Prospective cohort study of prevention of mother to child transmission of hepatitis B infection and 9 months follow-up of hepatitis B-exposed infants at Ile-Ife, Nigeria
| Autor: | Dennis Ndububa, Oluwafemi Kuti, Ibraheem Awowole, Olusegun Adekanle, Oluwasegun Ijarotimi, Olufemiwa Makinde, Adebanjo Adeyemi, Chineme Anyabolu, Macellina Ijadunola |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Hepatitis B virus Hepatitis B Surface Antigens Infant Newborn Infant Nigeria Immunoglobulins General Medicine Hepatitis B Infectious Disease Transmission Vertical Hepatitis B Chronic Pregnancy DNA Viral Humans Female Hepatitis B Vaccines Hepatitis B e Antigens Prospective Studies Pregnancy Complications Infectious Tenofovir Follow-Up Studies |
| Zdroj: | BMJ open. 12(11) |
| ISSN: | 2044-6055 |
| Popis: | ObjectivesEliminating mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is central to WHO’s target of reducing hepatitis B infection in children to DesignA prospective cohort study.SettingA University Teaching Hospitals Complex in Nigeria between 2015 and 2021.Participants10 866 pregnant women and their pre-existing children.InterventionsEligible pregnant women were screened for HBsAg using chromatographic immunoassay (Micropoint, USA). HbsAg-positive women had HBV serological assay done and their pre-existing children were screened. Women with HBV DNA ≥2 00 000 IU/mL and those positive for hepatitis B e-antigen (HBeAg) had 300 mg/day of Tenofovir Disoproxil Fumarate (TDF) in the third trimester. The newborns had hepatitis B vaccinesand HB immunoglobulin (HBIG) administered, followed by testing for HBsAg at 9 months postnatally.Primary outcome measuresPrevalence of chronic hepatitis B infection in pregnancy, and the incidence of MTCT of HBV.ResultsOverall, 395 women had chronic HBV infection, giving a prevalence of 3.64%. Their mean age was 31.51±5.71 years, with a median parity of 1.2. Thirteen women (5.2%) were positive for HBeAg, seven (3.1%) of the 225 pre-existing hepatitis B-exposed children were HbsAg positive and 17 women had prenatal TDF. Overall, 376 women completed the study, with mean birth weight of 3.21±1.86 kg and perinatal mortality rate of 29.2/1000 births. Hepatitis Bvaccine-HBIG combination was administered to 260 newborns, while the others had hepatitis B vaccine alone. All the children tested negative to the HbsAg at 9 months.ConclusionEliminating MTCT of HBV infection through validated protocols in low and middle income countries with the highest burden of chronic HBV infections is feasible. National scale-up of such protocols is recommended. |
| Databáze: | OpenAIRE |
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