Residual risk of mother-to-child transmission of HBV despite timely Hepatitis B vaccination: a major challenge to eliminate hepatitis B infection in Cambodia

被引：9

作者：

Bunthen, E. ^{[1
,2
]}

Ko, Ko ^{[1
]}

Kim, Rattana ^{[3
]}

Nagashima, Shintaro ^{[1
]}

Ouoba, Serge ^{[1
,4
]}

Hussain, Md Razeen Ashraf ^{[1
]}

Sato, Tomoki ^{[5
]}

Chuon, Channarena ^{[6
]}

Abe, Kanon ^{[1
]}

Sugiyama, Aya ^{[1
]}

Takahashi, Kazuaki ^{[1
]}

Akita, Tomoyuki ^{[1
]}

Tung, Rathavy ^{[7
]}

Ork, Vichit ^{[8
]}

Hossain, Md. Shafiqul ^{[9
]}

Saphonn, Vonthanak ^{[10
]}

Tanaka, Junko ^{[1
]}

机构：

[1] Hiroshima Univ, Grad Sch Biomed & Hlth Sci, Dept Epidemiol Infect Dis Control & Prevent, 1-2-3, Kasumi, Minami Ku, Hiroshima 7348551, Japan

[2] Payment Certificat Agcy PCA, Minist Hlth, Phnom Penh, Cambodia

[3] Natl Maternal & Child Hlth Ctr NMCHC, Minist Hlth, Phnom Penh, Cambodia

[4] Inst Rech Sci La Sante IRSS, Unite Rech Clin Nanoro URCN, Nanoro, Burkina Faso

[5] Hiroshima City Funairi Citizens Hosp, Hiroshima, Japan

[6] Doctor Alliance Union Youth Federat Cambodia DAUY, Phnom Penh, Cambodia

[7] Minist Hlth, Phnom Penh, Cambodia

[8] Natl Immunizat Program NIP, Minist Hlth, Phnom Penh, Cambodia

[9] Expanded Program Immunizat, World Hlth Org Country Off, Phnom Penh, Cambodia

[10] Univ Hlth Sci UHS, Phnom Penh, Cambodia

来源：

BMC INFECTIOUS DISEASES | 2023年 / 23卷 / 01期

基金：

日本学术振兴会;

关键词：

Epidemiology; Hepatitis B Virus; Mother-to-child transmission; Prevalence; Pregnant women; HBeAg; Longitudinal study; E-ANTIGEN; INTRAUTERINE TRANSMISSION; VIRUS-INFECTIONS; IMMUNE GLOBULIN; PREGNANT-WOMEN; INTERRUPTION; PREVENTION; MANAGEMENT; MUTATION;

D O I：

10.1186/s12879-023-08249-1

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

BackgroundIn countries with intermediate or high hepatitis B virus (HBV) endemicity, mother-to-child transmission (MTCT) represents the main route of chronic HBV infection. There is a paucity of information on HBV MTCT in Cambodia. This study aimed to investigate the prevalence of HBV infection among pregnant women and its MTCT rate in Siem Reap, Cambodia.MethodsThis longitudinal study included two parts, study-1 to screen HBsAg among pregnant women and study-2 to follow up babies of all HBsAg-positive and one-fourth of HBsAg-negative mothers at their delivery and six-month post-partum. Serum or dried blood spot (DBS) samples were collected to examine HBV sero-markers by chemiluminescent enzyme immunoassay (CLEIA), and molecular analyses were performed on HBsAg-positive samples. Structured questionnaires and medical records were used to examine the risk factors for HBV infection. MTCT rate was calculated by HBsAg positivity of 6-month-old babies born to HBsAg-positive mothers and ascertained by the homology of HBV genomes in mother-child pair at 6-month-old.ResultsA total of 1,565 pregnant women were screened, and HBsAg prevalence was 4.28% (67/1565). HBeAg positivity was 41.8% and was significantly associated with high viral load (p < 0.0001). Excluding subjects who dropped out due to restrictions during COVID-19, one out of 35 babies born to HBsAg-positive mothers tested positive for HBsAg at 6 months of age, despite receiving timely HepB birth dose and HBIG, followed by 3 doses of HepB vaccine. Hence the MTCT rate was 2.86%. The mother of the infected baby was positive for HBeAg and had a high HBV viral load (1.2 x 10(9) copies/mL). HBV genome analysis showed 100% homology between the mother and the child.ConclusionsOur findings illustrate the intermediate endemicity of HBV infection among pregnant women in Siem Reap, Cambodia. Despite full HepB vaccination, a residual risk of HBV MTCT was observed. This finding supports the recently updated guidelines for the prevention of HBV MTCT in 2021, which integrated screening and antiviral prophylaxis for pregnant women at risk of HBV MTCT. Furthermore, we strongly recommend the urgent implementation of these guidelines nationwide to effectively combat HBV in Cambodia.

引用

页数：12