The epidemiology of hepatitis B virus infection in HIV-infected and HIV-uninfected pregnant women in the Western Cape, South Africa
Author(s)
Type
Journal Article
Abstract
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 × 107 IU/ml and in the HIV-uninfected group 1.19 × 106 IU/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.
Date Issued
2013-11-12
Date Acceptance
2013-08-09
ISSN
0264-410X
Publisher
Elsevier
Start Page
5579
End Page
5584
Journal / Book Title
Vaccine
Volume
31
Issue
47
Copyright Statement
© 2013 The Authors. Published by Elsevier Ltd. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-No Derivative Works License, which permits
non-commercial use, distribution, and reproduction in any medium, provided the
original author and source are credited.
non-commercial use, distribution, and reproduction in any medium, provided the
original author and source are credited.
Identifier
https://www.sciencedirect.com/science/article/pii/S0264410X13011195?via%3Dihub
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000327419800013&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Immunology
Medicine, Research & Experimental
Research & Experimental Medicine
HBV
HIV
Antenatal
Virus escape
Sub-Saharan Africa
NATURAL-HISTORY
HOMOSEXUAL-MEN
VACCINE
TRANSMISSION
PREVALENCE
EXPOSURE
THERAPY
RISK
Antenatal
HBV
HIV
Sub-Saharan Africa
Virus escape
Adolescent
Adult
Anti-Retroviral Agents
Child
Cross-Sectional Studies
Female
Genotype
HIV Infections
Hepatitis B
Hepatitis B Surface Antigens
Hepatitis D
Humans
Mass Spectrometry
Pregnancy
Pregnancy Complications, Infectious
Retrospective Studies
Sequence Analysis, DNA
South Africa
Viral Load
Young Adult
Humans
Pregnancy Complications, Infectious
Hepatitis B
Hepatitis D
HIV Infections
Hepatitis B Surface Antigens
Anti-Retroviral Agents
Viral Load
Retrospective Studies
Cross-Sectional Studies
Sequence Analysis, DNA
Pregnancy
Genotype
Adolescent
Adult
Child
South Africa
Female
Mass Spectrometry
Young Adult
Science & Technology
Life Sciences & Biomedicine
Immunology
Medicine, Research & Experimental
Research & Experimental Medicine
HBV
HIV
Antenatal
Virus escape
Sub-Saharan Africa
NATURAL-HISTORY
HOMOSEXUAL-MEN
VACCINE
TRANSMISSION
PREVALENCE
EXPOSURE
THERAPY
RISK
Virology
06 Biological Sciences
07 Agricultural and Veterinary Sciences
11 Medical and Health Sciences
Publication Status
Published
Date Publish Online
2013-08-21