撒哈拉以南非洲和南亚地区孕妇及脐带血乙型肝炎表面抗原阳性新生儿中乙型肝炎病毒感染的患病率。

Prevalence of hepatitis B virus infection among pregnant women and cord blood hepatitis B surface antigen positive newborns in sub-Saharan Africa and South Asia.

作者信息

Bokop Carine, Dhar Nisha, Izu Alane, Thaver-Kleitman Jayendrie, Prabdial-Sing Nishi, Ali Musa Mohammed, Akaba Godwin, Barsosio Hellen C, Berkley James A, Beck Manisha Madhai, Chaka Tolossa E, Cutland Clare L, Dorji Phurb, Islam Maksuda, Keita Adama Mamby, Lema Feleke Belachew, Medugu Nubwa, Mwakio Stella, Obaro Stephen, Olateju Eyinade K, Sahni Rani Diana, Saha Samir K, Santhanam Sridhar, Sharma Ragunath, Sigaúque Betuel, Simoes Eric A F, Sow Samba O, Tapia Milagritos D, Veeraraghavan Balaji, Kwatra Gaurav, Madhi Shabir A

机构信息

South Africa Medical Research Council Vaccines and Infectious Diseases Analytics Research unit, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa.

South Africa Medical Research Council Vaccines and Infectious Diseases Analytics Research unit, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa; Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

出版信息

J Clin Virol. 2025 Jun 11;179:105826. doi: 10.1016/j.jcv.2025.105826.

DOI:10.1016/j.jcv.2025.105826

PMID:40532465

Abstract

BACKGROUND

Newborns infected with Hepatitis B Virus (HBV) are at risk of chronic liver disease and hepatocellular carcinoma.

OBJECTIVES

This study investigated the prevalence of HBV infection among pregnant women and cord blood Hepatitis B surface antigen (HBsAg) positivity of their newborns in Bangladesh, Bhutan, India, Ethiopia, Mozambique, Kenya, Nigeria, Mali, and South Africa.

STUDY DESIGN

Randomly selected paired maternal and cord blood samples (n = 101 each site) taken at delivery were tested for HBsAg and Hepatitis B extractable antigen (HBeAg) in the women using a chemiluminescent microparticle immunoassay. Similarly, cord blood sample of newborn was assessed for HBsAg reactivity. HBV DNA was quantified using the Xpert® HBV viral load assay, followed by genotyping.

RESULTS

The overall prevalence of maternal HBsAg positivity was 5.5 % (95 %CI: 0.4 %-7.1 %; n = 50/909). HBsAg positivity was higher in African countries (7.3 %; 95 %CI: 5.4 %-9.6 %; n = 44/606) compared to South Asian countries (2.0 %; 95 %CI: 0.8 %-4.3 %; n = 6/303; p = 0.002). Relative to South Africa, there were higher odds of HBsAg sero-positivity in women from Mozambique ((aOR): 7.7, 95 %CI: 1.6 %-37.8 %) and Mali (aOR: 5.7; 95 %CI: 1.1 %-29.7 %). The rate of HBsAg positivity in cord blood of babies born to HBsAg positive women was 28.0 % (95 %CI: 17.1 %-42.3 %; n = 14/50), including 31.8 % (95 %CI: 19.5-47.4 %; n = 14/44) in African countries. No cord blood HBsAg positivity was observed in South Asia. Genotypic analysis revealed HBV genotypes A (41.7 %) and E (58.3 %) were pre-dominant.

CONCLUSION

The high rate of cord blood positivity (28.0 %) for HBsAg underscores the urgency of enhancing HBV prevention strategies to meet the World Health Organization's target of a 90 % reduction in new HBV infections by 2030.

摘要

背景

感染乙型肝炎病毒（HBV）的新生儿有患慢性肝病和肝细胞癌的风险。

目的

本研究调查了孟加拉国、不丹、印度、埃塞俄比亚、莫桑比克、肯尼亚、尼日利亚、马里和南非孕妇中HBV感染的患病率及其新生儿脐带血乙型肝炎表面抗原（HBsAg）阳性率。

研究设计

在分娩时随机采集配对的产妇和脐带血样本（每个地点n = 101），使用化学发光微粒免疫分析法检测产妇的HBsAg和乙型肝炎可提取抗原（HBeAg）。同样，评估新生儿脐带血样本的HBsAg反应性。使用Xpert® HBV病毒载量测定法对HBV DNA进行定量，然后进行基因分型。

结果

产妇HBsAg阳性的总体患病率为5.5%（95%CI：0.4% - 7.1%；n = 50/909）。与南亚国家（2.0%；95%CI：0.8% - 4.3%；n = 6/303；p = 0.002）相比，非洲国家的HBsAg阳性率更高（7.3%；95%CI：5.4% - 9.6%；n = 44/606）。相对于南非，莫桑比克（调整后比值比（aOR）：7.7，95%CI：1.6% - 37.8%）和马里（aOR：5.7；95%CI：1.1% - 29.7%）的女性HBsAg血清阳性几率更高。HBsAg阳性女性所生婴儿的脐带血中HBsAg阳性率为28.0%（95%CI：17.1% - 42.3%；n = 14/50），其中非洲国家为31.8%（95%CI：19.5 - 47.4%；n = 14/44）。在南亚未观察到脐带血HBsAg阳性。基因分析显示HBV基因型A（41.7%）和E（58.3%）占主导。