Advertisement

Pattern and interpretation of hepatitis B virus markers among pregnant women in North East Egypt

  • Rania KishkEmail author
  • Mohamed Mandour
  • Mohamed Elprince
  • Ayman Salem
  • Nader Nemr
  • Mohammed Eida
  • Mostafa Ragheb
Clinical Microbiology - Research Paper
  • 19 Downloads

Abstract

Introduction

Hepatitis B vaccination of newborns (HBV) and surveillance of pregnant women during antenatal care are complementary to prevent mother to child transmission (MTCT) of HBV infection.

Aim

The aim was to identify the prevalence and pattern of HBV infection in pregnant women born before and after implementing HBV vaccination of newborn in Egypt.

Methods

The study included 600 women attended antenatal clinic of the Suez Canal University Hospital, Ismailia, Egypt. All were inquired about risk factors of HBV infection, vaccination, and screened for hepatitis markers. HBsAg carriers were tested for HBeAg, HBeAb, ALT, and HBV DNA. Participants were divided into group 1 of 285 (47.5%) vaccinated women ≤ 25 years, and 315 (52.5%) non-vaccinated > 25 years.

Results

The prevalence of HBcAg, HBsAg, and HBsAb were 18.3%, 5.0%, and 30.7%. Of the 110 women exposed to infection, 40 (36.4%) cleared infection, 30 (27.2%) were HBsAg carriers, and 40 (36.4%) showed isolated HBcAb. HBsAg carriers were HBeAg negative, HBeAb positive, and HBV-DNA positive and had high ALT. Group 1 had significantly higher frequency of vaccination-related immunity, lower frequency of isolated HBcAb, and susceptibles than group 2 (44.9%, 3.5%, and 38.6% vs. 4.1%, 9.5%, and 75.9% ). The prevalence of HBV exposure and chronic HBsAb carriers in both groups were close (4.9% and 16.5% for group 1 vs. 5.1% and 20% for group 2, p > 0.05).

Conclusion

Although the outcomes of HBV infection were favorable in vaccinated group, chronic HBV represents a potential risk for MTCT that necessitates screening during pregnancy in all public health care settings.

Keywords

HBV Vaccination Hepatitis markers Pregnancy Egypt 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Hepatitis B http://www.who.int/mediacentre/factsheets/fs204/en/ Accessed on 27.3.2019
  2. 2.
    Lingala S, Ghany MG (2015) Natural history of hepatitis C. Gastroenterol Clin North Am 44(4):717–734Google Scholar
  3. 3.
    Ragheb MM (2010) Prevalence of hepatitis B virus in Egypt: Current status in an Afro-Asian country. Hepatology Research 40:732.  https://doi.org/10.1111/j.1872-034X.2010.00677.x CrossRefGoogle Scholar
  4. 4.
    Elinav E, Ben-Dov IZ, Shapira Y, Daudi N, Adler R, Shouval D, Ackerman Z (2006) Acute hepatitis A infection in pregnancy is associated with high rates of gestational complications and preterm labor. Gastroenterology 130(4):1129–1134CrossRefGoogle Scholar
  5. 5.
    Ragheb M, Elkady A, Tanaka Y, Murakami S, Attia FM, Hassan AA, Hassan MF, Shedid MM, Abdel Reheem HB, Khan A, Mizokami M (2012) Multiple intra-familial transmission patterns of hepatitis B virus genotype D in north-eastern Egypt. J Med Virol. 84(4):587–595.  https://doi.org/10.1002/jmv.23234 CrossRefPubMedGoogle Scholar
  6. 6.
    Schweitzer A, Akmatov MK, Krause G (2017) Background characteristics and sampling for the 47 low- and middle-income countries surveyed, by national hepatitis B vaccination schedule. Bull World Health Organ. 95(3):199–209G.  https://doi.org/10.2471/BLT.16.178822 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Edmunds WJ, Medley GF, Nokes DJ, Hall AJ, Whittle HC (1993) The influence of age on the development of the hepatitis B carrier state. Proc Biol Sci 253(1337):197–201CrossRefGoogle Scholar
  8. 8.
    Elmaghloub R, Elbahrawy A, Didamony GE, Elwassief A, Saied Mohammad AG, Alashker A, Zedan H, Abdallah AM, Hemidah MH, Elmestikawy A, Fayoumei ME, Shahba H, Gawish A, Morsy MH, Hashim A, Abdelbaseer MA, Ueda Y, Chiba T, Abdelhafeez H (2017) Hepatitis B virus genotype E infection among Egyptian health care workers. J Transl Int Med. 5(2):100–105.  https://doi.org/10.1515/jtim-2017-0012. eCollection 2017 JunCrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Unicef (2015) Children in Egypt, 2015, A statistical Digtest, https://www.unicef.org/egypt/eg_Ch4.Immunization_and_Health_2015.pdf. Accessed 20 July 2019
  10. 10.
    Babanejad M, Izadi N, Najafi F, Alavian SM (2016) The HBsAg prevalence among blood donors from Eastern Mediterranean and Middle Eastern countries: a systematic review and meta-analysis. Hepat Mon 16(3):e35664.  https://doi.org/10.5812/hepatmon.35664 eCollection 2016 Mar
  11. 11.
    Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ (2015) Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 386:1546–1555CrossRefGoogle Scholar
  12. 12.
    El-Zanaty and Associates. EGYPT HEALTH ISSUES SURVEY (2015) Ministry of Health and Population, Cairo, Egypt. The DHS Program, ICF International, RockvilleGoogle Scholar
  13. 13.
    Youssef MA, Abd-Elaleem HA, Elkabsh MY (1993) Prevalence of hepatitis C and hepatitis B among pregnant women in Assiut. Proceedings of Egyptian medical syndicate (EMS) annual scientific congress, February 2-4, Cairo, EgyptGoogle Scholar
  14. 14.
    Zahran KM, Badary MS, Agban MN, Abdel Aziz NH (2010) Pattern of hepatitis virus infection among pregnant women and their newborns at the Women’s Health Center of Assiut University, Upper Egypt. Int J Gynaecol Obstet 111(2):171–174CrossRefGoogle Scholar
  15. 15.
    Abo-Salem ME, Mahrous OA, El-Shaarawy AA, Mohamed HM, Yehia SA (2014) Seroprevalence of hepatitis B among pregnant women attending maternal and child health centres in Shebin El-Kom district (Menoufia governorate). Menoufia Med J 27:847–852CrossRefGoogle Scholar
  16. 16.
    Gad MA, Metwally MA, Eissa HA, Gehad MA, Rayan MM (2017) Antenatal screening for hepatitis B virus infection. Benha Med J 34:113–118CrossRefGoogle Scholar
  17. 17.
    EL-Shabraw M, Mohamed MF, Hamdi MS, Ehab M et al (2013) Prevalence of hepatitis B virus infection among Egyptian pregnant women - a single center study. International Journal of Tropical Disease & Health 3(2):157–168CrossRefGoogle Scholar
  18. 18.
    El-Karaksy HM, Mohsen LM, Saleh DA, Hamdy MS, Yassin NA, Farouk M, Salit ME, El-Shabrawi MH (2014) Applicability and efficacy of a model for prevention of perinatal transmission of hepatitis B virus infection: single center study in Egypt. World J Gastroenterol 20(45):17075–17083.  https://doi.org/10.3748/wjg.v20.i45.17075 CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Mansour E, Abdul-Rahim S, Batouty G, Zaghloul I, Abdel-Hadi S (1993) Integration of hepatitis B immunization in the expanded program on immunization of the child survival project. J Egypt Public Health Assoc. 68(5-6):487–494PubMedGoogle Scholar
  20. 20.
    Preventing mother to child transmission of hepatitis B: operational field guidelines for delivery of birth dose of hepatitis B vaccine. http://www.wpro.who.int/hepatitis/hepb_operationalfieldguidelines.pdf. Accessed 20 July 2019
  21. 21.
    Lee C, Gong Y, Brok J, Boxall EH, Gluud C. Effect of hepatitis B immunisation in newborn infants of mothers positive for hepatitis B surface antigen: systematic review and meta-analysis. BMJ. Feb 11 2006;332(7537):328-336.Google Scholar
  22. 22.
  23. 23.
    Center of Disease and Control: Interpretation of Hepatitis B Serologic Test Results https://www.cdc.gov/hepatitis/hbv/pdfs/serologicchartv8.pdf?fbclid=IwAR1qt6lj4RU1WksaIhRT8O-aPy3NsqsQINIJNBJRhUg0XhUNnpikWy9Gmv4. Accessed 21 July 2019
  24. 24.
    Tanaka Y, Hasegawa I, Kato T, Orito E, Hirashima N, Acharya SK et al (2004) A case–control study for differences among hepatitis B virus infections of genotypes A (subtypes Aa and Ae) and D. Hepatology 40:747–755.  https://doi.org/10.1002/hep.20365 CrossRefPubMedGoogle Scholar
  25. 25.
    Shin IT, Tanaka Y, Tateno Y, Mizokami M (2008) Development and public release of a comprehensive hepatitis virus database. Hepatol Res 38:234–243.  https://doi.org/10.1111/j.1872-034X.2007.00262.x CrossRefGoogle Scholar
  26. 26.
    Han G-R, Cao M-K, Zhao W, Jiang H-X, Wang C-M, Bai S-F, Yue X, Wang GJ, Tang X, Fang ZX (2011) A prospective and open-label study for the efficacy and safety of telbivudine in pregnancy for the prevention of perinatal transmission of hepatitis B virus infection. J Hepatol. 55:1215–1221.  https://doi.org/10.1016/j.jhep.2011.02.032 CrossRefPubMedGoogle Scholar
  27. 27.
    Wen W-H, Chang M-H, Zhao L-L, Ni Y-H, Hsu H-Y, Wu J-F, Chen PJ, Chen DS, Chen HL (2013) Mother-to-infant transmission of hepatitis B virus infection: significance of maternal viral load and strategies for intervention. J Hepatol. 59:24–30.  https://doi.org/10.1016/j.jhep.2013.02.015 CrossRefPubMedGoogle Scholar
  28. 28.
    Oon CJ, Chen WN (1998) Current aspects of hepatitis B surface antigen mutants in Singapore. J Viral Hepat 5 Suppl 2:17–23CrossRefGoogle Scholar
  29. 29.
    Carman WF, Zanetti AR, Karayiannis P, Waters J, Manzillo G, Tanzi E, Zuckerman AJ, Thomas HC (1990) Vaccine-induced escape mutant of hepatitis B virus. Lancet. 336(8711):325–329CrossRefGoogle Scholar
  30. 30.
    Ghaffar YA, elSobky MK, Raouf AA, Dorgham LS (1989) Mother-to-child transmission of hepatitis B virus in a semirural population in Egypt. J Trop Med Hyg 92(1):20–26PubMedGoogle Scholar
  31. 31.
    Nelson NP, Easterbrook PJ, McMahon BJ (2016) Epidemiology of hepatitis B virus infection and impact of vaccination on disease. Clin Liver Dis. 20(4):607–628CrossRefGoogle Scholar
  32. 32.
    Ponde RA, Cardoso DD, Ferro MO (2010) The underlying mechanisms for the ‘anti-HBc alone’ serological profile. Archives of Virology 155:149–158CrossRefGoogle Scholar
  33. 33.
    Poovorawan Y, Chongsrisawat V, Theamboonlers A, Bock HL, Leyssen M, Jacquet JM (2010) Persistence of antibodies and immune memory to hepatitis B vaccine 20 years after infant vaccination in Thailand. Vaccine 28(3):730–736CrossRefGoogle Scholar
  34. 34.
    Huang LM, Chiang BL, Lee CY, Lee PI, Chi WK, Chang MH (1999) Long-term response to hepatitis B vaccination and response to booster in children born to mothers with hepatitis B e antigen. Hepatology 29(3):954–959CrossRefGoogle Scholar
  35. 35.
    Resti M, Azzari C, Rossi ME, Adami Lami C, Tucci F, Vierucci A (1991) Five-year follow-up of vaccination against hepatitis B virus in newborns vaccinated with a reduced number of doses. Vaccine 9(1):15–18CrossRefGoogle Scholar
  36. 36.
    Pileggi C, Papadopoli R, Bianco A, Pavia M (2017) Hepatitis B vaccine and the need for a booster dose after primary vaccination. Vaccine. 35(46):6302–6307.  https://doi.org/10.1016/j.vaccine.2017.09.076 CrossRefPubMedGoogle Scholar
  37. 37.
    Bini C, Grazzini M, Chellini M, Mucci N, Arcangeli G, Tiscione E, Bonanni P (2018) Is hepatitis B vaccination performed at infant and adolescent age able to provide long-term immunological memory? An observational study on healthcare students and workers in Florence. Italy. Hum Vaccin Immunother. 14(2):450–455.  https://doi.org/10.1080/21645515.2017.1398297 CrossRefPubMedGoogle Scholar
  38. 38.
    Nelson NP, Jamieson DJ, Murphy TV (2014) Prevention of perinatal hepatitis B virus transmission. J Pediatric Infect Dis Soc. 3(Suppl 1):S7–S12CrossRefGoogle Scholar

Copyright information

© Sociedade Brasileira de Microbiologia 2019

Authors and Affiliations

  • Rania Kishk
    • 1
    Email author
  • Mohamed Mandour
    • 2
  • Mohamed Elprince
    • 3
  • Ayman Salem
    • 4
  • Nader Nemr
    • 5
  • Mohammed Eida
    • 5
  • Mostafa Ragheb
    • 5
  1. 1.Microbiology and Immunology Department, Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
  2. 2.Clinical Pathology Department, Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
  3. 3.Obstetrics and Gynecology Department, Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
  4. 4.Internal Medicine Department, Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
  5. 5.Endemic and Infectious Diseases Department, Faculty of MedicineSuez Canal UniversityIsmailiaEgypt

Personalised recommendations