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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
The epidemiology of hepatitis B virus infection in HIV-infected and HIV-uninfected pregnant women in the Western Cape, South Africa
Vaccine, Volume 31, No. 47, Year 2013
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Description
Objectives: Persistent hepatitis B virus (HBV) infection is a major cause of morbidity and mortality in sub-Saharan Africa. The HIV epidemic has the potential to affect its biology. Immunisation protocols established in the pre-HIV era are based upon data showing predominantly horizontal infant transmission. This study aimed to determine whether HIV co-infection will change the epidemiology of HBV both by increasing infectivity and by favouring the escape of viruses bearing phenotypically altered HBsAg. Methods: This retrospective cross-sectional study used antenatal samples from the 2008 Antenatal Sentinel HIV and Syphilis Prevalence Survey in the Western Cape, South Africa. All HIV-infected women were age and race-matched to HIV-uninfected women. Samples were tested for serological markers of HBV and HDV infection. HBV viral load, consensus sequencing and genotyping were performed. Luminex technology was used to determine HBsAg phenotype. All samples from HIV-infected women were tested for traces of antiretroviral drugs by mass spectrometry. Results: This study showed a trend toward loss of immune control of HBV in HIV-infected women with 3.4% of samples containing HBsAg, 18.9% contained HBeAg. In contrast, 2.9% of samples from HIV-uninfected women contained HBsAg and 17.1% of these HBeAg. The median HBV load in the HIV-infected group was 9.72×107IU/ml and in the HIV-uninfected group 1.19×106IU/ml. Genotyping showed 63/68 samples belonged to genotype A and the remainder genotype D. Mutations in the precore region were found in 35% and 33% of samples from HIV-infected and HIV-uninfected respectively. Although no major epitope ablation was found, marked variation in HBsAg profiles in HIV-infected group was demonstrated. No HDV infection was detected. Conclusion: HIV-HBV co-infected women exhibit a degree of immune escape. One in six HBV-infected pregnant women, irrespective of HIV status is HBeAg seropositive. HBV immunization of newborns in sub-Saharan Africa should be implemented. © 2013 The Authors.
Authors & Co-Authors
Andersson, Monique I. Ingrid
South Africa, Stellenbosch
Stellenbosch University
Maponga, Tongai G.
South Africa, Stellenbosch
Stellenbosch University
Ijaz, Samreen
United Kingdom, London
Public Health England
Barnes, Jo M.
South Africa, Stellenbosch
Stellenbosch University
Theron, Gerhard Barnard
South Africa, Stellenbosch
Stellenbosch University
Meredith, Sandra A.
South Africa, Cape Town
University of Cape Town
Preiser, Wolfgang
South Africa, Stellenbosch
Stellenbosch University
Tedder, Richard S.
United Kingdom, London
Public Health England
United Kingdom, London
University College London
Statistics
Citations: 64
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1016/j.vaccine.2013.08.028
ISSN:
0264410X
e-ISSN:
18732518
Research Areas
Genetics And Genomics
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
South Africa
Participants Gender
Female