Viral hepatitis B and C in HIV-exposed South African infants
Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
Background: Whilst much attention is given to eliminating HIV mother-to-child transmission (MTCT), little has been
done to ensure the same for hepatitis B virus (HBV) transmission. The introduction of HBV immunization at six
weeks of age has reduced HBV horizontal transmission in South Africa. However, in order to eliminate HBV MTCT,
further interventions are needed. The risk of hepatitis C virus (HCV) MTCT in HIV-infected (HIV+) African women is
not yet well described. This study aimed to determine the rate of HBV and HCV vertical transmission in HIV-exposed
infants in South Africa.
Methods: Serum samples from infants enrolled in an isoniazid prevention study (P1041) were screened for HBV and
HCV serology markers; screening was performed on samples collected at approximately 60 weeks of age of the
infants. HBV DNA was quantified in HBsAg positive samples and HBV strains characterized through gene
sequencing. All HCV antibody samples with inconclusive results underwent molecular testing.
Results: Three of 821 infants were positive for both HBsAg and HBV DNA. All HBV strains belonged to HBV subgenotype
A1. The rtM204I mutation associated with lamivudine resistance was identified in one infant, a second
infant harboured the double A1762T/G1764A BCP mutation. Phylogenetic analysis showed clustering between
mother and infant viral genomic sequences. Twenty-one of 821 HIV-exposed infants tested had inconclusive HCV
antibody results, none were HCV PCR positive.
Conclusions: This study suggests that HBV vertical transmission is likely to be occurring in HIV-exposed infants in
South Africa.. A more robust strategy of HBV prevention, including birth dose vaccination, is required to eradicate
HBV MTCT. HCV infection was not detected.
Description
CITATION: Tchuem, C. T., et al. 2020. Viral hepatitis B and C in HIV-exposed South African infants, BMC Pediatrics, 20:563, doi:10.1186/s12887-020-02479-x.
The original publication is available at https://bmcpediatr.biomedcentral.com
Publication of this article was funded by the Stellenbosch University Open Access Fund
The original publication is available at https://bmcpediatr.biomedcentral.com
Publication of this article was funded by the Stellenbosch University Open Access Fund
Keywords
Hepatitis, Hepatitis, Viral, HIV (Viruses) infections -- Infants, South Africa
Citation
Tchuem, C. T., et al. 2020. Viral hepatitis B and C in HIV-exposed South African infants, BMC Pediatrics, 20:563, doi:10.1186/s12887-020-02479-x