TY - JOUR
T1 - Hepatitis B Virus Prevalence and Transmission in the Households of Pregnant Women in Kinshasa, Democratic Republic of Congo
AU - Morgan, Camille E.
AU - Ngimbi, Patrick
AU - Boisson-Walsh, Alix J.N.
AU - Ntambua, Sarah
AU - Matondo, Jolie
AU - Tabala, Martine
AU - Kashamuka, Melchior Mwandagalirwa
AU - Emch, Michael
AU - Edwards, Jessie K.
AU - Powers, Kimberly A.
AU - James, Linda
AU - Mbonze, Nana
AU - Mampunza, Samuel
AU - Yotebieng, Marcel
AU - Thompson, Peyton
AU - Parr, Jonathan B.
N1 - Publisher Copyright:
© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
PY - 2024/4/1
Y1 - 2024/4/1
N2 - Background. The World Health Organization Africa region has high regional hepatitis B virus (HBV) prevalence, and evidence suggests more frequent horizontal HBV transmission than other regions. Context-specific epidemiological studies are needed to inform additional HBV prevention measures. Methods. In the cross-sectional Horizontal and Vertical Transmission of Hepatitis B (HOVER-HBV) study, we introduced HBV surface antigen (HBsAg) screening alongside existing HIV screening as part of routine antenatal care in high-volume maternity clinics in Kinshasa, Democratic Republic of Congo. We recruited households of pregnant women (“index mothers”) who were HBsAg-positive and HBsAg-negative, defining households as index-positive and index-negative, respectively. Household members underwent HBsAg testing and an epidemiological survey. We evaluated HBsAg prevalence and potential transmission correlates. Results. We enrolled 1006 participants from 200 households (100 index-positive, 100 index-negative) across Kinshasa. HBsAg-positivity prevalence was more than twice as high in index-positive households (5.0% [95% confidence interval {CI}, 2.8%–7.1%]) as in index-negative households (1.9% [95% CI, .6%–3.2%]). HBsAg-positivity prevalence was 3.3 (95% CI, .9–11.8) times as high among direct offspring in index-positive versus index-negative households. Factors associated with HBsAg positivity included older age, marriage, and having multiple recent partners or any new sexual partners among index mothers; and older age, lower household wealth, sharing nail clippers, and using street salons among offspring in index-positive households. Conclusions. Vertical and horizontal HBV transmission within households is ongoing in Kinshasa. Factors associated with infection reveal opportunities for HBV prevention efforts, including perinatal prevention, protection during sexual contact, and sanitation of shared personal items.
AB - Background. The World Health Organization Africa region has high regional hepatitis B virus (HBV) prevalence, and evidence suggests more frequent horizontal HBV transmission than other regions. Context-specific epidemiological studies are needed to inform additional HBV prevention measures. Methods. In the cross-sectional Horizontal and Vertical Transmission of Hepatitis B (HOVER-HBV) study, we introduced HBV surface antigen (HBsAg) screening alongside existing HIV screening as part of routine antenatal care in high-volume maternity clinics in Kinshasa, Democratic Republic of Congo. We recruited households of pregnant women (“index mothers”) who were HBsAg-positive and HBsAg-negative, defining households as index-positive and index-negative, respectively. Household members underwent HBsAg testing and an epidemiological survey. We evaluated HBsAg prevalence and potential transmission correlates. Results. We enrolled 1006 participants from 200 households (100 index-positive, 100 index-negative) across Kinshasa. HBsAg-positivity prevalence was more than twice as high in index-positive households (5.0% [95% confidence interval {CI}, 2.8%–7.1%]) as in index-negative households (1.9% [95% CI, .6%–3.2%]). HBsAg-positivity prevalence was 3.3 (95% CI, .9–11.8) times as high among direct offspring in index-positive versus index-negative households. Factors associated with HBsAg positivity included older age, marriage, and having multiple recent partners or any new sexual partners among index mothers; and older age, lower household wealth, sharing nail clippers, and using street salons among offspring in index-positive households. Conclusions. Vertical and horizontal HBV transmission within households is ongoing in Kinshasa. Factors associated with infection reveal opportunities for HBV prevention efforts, including perinatal prevention, protection during sexual contact, and sanitation of shared personal items.
KW - HBV
KW - horizontal transmission
KW - prevention of mother-to-child transmission (PMTCT)
KW - vertical transmission
KW - viral hepatitis
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U2 - 10.1093/ofid/ofae150
DO - 10.1093/ofid/ofae150
M3 - Article
AN - SCOPUS:85191846081
SN - 2328-8957
VL - 11
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 4
M1 - ofae150
ER -
