1887

Abstract

To determine whether maternofetal transmission of hepatitis B virus (HBV) is a common route of infection leading to chronic infection in west Africa, plasma samples, obtained at delivery from 1368 pregnant Ghanaian women and paired umbilical cord blood or newborn whole blood samples, were tested for HBV surface antigen (HBsAg) and DNA. A 16 % prevalence of HBV chronic carriers, defined as detectable HBsAg and/or HBV DNA, was found, >80 % contained less than 1×10 IU ml HBV DNA and 99 % were infected with genotype E strains. HBV maternofetal transmission was documented in 17 out of 204 (8.3 %) paired HBV carrier women–cord blood/newborn samples. The rate of transmission was 55 % and 3.3 % when maternal viral load was above or below 1×10 IU ml, respectively (=0.0008). Maternofetal transmission of HBV genotype E was estimated to account for 8 % of the cases of chronic HBsAg carriers. Six women with low viral load at delivery (five <20 IU ml) and anti-HBe (hepatitis B e antigen) transmitted HBV. Surprisingly, while non-transmitted low viral load strains had 79 % mutations at position 1896 of HBV genome, transmitted strains were all wild-type despite anti-HBe presence (=0.0041), suggesting the possible role of HBeAg as risk factor for HBV maternofetal transmission. The relative risk of maternofetal transmission was 2.4 when pregnant women carried high viral load and 11.5 when carrying wild-type strains at position 1896, irrespective of viral load. We conclude that viral load and pre-core wild-type at position 1896 are two independent risk factors for HBV genotype E maternofetal transmission, which remains a minor contributor to high prevalence of chronic infection.

Loading

Article metrics loading...

/content/journal/jgv/10.1099/vir.0.83102-0
2007-10-01
2019-11-18
Loading full text...

Full text loading...

/deliver/fulltext/jgv/88/10/2686.html?itemId=/content/journal/jgv/10.1099/vir.0.83102-0&mimeType=html&fmt=ahah

References

  1. Allain, J.-P., Candotti, D., Soldan, K., Sarkodie, F., Phelps, B., Giachetti, C., Shyamala, V., Yeboah, F., Anokwa, M. & other authors ( 2003; ). The risk of hepatitis B virus infection by transfusion in Kumasi, Ghana. Blood 101, 2419–2425.[CrossRef]
    [Google Scholar]
  2. Burk, R. D., Hwang, L. Y., Ho, G. Y., Shafritz, D. A. & Beasley, R. P. ( 1994; ). Outcome of perinatal hepatitis B virus exposure is dependent on maternal virus load. J Infect Dis 170, 1418–1423.[CrossRef]
    [Google Scholar]
  3. Cacciola, I., Cerenzia, G., Pollicino, T., Squadrito, G., Castellaneta, S., Zanetti, A. R., Mieli-Vergani, G. & Raimondo, G. ( 2002; ). Genomic heterogeneity of hepatitis B virus (HBV) and outcome of perinatal HBV infection. J Hepatol 36, 426–432.[CrossRef]
    [Google Scholar]
  4. Candotti, D., Danso, K., Parsyan, A., Dompreh, A. & Allain, J.-P. ( 2006a; ). Maternal-fetal transmission of human parvovirus B19 genotype 3. J Infect Dis 194, 608–611.[CrossRef]
    [Google Scholar]
  5. Candotti, D., Opare-Sem, O., Rezvan, H., Sarkodie, F. & Allain, J.-P. ( 2006b; ). Molecular and serological characterization of hepatitis B virus in deferred Ghanaian blood donors with and without elevated alanine aminotransferase. J Viral Hepat 13, 715–724.[CrossRef]
    [Google Scholar]
  6. Chen, M., Sällberg, M., Hughes, J., Jones, J., Guidotti, L. G., Chisari, F. V., Billaud, J.-N. & Milich, D. R. ( 2005; ). Immune tolerance split between hepatitis B virus precore and core proteins. J Virol 79, 3016–3027.[CrossRef]
    [Google Scholar]
  7. Chu, C. J., Hussain, M. & Lok, A. S. F. ( 2002; ). Hepatitis B virus genotype B is associated with earlier HBeAg seroconversion compared with hepatitis B virus genotype C. Gastroenterology 122, 1756–1762.[CrossRef]
    [Google Scholar]
  8. Dow, B. C., Peterkin, M. A., Green, R. H. A. & Cameron, S. O. ( 2001; ). Hepatitis B virus transmission by blood donation negative for hepatitis B surface antigen, antibody to HBsAg, antibody to hepatitis B core antigen and HBV DNA. Vox Sang 81, 140 [CrossRef]
    [Google Scholar]
  9. Dumpis, U., Holmes, E. C., Mendy, M., Hill, A., Thursz, M., Hall, A., Whittle, H. & Karayiannis, P. ( 2001; ). Transmission of hepatitis B virus infection in Gambian families revealed by phylogenetic analysis. J Hepatol 35, 99–104.[CrossRef]
    [Google Scholar]
  10. Gerlich, W. H. ( 2006; ). Breakthrough of hepatitis B virus escape mutants after vaccination and virus reactivation. J Clin Virol 36 (Suppl. 1), S18–S22.
    [Google Scholar]
  11. Ghendon, Y. ( 1987; ). Perinatal transmission of hepatitis B virus in high-incidence countries. J Virol Methods 17, 69–79.[CrossRef]
    [Google Scholar]
  12. Greenfield, C., Osidiana, V., Karayiannis, P., Galpin, S., Musoke, R., Jowett, T. P., Mati, P., Tukei, P. M. & Thomas, H. C. ( 1986; ). Perinatal transmission of hepatitis B virus in Kenya: its relation to the presence of serum HBV-DNA and anti-HBe in the mother. J Med Virol 19, 135–142.[CrossRef]
    [Google Scholar]
  13. Hyams, K. C. ( 1995; ). Risks of chronicity following acute hepatitis B virus infection: a review. Clin Infect Dis 20, 992–1000.[CrossRef]
    [Google Scholar]
  14. Inaba, S., Miyata, Y., Ishii, H., Kajimoto, S., Yugi, H., Hino, M. & Tadokoro, K. ( 2005; ). Hepatitis B transmission from an occult HB virus carrier (abstract SP217). Transfusion 45 (Suppl. S3), 94A
    [Google Scholar]
  15. Ip, H. M. H., Lelie, P. N., Wong, V. C. W., Kuhns, M. C. & Reesink, H. W. ( 1989; ). Prevention of hepatitis B virus carrier state in infants according to maternal serum levels of HBV DNA. Lancet 1, 406–410.
    [Google Scholar]
  16. Kao, J. H., Chen, P. J., Lai, M. Y. & Chen, D. S. ( 2002; ). Clinical and virological aspects of blood donors infected with hepatitis B virus genotypes B and C. J Clin Microbiol 40, 22–25.[CrossRef]
    [Google Scholar]
  17. Kew, M. C. ( 1996; ). Progress towards the comprehensive control of hepatitis B virus in Africa: a view from South Africa. Gut 38 (Suppl. 2), S31–S36.[CrossRef]
    [Google Scholar]
  18. Kew, M. C., Kassianides, C., Berger, E. L., Song, E. & Dusheiko, G. M. ( 1987; ). Prevalence of chronic hepatitis B virus infection in pregnant black women living in Soweto. J Med Virol 22, 263–268.[CrossRef]
    [Google Scholar]
  19. Kuhns, M. C., Kleinman, S. H., McNamara, A. L., Rawal, B., Glynn, S. & Busch, M. P., The REDS Study Group ( 2004; ). Lack of correlation between HBsAg and HBV DNA levels in blood donors who test positive for HBsAg and anti-HBc: implications for future HBV screening policy. Transfusion 44, 1332–1339.[CrossRef]
    [Google Scholar]
  20. Lin, H.-H., Lee, T.-Y., Chen, D.-S., Sung, J.-L., Ohto, H., Etoh, T., Kawana, T. & Mizuno, M. ( 1987; ). Transplacental leakage of HBeAg-positive maternal blood as the most likely route in causing intrauterine infection with hepatitis B virus. J Pediatr 111, 877–881.[CrossRef]
    [Google Scholar]
  21. Lo, Y. M. D., Lau, T. K., Chan, L. Y. S., Leung, T. N. & Chang, A. M. Z. ( 2000; ). Quantitative analysis of the bidirectional fetomaternal transfer of nucleated cells and plasma DNA. Clin Chem 46, 1301–1309.
    [Google Scholar]
  22. Maddrey, W. C. ( 2000; ). Hepatitis B: an important public health issue. J Med Virol 61, 362–366.[CrossRef]
    [Google Scholar]
  23. Martinson, F. E., Weigle, K. A., Royce, R. A., Weber, D. J., Suchindran, C. M. & Lemon, S. M. ( 1998; ). Risk factors for horizontal transmission of hepatitis B virus in a rural district in Ghana. Am J Epidemiol 147, 478–487.[CrossRef]
    [Google Scholar]
  24. Menendez, C., Sanchez-Tapias, J. M., Kahigwa, E., Mshinda, H., Costa, J., Vidal, J., Acosta, C., Lopez-Labrador, X., Olmedo, E. & other authors ( 1999; ). Prevalence and mother-to-infant transmission of hepatitis viruses B, C, and E in Southern Tanzania. J Med Virol 58, 215–220.[CrossRef]
    [Google Scholar]
  25. Ohto, H., Lin, H. H., Kawana, T., Etoh, T. & Tohyama, H. ( 1987; ). Intrauterine transmission of hepatitis B virus is closely related to placental leakage. J Med Virol 21, 1–6.[CrossRef]
    [Google Scholar]
  26. Owusu-Ofori, S., Temple, J., Sarkodie, F., Anokwa, M., Candotti, D. & Allain, J.-P. ( 2005; ). Predonation screening of blood donors with rapid tests: implementation and efficacy of a novel approach to blood safety in resource-poor settings. Transfusion 45, 133–140.[CrossRef]
    [Google Scholar]
  27. Petit, T., Dommergues, M., Socié, G., Dumez, Y., Gluckman, E. & Brison, O. ( 1997; ). Detection of maternal cells in human fetal blood during the third trimester of pregnancy using allele-specific PCR amplification. Br J Haematol 98, 767–771.[CrossRef]
    [Google Scholar]
  28. Roingeard, P., Diouf, A., Sankale, J. L., Boyce, C., Mboup, S., Diadhiou, F. & Essex, M. ( 1993; ). Perinatal transmission of hepatitis B virus in Senegal, West Africa. Viral Immunol 6, 65–73.[CrossRef]
    [Google Scholar]
  29. Shepard, C. W., Simard, E. P., Finelli, L., Fiore, A. E. & Bell, B. P. ( 2006; ). Hepatitis B virus infection: epidemiology and vaccination. Epidemiol Rev 28, 112–125.[CrossRef]
    [Google Scholar]
  30. Vranckx, R., Alisjahbana, A. & Meheus, A. ( 1999; ). Hepatitis B virus vaccination and antenatal transmission of HBV markers to neonates. J Viral Hepat 6, 135–139.[CrossRef]
    [Google Scholar]
  31. Wang, Z., Zhang, J., Yang, H., Li, X., Wen, S., Guo, Y., Sun, J. & Hou, J. ( 2003; ). Quantitative analysis of HBV DNA level and HBeAg titer in hepatitis B surface antigen positive mothers and their babies: HBeAg passage through the placenta and the rate of decay in babies. J Med Virol 71, 360–366.[CrossRef]
    [Google Scholar]
  32. Xu, D.-Z., Yan, Y.-P., Choi, B. C. K., Xu, J.-Q., Men, K., Zhang, J.-X., Liu, Z.-H. & Wang, F.-S. ( 2002; ). Risk factors and mechanism of transplacental transmission of hepatitis B virus: a case-control study. J Med Virol 67, 20–26.[CrossRef]
    [Google Scholar]
  33. Xu, H., Peng, M., Qing, Y., Ling, N., Lan, Y., Liang, Z., Cai, D., Li, Y. & Ren, H. ( 2006; ). A quasi species of the pre-S/S gene and mutations of enhancer II/core promoter/pre-C in mothers and their children infected with hepatitis B virus via mother-to-infant transmission. J Infect Dis 193, 88–97.[CrossRef]
    [Google Scholar]
  34. Zhang, S.-L., Han, X.-B. & Yue, Y.-F. ( 1998; ). Relationship between HBV viremia level of pregnant women and intrauterine infection: nested PCR for detection of HBV DNA. World J Gastroenterol 4, 61–63.
    [Google Scholar]
  35. Zhang, S.-L., Yue, Y.-F., Bai, G.-Q., Shi, L. & Jiang, H. ( 2004; ). Mechanism of intrauterine infection of hepatitis B virus. World J Gastroenterol 10, 437–438.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jgv/10.1099/vir.0.83102-0
Loading
/content/journal/jgv/10.1099/vir.0.83102-0
Loading

Data & Media loading...

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error