each HBV-infected mother-infant pair was analyzed by direct sequencing of amplified HBsAg-encoding gene and cloning of amplified products. RESULTS Among 3312 HIV-1 infected pregnant women, 245 (7.4%) were HBsAg-positive, of whom 125 were HBeAg-positive. Of 230 evaluable infants born to HBsAg-positive women, 11 (4.8%) were found HBsAg and HBV DNA positive at 4-6 months; 8 were born to HBeAg-positive mothers. HBV genetic analysis was performed in 9 mother-infant pairs and showed that 5 infants were infected with maternal HBV variants harboring mutations within the HBsAg "a" determinant, and four were infected with wild-type HBV present in highly viremic mothers. CONCLUSIONS HBV-MTCT still occurs when women have high HBV DNA load and/or are infected with HBV variants. Additional interventions targeting highly viremic women are thus needed to reduce further HBV-MTCT.
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Bado G, Penot P, N'Diaye MD, Amiel C, Hema A, Kamboulé EB, Guiard-Schmid JB, Kaboré NF, Slama L, Bambara A, Laurent C, Sangaré L, Sawadogo AB. Hepatitis B seroprevalence in HIV-infected patients consulting in a public day care unit in Bobo Dioulasso, Burkina Faso. Med Mal Infect 2013; 43:202-7. [PMID: 23701923 DOI: 10.1016/j.medmal.2013.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Revised: 02/21/2013] [Accepted: 04/16/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The authors had for aim to assess the prevalence of hepatitis B co-infection in a cohort of HIV-infected patients, routinely followed-up at the Day Care Unit of the Bobo Dioulasso Sanou Souro University Hospital, Burkina Faso. PATIENTS AND METHODS The Elisa technique was used to dose HBs antigen (AgHBs), antibodies anti-HBs and anti-HBc in all the patients followed by the biological laboratory, from October to December 2008. RESULTS The AgHBs prevalence was 12.7% [CI at 95%: 10.7-15.0%] and men were slightly more likely to be positive for AgHBs than women (16.5% [12.0-21.9%] versus 11.6% [9.4-14.1%]; P=0.047); 83.3% of the patients [80.8-85.6%] were positive for hepatitis B core antibody, and 32.6% [29.7-35.6%] for hepatitis B surface antibody; 29.9% of the patients [27.1-32.8%] had a complete profile of former hepatitis B infection, 41.3% [38.2-44.4%] expressed core antibodies only; 13.8% [11.7-16.0%] had a negative serological test, and 2.3% [1.5-3.4%] presented a vaccinal immunity. CONCLUSION These results stress the usefulness of screening for hepatitis B in all HIV-infected patients, along with the initial biological tests. This would help adapt HIV treatment to co-infected patients and to build an expanded program of vaccination for non-immune patients.
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Affiliation(s)
- G Bado
- Département de Médecine, Hôpital de Jour, CHU Souro Sanou Bobo Dioulasso, 01 BP 3437, Bobo Dioulasso, Burkina Faso.
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Yu M, Jiang Q, Ji Y, Jiang H, Wu K, Ju L, Tang X, Wu M. The efficacy and safety of antiviral therapy with lamivudine to stop the vertical transmission of hepatitis B virus. Eur J Clin Microbiol Infect Dis 2013; 31:2211-8. [PMID: 22314409 DOI: 10.1007/s10096-012-1557-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 01/11/2012] [Indexed: 01/14/2023]
Abstract
The purpose of this study was to investigate the efficacy and safety of lamivudine (LAM) in stopping the vertical transmission of hepatitis B virus (HBV). Pregnant women with normal alanine transaminase (ALT) (n = 100) and with abnormal ALT (n = 100) who were positive for hepatitis B e antigen (HBeAg), and with HBV DNA (deoxyribonucleic acid) levels ≥1.0 × 107 copies/ml were enrolled in this study. One hundred volunteers (50 with normal ALT, 50 with abnormal ALT) received 100 mg of LAM daily from the 24th to 32nd week of gestation and the untreated 100 volunteers served as controls. All infants received passive-active immunoprophylaxis. Compared to the control group, the study group got a marked reduction in serum levels (P < 0.001) and high negativity (P < 0.001) of HBV DNA before delivery. They also got normalization in ALT levels as much as controls received general medication (P > 0.05). The prenatal transmission rate in the study group was significantly lower than that of the control group (P < 0.05). There were no differences in incidences of congenital malformation between the two groups (P > 0.05). LAM treatment can effectively and safely stop vertical transmission of HBV and normalize the ALT levels of pregnant women.
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Affiliation(s)
- M Yu
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of Southeast University, Nanjing, 210003, China.
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Salihu HM, Connell L, Salemi JL, August EM, Weldeselasse HE, Alio AP. Prevalence and temporal trends of hepatitis B, hepatitis C, and HIV/AIDS co-infection during pregnancy across the decade, 1998-2007. J Womens Health (Larchmt) 2011; 21:66-72. [PMID: 22011209 DOI: 10.1089/jwh.2011.2979] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Limited data are available on hepatitis rates during pregnancy by socio-demographic characteristics. This study examined temporal trends in hepatitis B virus (HBV) and hepatitis C virus (HCV) mono-infections and HIV/HBV and HIV/HCV co-infections in subpopulations among pregnant women in Florida between 1998 and 2007. METHODS We analyzed all Florida live births from 1998 to 2007 using hospital discharge data linked to birth records. RESULTS The total sample size was 1,700,734 singleton live births. The prevalance of HBV in pregnancy rose from 65.4 per 100,000 births to 123.5 per 100,000 births (p<0.0001 for trend), and the prevalence of HCV in pregnancy increased from 17.0 per 100,000 births to 125.1 per 100,000 births (p<0.0001 for trend). Compared with white mothers, black mothers were more than twice as likely to have HBV in pregnancy (adjusted rate ratios [ARR]=2.24; 95% CI=1.97-2.53). Black mothers were 69% (ARR=0.31, 95% CI=0.25-0.39) and Hispanic mothers were 51% (ARR=0.49, 95% CI=0.41-0.60) less likely to have HCV compared with white mothers. CONCLUSIONS Although the overall prevalence rate of HBV increased over the past decade, black women still had a noticeably higher rate of infection. Similarly, white women and those with HIV co-infection had noticeably higher rates of HCV infection over the study period. Our findings call for improved and increased HBV/HCV prevention, screening, and immunization programs among minority women of childbearing age.
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Affiliation(s)
- Hamisu M Salihu
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL 33613, USA.
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Phillips KD, Moneyham L, Tavakoli A. Development of an instrument to measure internalized stigma in those with HIV/AIDS. Issues Ment Health Nurs 2011; 32:359-66. [PMID: 21692574 DOI: 10.3109/01612840.2011.575533] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Stigma has grave consequences for persons living with HIV/AIDS. Stigma hampers prevention of HIV transmission to sexual partners and to unborn babies, diagnosis, and early treatment, and negatively affects mental and physical health, quality of life, and life satisfaction. Internalized stigma of HIV/AIDS may have even more severe consequences than perceived or enacted stigma. The purpose of this study was to develop an instrument to measure internalized stigma in those with HIV/AIDS. Data were drawn from the Rural Women's Health Project. Research assistants administered structured interviews at baseline, 3 months, and 6 months. Instruments used in these analyses included a demographic data form, the Centers for Epidemiological Studies Depression Scale (CES-D), the Perceived Stigma Scale (PSS), and the Internalized Stigma of AIDS Tool (ISAT). Exploratory factor analysis confirmed that the ten items of the ISAT measure a single factor that explains 88% of the variance in the construct. Internal consistency was demonstrated by a Cronbach's alpha of .91 (Time 1), .92 (Time 2), and .92 (Time 3). Convergent validity was supported with significant positive correlations with the CES-D (rho = 0.33, p < 0.0001) and the PSS (rho = 0.56, < 0.0001). The Internalized Stigma of AIDS Tool appears to be a reliable and valid instrument to measure internalization of the stigma of HIV/AIDS. It may be of value in research and clinical assessment.
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Affiliation(s)
- Kenneth D Phillips
- The University of Tennessee-Knoxville, College of Nursing, Knoxville, Tennessee, USA.
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