Etti Melanie, Davies Hannah G, Amone Alexander, Kyohere Mary, Tusubira Valerie, Burt Jessica, O'Hara Geraldine, Matovu Godfrey, Peacock Joseph, Nakimuli Annettee, Musoke Philippa, Sekikubo Musa, Le Doare Kirsty
Institute for Infection and Immunity, St George's, University of London, London, United Kingdom.
Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda.
Open Forum Infect Dis. 2025 Mar 10;11(Suppl 3):S193-S199. doi: 10.1093/ofid/ofae603. eCollection 2024 Dec.
Hepatitis B virus (HBV) infection is a significant cause of morbidity and mortality globally. The World Health Organization estimates that just 10.5% of individuals living with HBV globally are aware of their status. Antenatal care provides an opportunity to screen pregnant women for HBV and to treat those who are eligible to reduce the risk of vertical transmission. We conducted an observational study to determine the proportion of pregnant women with active HBV infection delivering at a government-funded hospital in Kampala, Uganda, to estimate the number of missed opportunities to prevent vertical transmission.
Eligible participants were enrolled via the PROGRESS study, an observational cohort study undertaken in Kampala, Uganda, between November 2018 and April 2021. Results presented here describe data from April 2019 to November 2020. Five milliliters of venous blood was drawn shortly after delivery. Serum aliquots were analyzed for hepatitis B surface antigen (HBsAg). HBsAg-positive participants were informed of their result by telephone and referred to the gastroenterology service for specialist management.
In total, 6062 women were enrolled between April 2019 and November 2020. Results were available for 6012 (99.6%) participants, among whom 131 (2.2%) were HBsAg positive. Only 10 of 131 (7.6%) HBsAg-positive participants were successfully referred to the gastroenterology service at Mulago Hospital for treatment of their infection.
Our study identified a number of missed opportunities to identify active HBV infection among our pregnant cohort. Additional resources are urgently required to increase the coverage of antenatal HBV screening while also improving treatment pathways for pregnant women with HBV infection in this region.
乙型肝炎病毒（HBV）感染是全球发病和死亡的一个重要原因。世界卫生组织估计，全球感染HBV的人中只有10.5%知晓自己的感染状况。产前检查为筛查孕妇是否感染HBV以及治疗符合条件的孕妇提供了机会，以降低垂直传播的风险。我们进行了一项观察性研究，以确定在乌干达坎帕拉一家政府资助医院分娩的活动性HBV感染孕妇的比例，估计预防垂直传播错失的机会数量。
符合条件的参与者通过“进展”研究招募，这是一项于2018年11月至2021年4月在乌干达坎帕拉进行的观察性队列研究。此处呈现的结果描述了2019年4月至2020年11月的数据。分娩后不久采集5毫升静脉血。对血清样本进行乙型肝炎表面抗原（HBsAg）分析。通过电话将HBsAg阳性参与者的结果告知他们，并将其转诊至胃肠病科接受专科治疗。
2019年4月至2020年11月期间共招募了6062名女性。6012名（99.6%）参与者有结果，其中131名（2.2%）HBsAg呈阳性。131名HBsAg阳性参与者中只有10名（7.6%）成功转诊至穆拉戈医院胃肠病科接受感染治疗。
我们的研究发现了在我们的孕妇队列中识别活动性HBV感染的一些错失机会。迫切需要额外资源以提高产前HBV筛查的覆盖率，同时改善该地区HBV感染孕妇的治疗途径。
