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Prevalence and factors associated with hepatitis C among pregnant women in China: a cross-sectional study. Sci Rep 2023; 13:759. [PMID: 36641539 PMCID: PMC9840611 DOI: 10.1038/s41598-023-27668-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023] Open
Abstract
Pregnant women infected with HCV should be given attention due to their special physiological stage and the effect on offspring health. To examine the prevalence of HCV infection among pregnant women in part of China and explore relevant factors during pregnancy, a cross-sectional study was conducted in four maternal and children health care institutions (MCHC) in Guangdong, Hunan and Chongqing. Pregnant women who were delivered, induced or spontaneous abortion were included and relevant information was collected through the Hospital Information System. Results showed that the prevalence of HCV among pregnant women in four MCHCs was 0.11% (95% CI 0.09-0.13%). Age, occupations, regions, syphilis-infection, intrahepatic cholestasis of pregnancy (ICP), and placenta previa were significant factors (all P < 0.05). Age and syphilis-infection were positively correlated with HCV infection (Z = 3.41, P = 0.0006; OR = 18.16, 95% CI 9.34-35.29). HCV and HBV infection were risk factors of ICP (OR = 4.18, 95% CI 2.18-8.04; OR = 2.59, 95% CI 2.31-2.89). Our study indicates that the prevalence of HCV among pregnant women in the three provinces(city) was low compared with the general population in China. Older age and syphilis-infection increased the risk of HCV infection during pregnancy. HCV infection was a risk factor of ICP. Generally, we need keep a watchful eye on HCV infection and relevant factors mentioned above during pregnancy in clinic, especially those also infected with syphilis. HCV testing based on risk factors is recommended in antenatal care and obstetrics.
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Ranes de Menezes Filho H, Maia LG, Machado SM, Ramos da Silva I, de Almeida-Neto C, Sabino EC, Witkin SS, Mendes-Corrêa MC. Knowledge of Hepatitis C virus vertical transmission and subsequent pregnancy outcome in virus-positive female blood donors. Braz J Infect Dis 2022; 26:102334. [PMID: 35180448 PMCID: PMC9387468 DOI: 10.1016/j.bjid.2022.102334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/18/2021] [Accepted: 01/01/2022] [Indexed: 11/04/2022] Open
Abstract
Introduction Hepatitis C virus (HCV) can be vertically transmitted from mother to fetus. We evaluated knowledge about HCV vertical transmission in female blood donors who became pregnant following detection of HCV in their donated blood. Methods This was a retrospective descriptive study of females seen at a single blood bank in Sao Paulo, Brazil who were diagnosed with HCV infection in their donated blood. HCV-infected donors who subsequently became pregnant were invited to participate through letters or phone calls. Individuals who agreed to participate were interviewed by questionnaire to evaluate their knowledge on HCV vertical transmission. Results Among 282 HCV-positive female blood donors, 69 reported becoming pregnant after their HCV diagnosis in donated blood. While 24 of these women were successful treated for their infection prior to becoming pregnant, 45 (65.2%) were at risk for vertical HCV transmission either because they had never been treated for HCV, were pregnant before treatment or became pregnant after unsuccessful treatment. Of the 59 women who responded to the question of whether they were informed about the risk of HCV vertical transmission, 58 (98.3%) reported never receiving this information either after obtaining their blood donation results or during their pregnancy. Conclusion The lack of knowledge of HCV-infected women on the possibility for mother-to-child transmission of this virus highlights the critical need to improve communication about pregnancy-related risks between health professionals and HCV-infected women of childbearing age.
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Prevalence and Predominant Genotype of Hepatitis C Virus Infection and Associated Risk Factors among Pregnant Women in Iran. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9294276. [PMID: 34589552 PMCID: PMC8476243 DOI: 10.1155/2021/9294276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/02/2021] [Accepted: 08/24/2021] [Indexed: 12/21/2022]
Abstract
Objective Knowledge regarding the prevalence and risk factors of hepatitis C virus (HCV) infection among pregnant women can give clue to health care providers regarding the appropriate management of HCV infection. Therefore, this study was conducted to determine the prevalence, genotypic pattern, and risk factors of HCV infection among pregnant women in the northern shores of the Persian Gulf, south of Iran. Methods From January 2018 to June 2019, serum samples were obtained from 1425 pregnant women, ages ranging from 14 to 46 years (28.1 ± 5.99). Serum samples were tested for detection of anti-HCV antibodies using an enzyme-linked immunosorbent assay (ELISA) (HCV Ab ELISA kit, Dia.Pro, Milan, Italy). Following the extraction of nucleic acid, the molecular evaluation of HCV infection was performed by seminested reverse transcriptase-polymerase chain reaction assay (RT-PCR), targeting the 5′ untranslated region (5′UTR) and core of HCV genome and sequencing. Results Of the 1425 pregnant women, 19 women (1.33%, 95% CI: 0.85%–2.07%) were positive for anti-HCV antibodies. The majority of HCV-seropositive women were in the third trimester of pregnancy, educated, and had a history of blood transfusion, abortion, surgery, or dentistry. Moreover, Arab and Fars pregnant women and those aged >39 years had the highest rate of HCV seroprevalence. Nevertheless, none of these variables were significantly associated with HCV seropositivity. In contrast, HCV seropositivity was associated with place of residency, so that residents of Khormuj city had significantly higher HCV seroprevalence compared to the residents of other cities (OR: 7.05; 95% CI: 1.75–28.39; P = 0.006). According to the molecular evaluation, 9 of the 19 HCV-seropositive pregnant women (47.37%) had HCV viremia with genotype 3a. Conclusion This study reports the HCV prevalence of 1.33% for anti-HCV antibodies and 0.63% for HCV RNA among pregnant women in the south of Iran. Considering the asymptomatic nature of chronic HCV infection and the fact that vertical transmission is possible in women with detectable viremia, therefore, screening of women before pregnancy is recommended to reduce the risk of HCV infection and its complications during pregnancy.
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Jindal N, Goyal LD, Singh C. Sociodemographic features associated with Hepatitis C Virus (HCV) in pregnant females: A tertiary care centre study from Malwa region of Punjab (North India). J Family Med Prim Care 2021; 10:2679-2683. [PMID: 34568154 PMCID: PMC8415663 DOI: 10.4103/jfmpc.jfmpc_2372_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 12/12/2022] Open
Abstract
Background Hepatitis C virus (HCV) infection is high in state of Punjab, however very few studies have been done till date. We all know that pregnant females are a most important section of our community and are usually screened for HCV, HIV, and Hepatitis B at time of presentation. HCV is capable of causing chronic infections and having long-term implications on a person's health. Vertical transmission of HCV can be one of the major route of transmission of this virus to the neonate and there have been various sociodemographic factors like age, literacy, socioeconomic status, occupational status, associated with the disease causation and transmission. Methods All pregnant females attending Obstetrics and gynecology department of our institute were included in study. All the sociodemographic characters and socioeconomic records were retrieved and analyzed. Results In our study also a lower socioeconomic status, illiteracy have been significantly associated with the HCV-positive group, thus emphasizing the role of education so as to impart education to the masses as regard to mode of transmission and its effects on the disease. Higher age of conceiving is also significant associated with the increased maternal risk. Conclusions The more involvement of health care officials and even persons not related to health care set up is required who can educate masses so as to protect the community.
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Affiliation(s)
- Neerja Jindal
- Department of Microbiology, GGS Medical College and Hospital, Faridkot, Punjab, India
| | - Lajya D Goyal
- Department of Obstetrics and Gynaecology, AIIMS, Bathinda, Punjab, India
| | - Charu Singh
- Department of Microbiology, IMS BHU, Varanasi, Uttar Pradesh, India
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Andes A, Ellenberg K, Vakos A, Collins J, Fryer K. Hepatitis C Virus in Pregnancy: A Systematic Review of the Literature. Am J Perinatol 2021; 38:e1-e13. [PMID: 32323289 DOI: 10.1055/s-0040-1709672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The aim of this study was to systematically review the literature to summarize recent demographic characteristics of hepatitis C virus (HCV) infection during pregnancy and the efficacy of risk-based versus universal screening. STUDY DESIGN PubMed, EMBASE, and Cochrane Library were searched to identify relevant studies. Studies that recognized hepatitis C as a primary or secondary outcome, with pregnant women as the population and written in English, were included. Studies were excluded if they were abstracts only, written in foreign language, or published prior to 1992. Two researchers independently screened all the studies by titles, abstracts, and full text. Conflicts were settled by a third researcher. RESULTS A total of 698 studies were identified with 78 fitting inclusion criteria. In total, 69 epidemiologic and 9 comparison studies were found. Identified risk factors for HCV infection include intravenous or illicit drug use, sexually transmitted coinfection, high-risk behaviors in the partners, high parity, and history of miscarriages or abortions. Demographic characteristics associated with HCV include non-Hispanic white race, American Indian or Alaskan Native ethnicity, and increasing age. Providers may fail to adequately screen for each risk factor, and up to two-thirds of women with a known risk factor are not screened under current guidelines. Finally, up to 27% of HCV+ women have no identifiable risk factors for infection. CONCLUSION There is evidence that risk-based screening fails to identify a large proportion of HCV positive women in pregnancy and that pregnant women with HCV risk factors and consistent with current screening guidelines fail to be tested. We urge for the adoption of universal screening to identify these women and offer treatment.
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Affiliation(s)
- Alexandra Andes
- Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Kerry Ellenberg
- Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Amanda Vakos
- Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - James Collins
- Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Kimberly Fryer
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida
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Sebastião CS, Neto Z, Jandondo D, Mirandela M, Morais J, Brito M. HIV, hepatitis B virus, hepatitis C virus, and syphilis among pregnant women attending antenatal care in Luanda, Angola: Seroprevalence and risk factors. J Med Virol 2020; 92:3265-3270. [PMID: 32515502 DOI: 10.1002/jmv.26148] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/20/2020] [Accepted: 06/07/2020] [Indexed: 01/17/2023]
Abstract
Infectious diseases during pregnancy remain a public health concern, especially in a resource-limited setting. The study aimed to determine the seroprevalence and determinants of HIV and co-infection with hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis among pregnant women attending antenatal care in Luanda, the capital city of Angola. A cross-sectional study was conducted with 1612 pregnant women screened for HIV during antenatal care. HIV-reactive were also screened for the HBV, HCV, and syphilis using immunoassay kits. A logistic regression model, adjusted odds ratios (AOR) and their 95% confidence interval (CI) were calculated with a level of significance set at 5%. The overall seroprevalence of HIV was 2.6%. About 13% of HIV-positive pregnant women were coinfected. From which, 7.5% were reactive to HBV and 5% to syphilis. There was no reactivity to HCV. Pregnant women younger aged than 25 years were significantly protected from HIV-infection (AOR, 0.43 [95% CI, 0.20-0.91], P = .026). The co-infection was 1.3 times (AOR, 0.04-41.0) in younger aged than 25 years, 7.0 times (AOR, 0.50-99.2) to residents in urbanized areas, and 1.4 times (AOR, 0.10-20.9) in pregnant women with a high educational level. In conclusion, infectious diseases are a public health burden among pregnant women in Luanda. However, include an integrated antenatal screening mainly in urbanized areas is crucial to reduce the spread of infectious diseases in different communities of Angola.
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Affiliation(s)
- Cruz S Sebastião
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
- Department of Laboratory, Centro de Investigação em Saúde de Angola, Luanda, Angola
- Instituto Superior de Ciências da Saúde, Universidade Agostinho Neto, Luanda, Angola
- Laboratory of Immunobiology and Pathogenesis of CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Zoraima Neto
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
| | - Domingos Jandondo
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
| | - Marinela Mirandela
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
| | - Joana Morais
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
- Department of Laboratory, Centro de Investigação em Saúde de Angola, Luanda, Angola
- Faculdade de Medicina, Universidade Agostinho Neto, Luanda, Angola
| | - Miguel Brito
- Department of Laboratory, Centro de Investigação em Saúde de Angola, Luanda, Angola
- Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisboa, Portugal
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Agboghoroma CO, Ukaire BC. Prevalence and Risk Factors of Human Immunodeficiency Virus and Hepatitis C Virus Infection among Pregnant Women Attending Antenatal Care at a Tertiary Hospital in Abuja, Nigeria. Niger Med J 2020; 61:245-251. [PMID: 33487847 PMCID: PMC7808292 DOI: 10.4103/nmj.nmj_241_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 07/16/2020] [Accepted: 08/26/2020] [Indexed: 01/26/2023] Open
Abstract
CONTEXT Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) co-infection in pregnant women has increased potential for Mother-to-Child Transmission risks of both viruses. The reports on the prevalence and risk factors for HIV and HCV co-infection in pregnancy are limited in Nigeria. AIM The aim of the study is to determine the prevalence and potential risk factors for HIV and HCV infection among pregnant women in Abuja. STUDY DESIGN A cross-sectional seroprevalence study carried out on pregnant women attending antenatal clinic of a tertiary hospital in Abuja from July 1st to October 31st 2016. Patients were recruited consecutively and counselled for HIV and HCV. Structured questionnaire was used to collect socio-demographic data, and information on potential risk factors for HIV and HCV infections. Blood samples were collected for HIV and HCV screening using rapid test kits following the national testing algorithm. Data generated were analyzed with statistical package for social sciences (SPSS) version 20.0. P-value less than 0.05 was considered statistically significant. RESULT 252 pregnant women participated in this study. The mean age of the study population was 31.7 ± 4.9 years. The prevalence of HIV and HCV was 12.3% and 1.2% respectively. The prevalence of HIV/HCV co-infection was 0.8%. The prevalence of HCV among HIV positive cohorts was 6.5%. HIV infection was significantly associated with history of blood transfusion (P = 0.047), presence of tattoo/scarification marks (P = 0.009) and multiple sexual partners (P < 0.0001). HCV infections was not significantly associated with any of the risk factors studied. CONCLUSION HIV prevalence is high among the pregnant women. HCV co-infection is common in women who are HIV infected. HIV infection unlike HCV was significantly associated with history of blood transfusion, presence of tattoo/scarification marks and multiple sexual partners.
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Aboubakar M, Kpossou AR, Glago BRGH, Aguiah AG, Mboreha ZH, Sehonou J. [Prevention and factors associated with anti-HCV carriage in pregnant women living in Cotonou]. Pan Afr Med J 2020; 36:182. [PMID: 32952826 PMCID: PMC7467609 DOI: 10.11604/pamj.2020.36.182.23122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/08/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction hepatitis C is an infection which can be passed from mother to child. The purpose of this study was to investigate the prevalence of colonization by anti-HCV antibodies in pregnant women living in Cotonou and to identify factors associated with it. Methods we conducted a cross-sectional study of 253 pregnant women admitted for prenatal care in four major maternity hospitals in Cotonou (Benin) from 01/06/2018 to 01/09/2018. Anti-HCV antibodies were detected using rapid diagnostic tests. A venous blood sample was collected from pregnant women tested positive for anti-HCV before confirmatory serological tests and screening tests for gestational diabetes. Results the prevalence of anti-HCV antibodies was 1.2% (3/253 pregnant women). Factors associated with HCV carriage couldn't be identified given the low number of positive cases. However, pregnant women who were carriers of hepatitis C antibodies had higher mean age (32 ± 3) compared to the remainder of the population (29.58 ± 5.5). Potential risk factors for HCV infection were scarifications, piercing, tattooing, sharing of manicure equipment, a history of surgery and blood transfusions. The prevalence of gestational diabetes in our study population was 7.9% (20/253). No association was found between gestational diabetes and hepatitis C. Conclusion the prevalence of anti-HCV antibodies in pregnant women living in Cotonou was low. A national-level study is needed to identify factors associated with this infection.
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Affiliation(s)
- Moufalilou Aboubakar
- Centre Hospitalier Universitaire de la Mère et de l´Enfant Lagune (CHU-MEL), Cotonou, Bénin
| | - Aboudou Raïmi Kpossou
- Clinique Universitaire d´Hépato-gastro-entérologie, Centre National Hospitalier et Universitaire Hubert Koutoukou Maga (CNHU-HKM), Cotonou, Bénin
| | | | - Amel Gildas Aguiah
- Clinique Universitaire de Gynécologie-obstétrique, Centre National Hospitalier et Universitaire Hubert Koutoukou Maga (CNHU-HKM), Cotonou, Bénin
| | - Zafy Hairou Mboreha
- Centre Hospitalier Universitaire de la Mère et de l´Enfant Lagune (CHU-MEL), Cotonou, Bénin
| | - Jean Sehonou
- Clinique Universitaire d´Hépato-gastro-entérologie, Centre National Hospitalier et Universitaire Hubert Koutoukou Maga (CNHU-HKM), Cotonou, Bénin
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Ejeta E, Dabsu R. Prevalence of Hepatitis C Virus and HIV Infection Among Pregnant Women Attending Antenatal Care Clinic in Western Ethiopia. Front Med (Lausanne) 2019; 5:366. [PMID: 30729110 PMCID: PMC6352848 DOI: 10.3389/fmed.2018.00366] [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: 07/10/2018] [Accepted: 12/31/2018] [Indexed: 12/29/2022] Open
Abstract
Background:Hepatitis C virus (HCV) and HIV infection remain a major public health challenge in Sub-Saharan Africa. The HCV and HIV infection among pregnant women have a serious outcome on maternal and newborn health. There is limited information in this regards in West part of Ethiopia. This study aims to identify the sero- prevalence and predictor factors of HCV and HIV infection among pregnant women attending antenatal care (ANC) in Western Ethiopia. Methods: An institutional based cross-sectional study was conducted from July to September, 2014 among 421 pregnant women's attending ANC services in purposively selected health facilities of western Ethiopia. The HCV and HIV infections were diagnosed by detection antibodies from aseptically collected serum sample. HCV was identified using an enzyme linked immune sorbent assay (ELISA) while HIV infection was tested with rapid HIV tests following the national HIV test algorithm. The pretested and structured questionnaire was used to collect socio-demographic data, and potential predictor factors of HCV and HIV infection. The collected data were analyzed using SPSS version 20.0 statistical software. Result: The overall sero-prevalence of HCV and HIV among the study population was 8.1% and 1.0%, respectively. The prevalence of HCV/HIV co-infection was 0.23% (1/421). Among HIV infected women, the prevalence of HCV infection was 25% (1/4). The risk of HCV infection was significantly low for urban residents (AOR = 0.38, 95%CI: 0.16-0.90) and illiterate (AOR = 0.24, 95%CI: 0.06-0.85). However, the history of blood transfusion was significantly increases the risk of HIV infection (AOR = 19.52, 95%CI: 1.80-150.6). Conclusion: Our study confirms public health importance of HCV and HIV infections among pregnant women in the study area. The study suggests need of attention for rural residents and educated segment of the population for HCV prevention, and national blood blank to check HIV test method used for blood transfusion.
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Affiliation(s)
- Eyasu Ejeta
- Department of Medical Laboratory Sciences, College of Medical and Health Sciences, Wollega University, Nekemte, Ethiopia.,Department of Medical Laboratory Sciences and Pathology, College Health Sciences, Jimma University, Jimma, Ethiopia
| | - Regea Dabsu
- Department of Medical Laboratory Sciences, College of Medical and Health Sciences, Wollega University, Nekemte, Ethiopia
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Lange B, Roberts T, Cohn J, Greenman J, Camp J, Ishizaki A, Messac L, Tuaillon E, van de Perre P, Pichler C, Denkinger CM, Easterbrook P. Diagnostic accuracy of detection and quantification of HBV-DNA and HCV-RNA using dried blood spot (DBS) samples - a systematic review and meta-analysis. BMC Infect Dis 2017; 17:693. [PMID: 29143616 PMCID: PMC5688458 DOI: 10.1186/s12879-017-2776-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The detection and quantification of hepatitis B (HBV) DNA and hepatitis C (HCV) RNA in whole blood collected on dried blood spots (DBS) may facilitate access to diagnosis and treatment of HBV and HCV infection in resource-poor settings. We evaluated the diagnostic performance of DBS compared to venous blood samples for detection and quantification of HBV-DNA and HCV-RNA in two systematic reviews and meta-analyses on the diagnostic accuracy of HBV DNA and HCV RNA from DBS compared to venous blood samples. METHODS We searched MEDLINE, Embase, Global Health, Web of Science, LILAC and Cochrane library for studies that assessed diagnostic accuracy with DBS. Heterogeneity was assessed and where appropriate pooled estimates of sensitivity and specificity were generated using bivariate analyses with maximum likelihood estimates and 95% confidence intervals. We also conducted a narrative review on the impact of varying storage conditions or different cut-offs for detection from studies that undertook this in a subset of samples. The QUADAS-2 tool was used to assess risk of bias. RESULTS In the quantitative synthesis for diagnostic accuracy of HBV-DNA using DBS, 521 citations were identified, and 12 studies met the inclusion criteria. Overall quality of studies was rated as low. The pooled estimate of sensitivity and specificity for HBV-DNA was 95% (95% CI: 83-99) and 99% (95% CI: 53-100), respectively. In the two studies that reported on cut-offs and limit of detection (LoD) - one reported a sensitivity of 98% for a cut-off of ≥2000 IU/ml and another reported a LoD of 914 IU/ml using a commercial assay. Varying storage conditions for individual samples did not result in a significant variation of results. In the synthesis for diagnostic accuracy of HCV-RNA using DBS, 15 studies met the inclusion criteria, and this included six additional studies to a previously published review. The pooled sensitivity and specificity was 98% (95% CI:95-99) and 98% (95% CI:95-99.0), respectively. Varying storage conditions resulted in a decrease in accuracy for quantification but not for reported positivity. CONCLUSIONS These findings show a high level of diagnostic performance for the use of DBS for HBV-DNA and HCV-RNA detection. However, this was based on a limited number and quality of studies. There is a need for development of standardized protocols by manufacturers on the use of DBS with their assays, as well as for larger studies on use of DBS conducted in different settings and with varying storage conditions.
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Affiliation(s)
- Berit Lange
- Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- Centre for Chronic Immunodeficiency, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | | | - Jennifer Cohn
- Department of Infectious Diseases, University of Pennsylvania, Philadelphia, PA, USA
| | - Jamie Greenman
- Department of Infectious Diseases, University of Pennsylvania, Philadelphia, PA, USA
| | - Johannes Camp
- Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Azumi Ishizaki
- Global Hepatitis Programme, HIV Department, World Health Organization, Geneva, Switzerland
| | - Luke Messac
- Department of Infectious Diseases, University of Pennsylvania, Philadelphia, PA, USA
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic Infections UMR 1058, INSERM/Université Montpellier/Etablissement Français du Sang, INSERM, 34394, Cedex 5, Montpellier, France
- Centre Hospitalier Universitaire (CHU) de Montpellier, département de bactériologie-virologie, Montpellier, France
| | - Philippe van de Perre
- Pathogenesis and Control of Chronic Infections UMR 1058, INSERM/Université Montpellier/Etablissement Français du Sang, INSERM, 34394, Cedex 5, Montpellier, France
- Centre Hospitalier Universitaire (CHU) de Montpellier, département de bactériologie-virologie, Montpellier, France
| | - Christine Pichler
- Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Philippa Easterbrook
- Global Hepatitis Programme, HIV Department, World Health Organization, Geneva, Switzerland
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Saffier IP, Kawa H, Harling G. A scoping review of prevalence, incidence and risk factors for HIV infection amongst young people in Brazil. BMC Infect Dis 2017; 17:675. [PMID: 29020929 PMCID: PMC5637257 DOI: 10.1186/s12879-017-2795-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/04/2017] [Indexed: 11/12/2022] Open
Abstract
Background Despite young people being a key population for HIV prevention, the HIV epidemic amongst young Brazilians is perceived to be growing. We therefore reviewed all published literature on HIV prevalence and risk factors for HIV infection amongst 10-25 year olds in Brazil. Methods We searched Embase, LILACS, Proquest, PsycINFO, PubMed, Scopus and Web of Science for studies published up to March 2017 and analyzed reference lists of relevant studies. We included published studies from any time in the HIV epidemic which provided estimates specific to ages 10-25 (or some subset of this age range) for Brazilians on either: (a) HIV prevalence or incidence; or (b) the association between HIV and socio-demographic or behavioral risk factors. Results Forty eight publications met the inclusion criteria: 44 cross-sectional, two case-control, two cohort. Four studies analysed national data. Forty seven studies provided HIV prevalence estimates, largely for six population subgroups: Counselling and Testing Center attendees; blood donors; pregnant women; institutional individuals; men-who-have-sex-with-men (MSM) and female sex workers (FSW); four provided HIV incidence estimates. Twelve studies showed HIV status to be associated with a wide range of risk factors, including age, sexual and reproductive history, infection history, substance use, geography, marital status, mental health and socioeconomic status. Conclusions Few published studies have examined HIV amongst young people in Brazil, and those published have been largely cross-sectional and focused on traditional risk groups and the south of the country. Despite these limitations, the literature shows raised HIV prevalence amongst MSM and FSW, as well as amongst those using drugs. Time trends are harder to identify, although rates appear to be falling for pregnant women, possibly reversing an earlier de-masculinization of the epidemic. Improved surveillance of HIV incidence, prevalence and risk factors is a key component of efforts to eliminate HIV in Brazil.
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Affiliation(s)
| | - Hélia Kawa
- Department of Epidemiology, Fluminense Federal University, Niterói, Brazil
| | - Guy Harling
- Institute for Global Health, University College London, Mortimer Market Centre, London, WC1E 6JB, UK. .,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA.
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Mutagoma M, Balisanga H, Sebuhoro D, Mbituyumuremyi A, Remera E, Malamba SS, Riedel DJ, Nsanzimana S. Hepatitis C virus and HIV co-infection among pregnant women in Rwanda. BMC Infect Dis 2017; 17:167. [PMID: 28228126 PMCID: PMC5322679 DOI: 10.1186/s12879-017-2269-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 02/17/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) infection is a pandemic causing disease; more than 185 million people are infected worldwide. An HCV antibody (Ab) prevalence of 6.0% was estimated in Central African countries. The study aimed at providing HCV prevalence estimates among pregnant women in Rwanda. METHODS HCV surveillance through antibody screening test among pregnant women attending antenatal clinics was performed in 30 HIV sentinel surveillance sites in Rwanda. RESULTS Among 12,903 pregnant women tested at antenatal clinics, 335 (2.6% [95% Confidence Interval 2.32-2.87]) tested positive for HCV Ab. The prevalence of HCV Ab in women aged 25-49 years was 2.8% compared to 2.4% in women aged 15-24 years (aOR = 1.3; [1.05-1.59]); This proportion was 2.7% [2.37-2.94] in pregnant women in engaged in non-salaried employment compared to 1.2% [0.24-2.14] in those engaged in salaried employment (aOR = 3.2; [1.60-6.58]). The proportion of HCV Ab-positive co-infected with HIV was estimated at 3.9% (13 cases). Women in urban residence were more likely to be associated with HCV-infection (OR = 1.3; 95%CI [1.0-1.6]) compared to those living in rural setting. CONCLUSION HCV is a public health problem in pregnant women in Rwanda. Few pregnant women were co-infected with HCV and HIV. Living in urban setting was more likely to associate pregnant women with HCV infection.
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Affiliation(s)
- Mwumvaneza Mutagoma
- Rwanda Biomedical Center, Ministry of Health, P.O. Box: 7162, Kigali, Rwanda
| | - Helene Balisanga
- Rwanda Biomedical Center, Ministry of Health, P.O. Box: 7162, Kigali, Rwanda
| | - Dieudonné Sebuhoro
- Rwanda Biomedical Center, Ministry of Health, P.O. Box: 7162, Kigali, Rwanda
| | | | - Eric Remera
- Rwanda Biomedical Center, Ministry of Health, P.O. Box: 7162, Kigali, Rwanda
| | - Samuel S. Malamba
- US Centers for Disease Control and Prevention (CDC), Center for Global Health (CGH), Division of Global HIV/AIDS (DGHA), Kigali, Rwanda
| | - David J. Riedel
- Institute of Human Virology and Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, MD USA
| | - Sabin Nsanzimana
- Rwanda Biomedical Center, Ministry of Health, P.O. Box: 7162, Kigali, Rwanda
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Ahmad I. Prevalence of Hepatitis B and C Viral Infection Among Pregnant Women in Peshawar, Pakistan. HEPATITIS MONTHLY 2016; 16:e36383. [PMID: 27630725 PMCID: PMC5011400 DOI: 10.5812/hepatmon.36383] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 05/03/2016] [Accepted: 05/13/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Viral hepatitis during pregnancy is associated with a high risk of maternal complications. The virus has a high risk of vertical transmission and it has been reported as the leading cause of maternal death. OBJECTIVES To study the prevalence of hepatitis B (HBV) and hepatitis C (HCV) viral infections among pregnant women in the Peshawar district of Pakistan. MATERIALS AND METHODS The cross-sectional study took place between July 2013 and April 2014. A total of 10,288 samples were collected from pregnant women living in different areas of the Peshawar district. The samples were centrifuged at a high speed in order to obtain a clear supernatant serum. All samples were screened for HBV and HCV using the immunochromatographic technique. RESULTS The overall prevalence of HBV was found to be 1.16%, although it varied throughout the study period. The highest prevalence of HBV (1.69%) was observed during January 2014. The overall prevalence of HCV infection among the pregnant women was observed to be 1.42%. The highest prevalence of HCV infection (2.22%) was found during March 2014. CONCLUSIONS The overall prevalence of HBV and HCV was 1.16% and 1.42%, respectively. The incidence of HCV infection among the pregnant women was higher than that of HBV infection.
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Affiliation(s)
- Irshad Ahmad
- Assistant Professor, Department of Life Sciences, King Fahd University of Petroleum and Minerals, Dhahran, Saudi Arabia
- Corresponding Author: Irshad Ahmad, Assistant Professor, Department of Life Sciences, King Fahd University of Petroleum and Minerals, Dhahran, Saudi Arabia. Tel: +96-638607032, Fax: +96638604277, E-mail:
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Kopilović B, Poljak M, Seme K, Klavs I. Hepatitis C virus infection among pregnant women in Slovenia: study on 31,849 samples obtained in four screening rounds during 1999, 2003, 2009 and 2013. ACTA ACUST UNITED AC 2015; 20:21144. [PMID: 26062646 DOI: 10.2807/1560-7917.es2015.20.22.21144] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The majority of people infected with hepatitis C virus (HCV) are unaware of their infection. Assessment of the prevalence of HCV infection in the general population and in key populations at increased risk is needed for evidence-based testing policies. Our objectives were to estimate the prevalence of antibodies to HCV (anti-HCV), the prevalence of HCV viraemia (HCV RNA), and to describe HCV genotype distribution among pregnant women in Slovenia. Unlinked anonymous testing was performed on residual sera obtained from 31,849 pregnant women for routine syphilis screening during 1999, 2003, 2009, and 2013. Anti-HCV reactive specimens were tested for HCV RNA and HCV genotypes were determined. Annual prevalence of anti-HCV ranged between 0.09% (95% confidence interval (CI): 0.03–0.18) in 2009 and 0.21% (95% CI: 0.12–0.34) in 2003 and HCV RNA positivity between 0.06% (95% CI: 0.02–0.14) in 2009 and 0.14% (95% CI: 0.07–0.25) in 2003. We observed no statistically significant differences in anti-HCV or HCV RNA prevalence between age groups (<20, 20–29 and ≥30 years) in any year and no trend in time. Of 29 HCV active infections, 19 were with genotype 1 and 10 with genotype 3. HCV infection among pregnant women was rare suggesting a low burden in the Slovenian general population. Antenatal screening for HCV in Slovenia could not be recommended.
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Affiliation(s)
- B Kopilović
- National Institute of Public Health, Ljubljana, Slovenia
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Domingues RMSM, Szwarcwald CL, Souza PRB, Leal MDC. Prenatal testing and prevalence of HIV infection during pregnancy: data from the "Birth in Brazil" study, a national hospital-based study. BMC Infect Dis 2015; 15:100. [PMID: 25880460 PMCID: PMC4346116 DOI: 10.1186/s12879-015-0837-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 02/13/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The rate of vertical HIV transmission has decreased in Brazil, but regional inequalities suggest problems in implementing control measures during pregnancy and delivery. The aims of this study were to ascertain the coverage of HIV testing during prenatal care and estimate the prevalence of HIV infection during pregnancy in Brazil. METHODS This was a national hospital-based study of 23,894 women that was conducted in 2011-2012. The data came from interviews with mothers during postpartum hospitalization, from hospital medical files and from prenatal cards. All the pregnant women with reactive serological results for HIV infection marked on their cards or with diagnoses of HIV infection during the hospital stay for delivery were considered cases of HIV infection. Univariate and multivariable logistic regression were performed to investigate factors associated with the prevalence of HIV infection and with performing at least one HIV test during pregnancy. RESULTS Among participating women, the coverage of testing for HIV infection was 81.7% among those who presented with prenatal card and the prevalence of HIV infection among pregnant women was 0.4% (95% CI: 0.32-0.51%). In the adjusted analysis, there was higher coverage of testing among women living in the South and Southeast regions; of women aged 35 years and over; with greater schooling levels; who self-reported as white; with prenatal care provided in private services; with an early start to prenatal care; and with an adequate number of consultations, defined as a minimum of six for a term pregnancy. In the adjusted analyses there was a greater odds ratio of HIV infection among women living in the South region, aged 35 years and over, with schooling of less than 8 years, who self-reported race as black, without a partner, with syphilis coinfection and who were attended by public services. CONCLUSIONS The prevalence of HIV infection among pregnant women in Brazil remains below 1% and the coverage of testing for HIV infection is over 80%. However, the regional and social inequalities in access to healthcare services and the missed opportunities for diagnoses of HIV infection indicate the importance of strengthening HIV infection control programs during pregnancy.
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Affiliation(s)
| | - Celia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (Icict/Fiocruz), Av. Brasil, 4.365 - Pavilhão Haity Moussatché-Manguinhos, Rio de Janeiro, CEP: 21045-360, Brasil.
| | - Paulo Roberto Borges Souza
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (Icict/Fiocruz), Av. Brasil, 4.365 - Pavilhão Haity Moussatché-Manguinhos, Rio de Janeiro, CEP: 21045-360, Brasil.
| | - Maria do Carmo Leal
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde da Escola Nacional de Saúde Pública Sérgio Arouca/Fiocruz, Rua Leopoldo Bulhões, 1480 Manguinhos, Rio de Janeiro, Brasil.
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El-Ghitany EM, Abdel Wahab MM, Abd El-Wahab EW, Hassouna S, Farghaly AG. A comprehensive hepatitis C virus risk factors meta-analysis (1989-2013): do they differ in Egypt? Liver Int 2015; 35:489-501. [PMID: 24923487 DOI: 10.1111/liv.12617] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 06/05/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS The prevention and control of HCV infection is complex and challenging in terms of describing risk factors and modes of transmission. This meta-analysis was conducted to summarize the best available data on HCV risk factors worldwide and in Egypt. METHODS Through exhaustive literature searches (1989-2013) of HCV risk factors, 357 original eligible articles were included in this study. RESULTS The highest detected risk was intravenous drug users (IDUs) (OR = 9.6) followed by HIV infection (OR = 4.9), having an IDU partner (OR = 4.1), HBV infection (OR = 3.5), Caesarean section (CS) (OR = 3.35), blood transfusion (OR = 3.2) and having an HCV+ partner (OR = 3). Organ transplantation, hospital admission, haemodialysis and having a sexually transmitted infection carry 2.96, 2.4, 2.18 and 2 risks of having HCV respectively. Other significant risk factors included poor education, older age, sharing sharp or blunt objects, MSM, tattooing, hijama, body piercing, minor operations and medical procedures. Some risks showed a decrease over the previous decade, including blood transfusion, organ transplantation, IDUs, IDU partner and CS. Others showed rising risks, including having an HCV+ partner, MSM and suffering from STI. In Egypt, male gender, rural residence, acupuncture and receiving parenteral antischistosomal treatment were significant risks, while neither HIV nor HBV were found to carry a risk of HCV infection. CONCLUSION Blood transfusion, organ transplantation, CS, IDUs, haemodialysis, minor operations and medical procedures are established risk factors. Attention and urgent intervention should be given to the sexual route of transmission, as well as that through minor operations and medical procedures.
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Affiliation(s)
- Engy Mohamed El-Ghitany
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Khamis HH, Farghaly AG, Shatat HZ, El-Ghitany EM. Prevalence of hepatitis C virus infection among pregnant women in a rural district in Egypt. Trop Doct 2014; 46:21-7. [PMID: 25515736 DOI: 10.1177/0049475514561330] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Egypt has the highest prevalence of hepatitis C virus (HCV) infection in the world. Screening of HCV during pregnancy is not as routinely done in Egypt compared with many other countries, although pregnancy is an important period where screening of HCV infection is important owing to low immunity, the possibility of vertical transmission and possible horizontal transmission to the baby or other household contacts at a later stage. AIM To determine the seroprevalence of HCV antibodies (HCV-Ab) and risk factors associated with infection among pregnant women in Egypt. PATIENTS AND METHOD A total of 360 pregnant women visiting the healthcare units for routine antenatal care were tested using third generation ELISA test for detection of HCV-Ab. Polymerase chain reaction (PCR) was done for seropositive cases. RESULTS A total of 6.1% (22/360) of pregnant women were HCV seropositive; of them only 45% (9/20) had viraemia. Risk factors were their age, the age of their husband and the presence of chronic liver disease in the husband. CONCLUSION The prevalence of HCV infection in pregnant women in Egypt appears to be lower than previously reported. The detected risk factors are old age of the pregnant women and their husbands, and chronic liver disease in the husbands. None of the other known risk factors was found to be significantly associated with HCV infection in pregnant women.
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Affiliation(s)
| | - Azza Galal Farghaly
- Professor, Tropical Health Department, Tropical Health High Institute of Public Health, University of Alexandria, Alexandria, Egypt
| | - Hanan Zakaria Shatat
- Professor, Tropical Health Department of Tropical Health, High Institute of Public Health, University of Alexandria, Alexandria, Egypt
| | - Engy Mohamed El-Ghitany
- Assistant Professor, Tropical Health Department, Tropical Health High Institute of Public Health, University of Alexandria, Alexandria, Egypt
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18
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Fernandes CNDS, Alves MDM, Souza MLD, Machado GA, Couto G, Evangelista RA. Prevalence of hepatitis B and C seropositivity in pregnant women. Rev Esc Enferm USP 2014; 48:91-8. [DOI: 10.1590/s0080-623420140000100011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 10/03/2013] [Indexed: 11/22/2022] Open
Abstract
The aim of the study was to identify the prevalence of hepatitis B and C seropositivity in pregnant women attended in a public maternity hospital located in Catalao-GO from 2005 to 2009. Descriptive, exploratory study conducted through patients` hospital records. For data analysis, we used SPSS version 18.0. The confidence interval (CI) was calculated using the Person χ² test, considering a significance level of 5% (p <0.05). The prevalence of HBV was 5.64% and HCV 0.098%, predominantly in young pregnant women aged between 20 and 30 years old, single and in their first pregnancy.
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Zuure FR, Urbanus AT, Langendam MW, Helsper CW, van den Berg CHSB, Davidovich U, Prins M. Outcomes of hepatitis C screening programs targeted at risk groups hidden in the general population: a systematic review. BMC Public Health 2014; 14:66. [PMID: 24450797 PMCID: PMC4016146 DOI: 10.1186/1471-2458-14-66] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 01/10/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Effective screening programs are urgently needed to provide undiagnosed hepatitis C virus (HCV)-infected individuals with therapy. This systematic review of characteristics and outcomes of screening programs for HCV focuses on strategies to identify HCV risk groups hidden in the general population. METHODS We conducted a comprehensive search of MEDLINE and EMBASE databases for articles published between 1991-2010, including studies that screened the general population using either a newly developed (nonintegrated) screening program or one integrated in existing health care facilities. Look-back studies, prevalence studies, and programs targeting high-risk groups in care (e.g., current drug users) were excluded. RESULTS After reviewing 7052 studies, we identified 67 screening programs: 24 nonintegrated; 41 programs integrated in a variety of health care facilities (e.g., general practitioner); and 2 programs with both integrated and nonintegrated strategies. Together, these programs identified approximately 25,700 HCV-infected individuals. In general, higher HCV prevalence was found in programs in countries with intermediate to high HCV prevalence, in psychiatric clinics, and in programs that used a prescreening selection based on HCV risk factors. Only 6 programs used a comparison group for evaluation purposes, and 1 program used theory about effective promotion for screening. Comparison of the programs and their effectiveness was hampered by lack of reported data on program characteristics, clinical follow-up, and type of diagnostic test. CONCLUSIONS A prescreening selection based on risk factors can increase the efficiency of screening in low-prevalence populations, and we need programs with comparison groups to evaluate effectiveness. Also, program characteristics such as type of diagnostic test, screening uptake, and clinical outcomes should be reported systematically.
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Affiliation(s)
- Freke R Zuure
- Public Health Service of Amsterdam, the Netherlands, Infectious Diseases Cluster, P.O. Box 2200, Amsterdam 1000 CE, The Netherlands
| | - Anouk T Urbanus
- Public Health Service of Amsterdam, the Netherlands, Infectious Diseases Cluster, P.O. Box 2200, Amsterdam 1000 CE, The Netherlands
- Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (University of Amsterdam), P.O. Box 22660, Amsterdam 1100 DD, The Netherlands
| | - Miranda W Langendam
- Dutch Cochrane Centre, Academic Medical Center, P.O. Box 22660, Amsterdam 1100 DD, The Netherlands
| | - Charles W Helsper
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, Utrecht 3508 GA, The Netherlands
| | - Charlotte HSB van den Berg
- Public Health Service of Amsterdam, the Netherlands, Infectious Diseases Cluster, P.O. Box 2200, Amsterdam 1000 CE, The Netherlands
- Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (University of Amsterdam), P.O. Box 22660, Amsterdam 1100 DD, The Netherlands
| | - Udi Davidovich
- Public Health Service of Amsterdam, the Netherlands, Infectious Diseases Cluster, P.O. Box 2200, Amsterdam 1000 CE, The Netherlands
| | - Maria Prins
- Public Health Service of Amsterdam, the Netherlands, Infectious Diseases Cluster, P.O. Box 2200, Amsterdam 1000 CE, The Netherlands
- Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (University of Amsterdam), P.O. Box 22660, Amsterdam 1100 DD, The Netherlands
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Costa ZB, Stefani MMDA, de Lima YAR, de Souza WV, de Siqueira Filha NT, Turchi MD, Borges WC, Filho CG, Filho JVM, Minuzzi AL, Martelli CMT. Estimated incidence and genotypes of HIV-1 among pregnant women in central Brazil. PLoS One 2013; 8:e79189. [PMID: 24223904 PMCID: PMC3817037 DOI: 10.1371/journal.pone.0079189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 09/24/2013] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To estimate the incidence of HIV-1 infection among pregnant women from central-western Brazil. DESIGN Observational cross-sectional study. METHODS A total of 54,139 pregnant women received antenatal HIV screening from a network of public healthcare centers in 2011. The incidence of confirmed HIV-1 infection was estimated using the Serological Testing Algorithms for Recent HIV Seroconversion (STARHS) methodology and BED-capture enzyme immunoassay (BED-CEIA). The yearly incidence was calculated, and adjusted incidence rates were estimated. For a subgroup of patients, protease and partial reverse transcriptase regions were retrotranscribed from plasma HIV-1 RNA and sequenced after performing a nested polymerase chain reaction. RESULTS Of the participants, 20% had a pregnancy before the age of 18 and approximately 40% were experiencing their first pregnancy. Of the 54,139 pregnant women screened, 86 had a confirmed HIV-1 diagnosis, yielding an overall prevalence of 1.59 cases per 1000 women (95% CI 1.27-1.96). A higher prevalence was detected in the older age groups, reflecting cumulative exposure to the virus over time. Among the infected pregnant women, 20% were considered recently infected according to the BED-CEIA. The estimated incidence of HIV infection was 0.61 per 1000 person-years (95% CI 0.33-0.89); the corrected incidence was 0.47 per 1000 person-years (95% CI 0.26-0.68). In a subgroup of patients, HIV-1 subtype C (16.7%) was the second most prevalent form after subtype B (66.7%); BF1 recombinants (11.1%) and one case of subtype F1 (5.5%) were also detected. CONCLUSION This study highlights the potential for deriving incidence estimates from a large antenatal screening program for HIV. The rate of recent HIV-1 infection among women in their early reproductive years is a public health warning to implement preventive measures.
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Affiliation(s)
| | | | | | | | | | - Marilia Dalva Turchi
- Institute of Tropical Medicine and Public Health / Federal University of Goias, Goias, Brazil
| | | | | | | | - Ana Lucia Minuzzi
- Associacao de Pais e Amigos dos Excepcionais de Goiania - APAE, Goias, Brazil
| | - Celina Maria Turchi Martelli
- Institute of Tropical Medicine and Public Health / Federal University of Goias, Goias, Brazil
- Faculty of Medicine / Federal University of Pernambuco, Pernambuco, Brazil
- * E-mail:
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Barros LAS, Pessoni GC, Teles SA, Souza SMBD, Matos MAD, Martins RMB, Del-Rios NHA, Matos MADD, Carneiro MADS. Epidemiology of the viral hepatitis B and C in female prisoners of Metropolitan Regional Prison Complex in the State of Goiás, Central Brazil. Rev Soc Bras Med Trop 2013; 46:24-9. [PMID: 23563821 DOI: 10.1590/0037-868216972013] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 01/11/2013] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Little information regarding hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among Brazilian female prisoners exists. This study investigated the prevalence and risk factors associated with HBV and HCV infections and identified viral genotypes among female prisoners in Goiás, Central Brazil. METHODS Women incarcerated in the largest prison in the State of Goiás were invited to participate in the study. All female prisoners were interviewed and tested for the detection of hepatitis B surface antigen (HBsAg), antibodies against HBsAg (anti-HBs), against hepatitis B core antigen (anti-HBc), and antibody against HCV (anti-HCV) by ELISA. HBsAg and anti-HCV positive samples were tested for HBV DNA and HCV RNA and genotyped, respectively. RESULTS Participants (n = 148; 98.6%) completed the study with an overall HBV prevalence of 18.9%. Age >30 years, a low education level, sex with a sexually transmitted diseases carrier, and a male sexual partner serving in the same penitentiary were associated with HBV infections. Only 24% of the women were anti-HBs positive suggesting previous HBV vaccination. Nine female prisoners (6.1%) were anti-HCV positive. Age >40 years, injecting drug use and length of incarceration were statistically associated with anti-HCV antibodies. Five samples were HCV RNA positive and classified as genotypes 1 (subtypes 1a; n = 3 and 1b; n = 1) and 3 (subtype 3a; n = 1). The HBsAg-reactive sample was HBV DNA positive and genotype A. CONCLUSIONS These findings highlight the necessity of public policies to control hepatitis B and C infections and emphasize the importance of hepatitis B vaccination in prison environments.
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da Costa ZB, de Lima YAR, Martelli CMT, Stefani MMDA. Transmitted HIV resistance among pregnant young women infected with HIV-1 in Brazil. AIDS Patient Care STDS 2013; 27:439-41. [PMID: 23968204 DOI: 10.1089/apc.2012.0448] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Zelma Bernades da Costa
- Department of Dermatology, Tropical Medicine and Public Health, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Brazil
| | - Yanna Andressa Ramos de Lima
- Department of Microbiology, Immunology, Parasitology and Pathology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Brazil
| | - Celina Maria Turchi Martelli
- Department of Dermatology, Tropical Medicine and Public Health, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Brazil
| | - Mariane Martins de Araújo Stefani
- Department of Microbiology, Immunology, Parasitology and Pathology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Brazil
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Kuehlkamp VM, Schuelter-Trevisol F. Prevalence of human immunodeficiency virus/hepatitis C virus co-infection in Brazil and associated factors: a review. Braz J Infect Dis 2013; 17:455-63. [PMID: 23680064 PMCID: PMC9428044 DOI: 10.1016/j.bjid.2012.10.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 10/29/2012] [Accepted: 10/29/2012] [Indexed: 11/18/2022] Open
Abstract
The hepatitis C virus and human immunodeficiency virus share the same transmission routes, which makes co-infection an unfavorable condition for the natural history of both viral diseases. In this context, it should be highlighted that the knowledge of the extent of co-infection and associated risk factors is a vital tool for prevention and control over infectious diseases. The aim of this study was to review the literature, seeking to examine the prevalence of human immunodeficiency virus/hepatitis C virus co-infection reported in studies conducted in Brazil, and identify the main risk factors associated with co-infection. The electronic search was conducted in the Medline, Lilacs and SciELO databases. The following keywords were used: human immunodeficiency virus and Hepatitis C or hepatitis C virus and Brazil. The search led to 376 articles, of which 69 were selected for data extraction. We excluded animal studies, reports or case series, review articles, letters to the editor, other types of hepatitis and those studies in which co-infected patients were intentionally selected for comparison to single infected individuals. As a result, 40 articles were reviewed. The majority of the population in these studies was male (71%) and young adults, with a mean age of 26.7 years. The prevalence of hepatitis C virus co-infection among individuals living with human immunodeficiency virus in the studies conducted in Brazil ranged from 3.3% (serum samples) to 82.4% (drug users), with an average of 20.3%. The findings reveal that the prevalence of human immunodeficiency virus/hepatitis C virus co-infection is highly variable, depending on the characteristics of the study population. Risk factors associated with human immunodeficiency virus/hepatitis C virus co-infection were injection drug use and blood transfusion.
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Tornatore M, Gonçalves CV, Bianchi MS, Germano FN, Garcés AX, Soares MA, Machado ES, de Martinez AMB. Co-infections associated with human immunodeficiency virus type 1 in pregnant women from southern Brazil: high rate of intraepithelial cervical lesions. Mem Inst Oswaldo Cruz 2013; 107:205-10. [PMID: 22415259 DOI: 10.1590/s0074-02762012000200009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Accepted: 10/10/2011] [Indexed: 11/22/2022] Open
Abstract
Human immunodeficiency virus type 1 (HIV-positive) pregnant women require specific prophylactic and therapeutic approaches. The efficacy of established approaches is further challenged by co-infection with other sexually transmitted diseases (STDs). The objective of this study was to determine the prevalence of co-infections in pregnant women infected with different HIV-1 subtypes and to relate these findings, together with additional demographic and clinical parameters, to maternal and infant outcomes. Blood samples from pregnant women were collected and tested for syphilis, hepatitis B virus (HBV) and hepatitis C virus (HCV). Human papillomavirus (HPV) diagnosis was evaluated by the presence of alterations in the cervical epithelium detected through a cytopathological exam. Medical charts provided patient data for the mothers and children. Statistical analyses were conducted with STATA 9.0. We found a prevalence of 10.8% for HCV, 2.3% for chronic HBV, 3.1% for syphilis and 40.8% for HPV. Of those co-infected with HPV, 52.9% presented high-grade intraepithelial lesions or in situ carcinoma. Prematurity, birth weight, Apgar 1' and 5' and Capurro scores were similar between co-infected and non-co-infected women. The presence of other STDs did not impact maternal and concept outcomes. More than half of the patients presenting cervical cytology abnormalities suggestive of HPV had high-grade squamous intraepithelial lesions or cervical cancer, evidencing an alarming rate of these lesions.
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Affiliation(s)
- Michele Tornatore
- Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil
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Marques BLC, Brandão CU, Silva EF, Marques VA, Villela-Nogueira CA, Do Ó KMR, de Paula MT, Lewis-Ximenez LL, Lampe E, Villar LM. Dried blood spot samples: optimization of commercial EIAs for hepatitis C antibody detection and stability under different storage conditions. J Med Virol 2013; 84:1600-7. [PMID: 22930508 DOI: 10.1002/jmv.23379] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study was undertaken to optimize and compare the efficiency of two commercial EIAs for anti-HCV detection (HCV Ab Radim, Pomezzia, Italy and ETI-AB-HCVK-4 DiaSorin, Vercelli, Italy), in dried blood spot (DBS) samples. The long-term stability of anti-HCV on DBS samples stored at three environmental conditions was also evaluated at: 2-8 °C, 20-25 °C, and -20 °C. Paired DBS and serum samples were obtained from individuals with or without anti-HCV. The type of elution buffer, sample and conjugate volume, sample incubation time and cut-off values were evaluated. For both EIAs, a larger sample volume was used, and the cut-off value determined by the manufacturer was employed for Radim EIA; however, ROC curve analysis was used for the DiaSorin EIA. The sensitivity and specificity of Radim EIA on DBS were 97.5% and 99.5%, respectively, and of DiaSorin EIA were 88.9% and 98.9%, respectively. Accurate results were obtained for a period of 117 days using DBS samples stored at all storage conditions, but storage at -20 °C resulted in the lowest variation among the absorbance values. Both EIAs demonstrated the same limit of detection (until dilution of 1:10(4) with estimated viral load of 3.1 × 10(-1) UI/ml), but the Radim EIA was associated with the best performance because a low coefficient of variation was observed in the repetition and reproducibility studies. In conclusion, commercial EIAs can be optimized for anti-HCV detection in DBS samples that are extremely stable at different conditions for more than 100 days.
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Affiliation(s)
- B L C Marques
- Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil
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26
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Caetano KAA, França DDDS, Carneiro MADS, Martins RMB, Stefani MMDA, Kerr LRFS, de Matos MA, Moraes LC, Teles SA. Prevalence and virologic profile of HIV infections among female sex workers in Goiânia City, central Brazil. AIDS Patient Care STDS 2013; 27:1-4. [PMID: 23066700 DOI: 10.1089/apc.2012.0268] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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27
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Identifying newly acquired cases of hepatitis C using surveillance: a literature review. Epidemiol Infect 2012; 140:1925-34. [PMID: 22651915 DOI: 10.1017/s0950268812001033] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Surveillance of newly acquired hepatitis C virus (HCV) infection is crucial for understanding the epidemiology of HCV and informing public health practice. However, monitoring such infections via surveillance systems is challenging because they are commonly asymptomatic. A literature review was conducted to identify methodologies used by HCV surveillance systems to identify newly acquired infections; relevant surveillance systems in 15 countries were identified. Surveillance systems used three main strategies to identify newly acquired infections: (1) asking physicians to classify cases; (2) identifying symptomatic cases or cases with elevated alanine aminotransferases; and (3) identifying cases with documented evidence of anti-HCV antibody seroconversion within a specific time-frame. Case-ascertainment methods varied with greater completeness of data in enhanced compared to passive surveillance systems. Automated systems that extract and link testing data from multiple laboratory and clinic databases may provide an opportunity for collecting testing histories for individuals that is less resource intensive than enhanced surveillance.
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Abstract
Changes in the liver biochemical profile are normal in pregnancy. However, up to 3% to 5% of all pregnancies are complicated by liver dysfunction. It is important that liver disease during pregnancy is recognized because early diagnosis may improve maternal and fetal outcomes, with resultant decreased morbidity and mortality. Liver diseases that occur in pregnancy can be divided into 3 different groups: liver diseases that are unique to pregnancy, liver diseases that are not unique to pregnancy but can be revealed or exacerbated by pregnancy, and liver diseases that are unrelated to but occur coincidentally during pregnancy.
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Affiliation(s)
- Arjmand R Mufti
- Department of Medicine, Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medical Center, IL 60637, USA
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29
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Velu PP, Gravett CA, Roberts TK, Wagner TA, Zhang JSF, Rubens CE, Gravett MG, Campbell H, Rudan I. Epidemiology and aetiology of maternal bacterial and viral infections in low- and middle-income countries. J Glob Health 2011; 1:171-88. [PMID: 23198117 PMCID: PMC3484781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Maternal morbidity and mortality in low- and middle-income countries has remained exceedingly high. However, information on bacterial and viral maternal infections, which are important contributors to poor pregnancy outcomes, is sparse and poorly characterised. This review aims to describe the epidemiology and aetiology of bacterial and viral maternal infections in low- and middle-income countries. METHODS A systematic search of published literature was conducted and data on aetiology and epidemiology of maternal infections was extracted from relevant studies for analysis. Searches were conducted in parallel by two reviewers (using OVID) in the following databases: Medline (1950 to 2010), EMBASE (1980 to 2010) and Global Health (1973 to 2010). RESULTS Data from 158 relevant studies was used to characterise the epidemiology of the 10 most extensively reported maternal infections with the following median prevalence rates: Treponema pallidum (2.6%), Neisseria gonorrhoeae (1.5%), Chlamydia trachomatis (5.8%), Group B Streptococcus (8.6%), bacterial vaginosis (20.9%), hepatitis B virus (4.3%), hepatitis C virus (1.4%), Cytomegalovirus (95.7% past infection), Rubella (8.9% susceptible) and Herpes simplex (20.7%). Large variations in the prevalence of these infections between countries and regions were noted. CONCLUSION This review confirms the suspected high prevalence of maternal bacterial and viral infections and identifies particular diseases and regions requiring urgent attention in public health policy planning, setting research priorities and donor funding towards reducing maternal morbidity and mortality in low- and middle-income countries.
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Affiliation(s)
- Prasad Palani Velu
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK
- Joint first or senior authorship
| | - Courtney A. Gravett
- Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), Seattle Children’s Hospital, Seattle, Washington, USA
- Joint first or senior authorship
| | - Tom K. Roberts
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK
| | - Thor A. Wagner
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Jian Shayne F. Zhang
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK
| | - Craig E. Rubens
- Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), Seattle Children’s Hospital, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
- Joint first or senior authorship
| | - Michael G. Gravett
- Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), Seattle Children’s Hospital, Seattle, Washington, USA
- Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA
- Joint first or senior authorship
| | - Harry Campbell
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK
- Joint first or senior authorship
| | - Igor Rudan
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK
- Joint first or senior authorship
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30
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Gardenal RVC, Figueiró-Filho EA, Luft JL, Paula GLSAD, Vidal FG, Turine Neto P, Souza RAAD. [Hepatitis C and pregnancy: an analysis of factors associated with vertical transmission]. Rev Soc Bras Med Trop 2011; 44:43-7. [PMID: 21340407 DOI: 10.1590/s0037-86822011000100011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 10/06/2010] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Data concerning hepatitis C virus infection during pregnancy in Brazilian medical services are scarce. This study aimed to verify factors associated with vertical transmission (VT) of HCV in pregnant women. METHODS Observational transversal study of pregnant women from Campo Grande, MS, central Brazil, with confirmed reagent serology for HCV infection from 2002 to 2005. Vertical transmission was considered to be positive HCV serology by ELISA, confirmed by PCR, after 18 months of life of the newborn. The factors studied associated with VT were: delivery mode, time of premature rupture of membranes, breastfeeding, blood transfusion history, drug addiction, number of sexual partners and the presence of body tattoos. RESULTS Fifty-eight pregnant women with HCV infection were identified, indicating a prevalence rate of 0.2% (58/31,187). Of these 58 pregnant women,23 (39.6%) fulfilled the inclusion criteria. The VT rate was 13% (3/23), and the most frequent HCV viral subtypes were 1a (53%), 1b (30%), 2b (4%) e 3a (13.0%). Two (8.7%) patients were coinfected with HIV. A significant association (p < 0.05) was observed between VT and high maternal serum viremia (> 2.5 x 10(6)) and VT and the use of illicit drugs by the mother. CONCLUSIONS The present study demonstrates that high serum maternal viremia for HCV and the use of illicit drugs by the mother are associated with vertical transmission of HCV.
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Barreto ML, Teixeira MG, Bastos FI, Ximenes RAA, Barata RB, Rodrigues LC. Successes and failures in the control of infectious diseases in Brazil: social and environmental context, policies, interventions, and research needs. Lancet 2011; 377:1877-89. [PMID: 21561657 DOI: 10.1016/s0140-6736(11)60202-x] [Citation(s) in RCA: 183] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Despite pronounced reductions in the number of deaths due to infectious diseases over the past six decades, infectious diseases are still a public health problem in Brazil. In this report, we discuss the major successes and failures in the control of infectious diseases in Brazil, and identify research needs and policies to further improve control or interrupt transmission. Control of diseases such as cholera, Chagas disease, and those preventable by vaccination has been successful through efficient public policies and concerted efforts from different levels of government and civil society. For these diseases, policies dealt with key determinants (eg, the quality of water and basic sanitation, vector control), provided access to preventive resources (such as vaccines), and successfully integrated health policies with broader social policies. Diseases for which control has failed (such as dengue fever and visceral leishmaniasis) are vector-borne diseases with changing epidemiological profiles and major difficulties in treatment (in the case of dengue fever, no treatment is available). Diseases for which control has been partly successful have complex transmission patterns related to adverse environmental, social, economic, or unknown determinants; are sometimes transmitted by insect vectors that are difficult to control; and are mostly chronic diseases with long infectious periods that require lengthy periods of treatment.
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Affiliation(s)
- Mauricio L Barreto
- Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil.
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Arshad M, El-Kamary SS, Jhaveri R. Hepatitis C virus infection during pregnancy and the newborn period--are they opportunities for treatment? J Viral Hepat 2011; 18:229-36. [PMID: 21392169 DOI: 10.1111/j.1365-2893.2010.01413.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The worldwide prevalence of hepatitis C virus (HCV) infection in pregnant women is estimated to be between 1 and 8% and in children between 0.05% and 5%. While parenteral transmission is still common in children living in developing countries, perinatal transmission is now the leading cause of HCV transmission in developed countries. The absence of an HCV vaccine or approved therapy during pregnancy means that prevention of vertical transmission is still not possible. However, a low vertical transmission rate of 3-5%, a high rate of spontaneous clearance (25-50%) and delayed morbidity have resulted in HCV being overlooked in pregnant women and their infants. Yet a study of the natural history in mothers and children demonstrates that the prognosis of HCV can vary greatly and should be taken seriously. Factors known to increase the risk of perinatal transmission include HIV coinfection and higher maternal viral loads, while elective C-section and withholding breastfeeding have not been demonstrated to reduce vertical transmission. Current guidelines for the diagnosis of persistent perinatal infection require a positive anti-HCV test in infants born to infected mothers after 12 months or two positive HCV RNA tests at least 6 months apart. Current HCV treatment options using pegylated interferon and ribavirin are both unsuitable for use in pregnancy and infancy. However, new agents currently in preclinical phases of development, along with the recently identified association between single-nucleotide polymorphisms within the IL28 gene and treatment response, may serve to create a therapeutic window for these patients.
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Affiliation(s)
- M Arshad
- Division of Infectious Diseases, Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA
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AbdulQawi K, Youssef A, Metwally MA, Ragih I, AbdulHamid M, Shaheen A. Prospective study of prevalence and risk factors for hepatitis C in pregnant Egyptian women and its transmission to their infants. Croat Med J 2010; 51:219-28. [PMID: 20564765 DOI: 10.3325/cmj.2010.51.219] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
AIM To estimate the hepatitis C virus (HCV) vertical transmission rate, the effect of potential risk factors, and the pattern of HCV antibody response and viremia in HCV-infected infants in Benha, Egypt. METHODS A total of 1224 pregnant women who were treated at Benha University Hospital, Egypt, were included in the study. They completed a questionnaire about risk factors for HCV acquisition and suspected risk factors for mother-to-infant transmission and were tested for HCV antibody using a third-generation ELISA test. Women positive for HCV antibody were tested for HCV RNA by polymerase chain reaction. Peripheral blood of infants of positive HCV-RNA women was tested for HCV antibody and HCV-RNA at 1 and after 6 months of age. RESULTS Out of 1224 pregnant women, 105 (8.6%; 95% confidence interval, 7.05-10.17) were positive for HCV antibody. Only 83 (6.8%; 5.39-7.21) were positive for HCV-RNA. HCV infection was associated with older age (1.16; 1.1-1.2, P=0.001), blood transfusion (2.69; 1.2-6.0, P=0.016), and HCV infection of the husband (5.47; 1.4-21, P=0.014) or other household members (2.29; 1.2-4.6, P=0.019). Out of 53 infants tested at first month, 43 (81%; 71-92%) were positive for HCV antibody, but only 7 (13%; 4.1-22%) were positive for HCV-RNA. After 6 months, only 2 (3.8%; 0-8.95%) remained positive for HCV RNA. CONCLUSIONS The prevalence of HCV in pregnant women in Egypt is lower than previously reported and the potential risk factors associated with HCV infection suggest intra-familial transmission. The frequency of vertical transmission of HCV in Egypt is not substantially different from other countries and does not play a role in the high prevalence of HCV in Egypt.
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Affiliation(s)
- Khaled AbdulQawi
- Department of Pediatrics, Benha University, 2 Saad Zaghloul st, Benha, PO Box:113, Qualyabia governorate, Egypt.
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Rauf A, Nadeem MS, Ali A, Iqbal M, Mustafa M, Latif MM, Latif MZ, Ahmed N, Shakoori AR. Prevalence of hepatitis B and C in internally displaced persons of war against terrorism in Swat, Pakistan. Eur J Public Health 2010; 21:638-42. [PMID: 20601693 DOI: 10.1093/eurpub/ckq084] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Hepatitis B and C are the most common blood-borne liver infections worldwide. According to the recent estimates, 270-300 million people worldwide are infected with hepatitis C virus (HCV) and more than 2 billion people have been infected with the hepatitis B virus (HBV). Transmission of these viruses is carried out by exposure to infectious blood or body fluids containing blood. METHODS Five-hundred and ninety (290 males and 300 females, 5-65 years) internally displaced persons (IDPs) from Swat area of northern Pakistan were screened for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies using immune-chromatography kits. The subjects, positive for virus-related antibody, were further confirmed for viral RNA (for HCV) and DNA (for HBV) in the blood by polymerase chain reaction (PCR) amplification. The virus of PCR-confirmed HCV-individuals was further genotyped and the prevalence of HCV infection was determined with respect to age, sex, history of exposure to blood or surgical operation and different types of liver diseases. RESULTS The HCV infection was found to be the predominant liver infection in the population which was 91% of the positive cases, as against 9% of HBV. Among the HCV-positive subjects (68% females, 32% males) 56% were asymptomatic. No co-incidence of HBV and HCV was found in any subject. Genotype 3a was the dominant strain of HCV followed by 2a > 3b > 1b > 1a, 2b. CONCLUSION The viral hepatitis among the apparently healthy population of a relatively natural and pollution free environment refers to an alarming condition about liver infections, particularly of HCV, in Pakistan.
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Affiliation(s)
- Abdul Rauf
- School of Biological Sciences, University of the Punjab, Quaid-e-Azam Campus, Lahore 54590, Pakistan.
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Mboto CI, Andy IE, Eni OI, Jewell AP. Prevalence, sociodemographic characteristics and risk factors for hepatitis C infection among pregnant women in Calabar municipality, Nigeria. HEPATITIS MONTHLY 2010; 10:116-20. [PMID: 22312384 PMCID: PMC3270354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2010] [Revised: 03/22/2010] [Accepted: 03/23/2010] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS The epidemiology and risk factors for hepatitis C virus (HCV) infection in developing countries where intravenous drug use (IDU) is uncommon its poorly understood. This study therefore aims to determine the prevalence of HCV and its associated risk factors among pregnant women in Calabar municipality. METHODS A total of 506 out of 716 antenatal care (ANC) patients seen at the General Hospital, Mary Slessor Avenue, Calabar between August and November 2005 and the University of Calabar Teaching Hospital (UCTH) between October and November 2005 were evaluated for their HCV status using the One Step HCV Test kit (Binomial diagnostics, UK), with reference to the subjects' demographic and behavioural risk factors. RESULTS HCV prevalence was determined to be 0.4% (2/506) and was only seen in women aged 38 years and over. Histories of blood transfusion, surgery, involvement in polygamous marriage, sharing of a toothbrush and female circumcision were all non-significant risk factors for the infecion. CONCLUSIONS This study reveals a low HCV prevalence among pregnant women in Calabar municipality with no identifiable risk factor. The study calls for a re-evaluation of the transmission modes of HCV especially in developing countries where intravenous drug use is rare.
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Affiliation(s)
- Clement Ibi Mboto
- Department of Microbiology, Faculty of Science, University of Calabar, Calabar, Nigeria,Corresponding author at: Clement Ibi Mboto, Department of Microbiology, Faculty of Science, University of Calabar, PMB 1115, Calabar, Cross River State, Calabar, Nigeria. Tel.: +234-8037818412, E-mail:
| | - Iniobong Ebenge Andy
- Department of Microbiology, Faculty of Science, University of Calabar, Calabar, Nigeria
| | - Ogban Ibor Eni
- Department of Pathology, General Hospital of Calabar, Calabar, Nigeria
| | - Andrew Paul Jewell
- Faculty of Health and Social Care Sciences, Kingston University and St George’s, University of London, London, UK
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