Residual risk of mother-to-child transmission of HBV despite timely Hepatitis B vaccination: a major challenge to eliminate hepatitis B infection in Cambodia
-
Published:2023-04-26
Issue:1
Volume:23
Page:
-
ISSN:1471-2334
-
Container-title:BMC Infectious Diseases
-
language:en
-
Short-container-title:BMC Infect Dis
Author:
E Bunthen,Ko Ko,Kim Rattana,Nagashima Shintaro,Ouoba Serge,Hussain Md Razeen Ashraf,Sato Tomoki,Chuon Channarena,Abe Kanon,Sugiyama Aya,Takahashi Kazuaki,Akita Tomoyuki,Tung Rathavy,Ork Vichit,Hossain Md. Shafiqul,Saphonn Vonthanak,Tanaka Junko
Abstract
Abstract
Background
In countries with intermediate or high hepatitis B virus (HBV) endemicity, mother-to-child transmission (MTCT) represents the main route of chronic HBV infection. There is a paucity of information on HBV MTCT in Cambodia. This study aimed to investigate the prevalence of HBV infection among pregnant women and its MTCT rate in Siem Reap, Cambodia.
Methods
This longitudinal study included two parts, study-1 to screen HBsAg among pregnant women and study-2 to follow up babies of all HBsAg-positive and one-fourth of HBsAg-negative mothers at their delivery and six-month post-partum. Serum or dried blood spot (DBS) samples were collected to examine HBV sero-markers by chemiluminescent enzyme immunoassay (CLEIA), and molecular analyses were performed on HBsAg-positive samples. Structured questionnaires and medical records were used to examine the risk factors for HBV infection. MTCT rate was calculated by HBsAg positivity of 6-month-old babies born to HBsAg-positive mothers and ascertained by the homology of HBV genomes in mother–child pair at 6-month-old.
Results
A total of 1,565 pregnant women were screened, and HBsAg prevalence was 4.28% (67/1565). HBeAg positivity was 41.8% and was significantly associated with high viral load (p < 0.0001). Excluding subjects who dropped out due to restrictions during COVID-19, one out of 35 babies born to HBsAg-positive mothers tested positive for HBsAg at 6 months of age, despite receiving timely HepB birth dose and HBIG, followed by 3 doses of HepB vaccine. Hence the MTCT rate was 2.86%. The mother of the infected baby was positive for HBeAg and had a high HBV viral load (1.2 × 109 copies/mL). HBV genome analysis showed 100% homology between the mother and the child.
Conclusions
Our findings illustrate the intermediate endemicity of HBV infection among pregnant women in Siem Reap, Cambodia. Despite full HepB vaccination, a residual risk of HBV MTCT was observed. This finding supports the recently updated guidelines for the prevention of HBV MTCT in 2021, which integrated screening and antiviral prophylaxis for pregnant women at risk of HBV MTCT. Furthermore, we strongly recommend the urgent implementation of these guidelines nationwide to effectively combat HBV in Cambodia.
Publisher
Springer Science and Business Media LLC
Subject
Infectious Diseases
Reference43 articles.
1. WHO. Global progress report on HIV, viral hepatitis and sexually transmitted infections. Geneva: World Health Organization; 2021.
2. WHO. Fact Sheets: Hepatitis B [Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-b.
3. Immunization dashboard Cambodia: World Health Organization; [Available from: https://immunizationdata.who.int/pages/profiles/khm.html.
4. Ork V, Woodring J, Shafiqul Hossain M, Wasley A, Nagashima S, Yamamoto C, et al. Hepatitis B surface antigen seroprevalence among pre- and post-vaccine cohorts in Cambodia, 2017. Vaccine. 2019;37(35):5059–66.
5. World_Health_Organization. Cambodia achieves national and regional goal for reducing hepatitis B in children [press release]. 2018. https://www.who.int/cambodia/news/detail/08-06-2018-cambodia-achieves-national-and-regional-goal-for-reducing-hepatitis-b-in-children. Accessed 20 Jan 2023.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献