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Point-of-care screening for hepatitis B virus infection in pregnant women at an antenatal clinic: A South African experience

BACKGROUND & AIMS: Elimination of HIV and syphilis mother-to-child transmission (MTCT) has received much attention but little consideration has been given to the possibility of elimination of HBV MTCT. In sub-Saharan Africa, HBV vertical transmission continues to be reported and it remains an im...

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Autores principales: Chotun, Nafiisah, Preiser, Wolfgang, van Rensburg, Christoffel Johannes, Fernandez, Pedro, Theron, Gerhard Barnard, Glebe, Dieter, Andersson, Monique Ingrid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5521792/
https://www.ncbi.nlm.nih.gov/pubmed/28732085
http://dx.doi.org/10.1371/journal.pone.0181267
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author Chotun, Nafiisah
Preiser, Wolfgang
van Rensburg, Christoffel Johannes
Fernandez, Pedro
Theron, Gerhard Barnard
Glebe, Dieter
Andersson, Monique Ingrid
author_facet Chotun, Nafiisah
Preiser, Wolfgang
van Rensburg, Christoffel Johannes
Fernandez, Pedro
Theron, Gerhard Barnard
Glebe, Dieter
Andersson, Monique Ingrid
author_sort Chotun, Nafiisah
collection PubMed
description BACKGROUND & AIMS: Elimination of HIV and syphilis mother-to-child transmission (MTCT) has received much attention but little consideration has been given to the possibility of elimination of HBV MTCT. In sub-Saharan Africa, HBV vertical transmission continues to be reported and it remains an important public health problem. This study aimed to assess the feasibility of screening pregnant women for HBV using a point-of-care (POC) test and implementing interventions to prevent HBV MTCT. METHODS: In this observational prospective cohort study, HIV-uninfected pregnant women who consented to testing were screened for HBV using a rapid POC test for HBsAg. Positive results were laboratory-confirmed and tested for HBV DNA and serological markers. Women with viral loads ≥ 20 000 IU/ml received tenofovir (TDF) treatment and all infants received birth-dose HBV vaccine. Two blood samples collected six months apart from HBV-exposed infants within their first year of life were tested for HBV DNA. RESULTS: Of 144 women who were approached, 134 consented to participating (93% acceptance rate of HBV POC test). Six women tested positive for HBsAg (4.5%; 95% CI 0.99%–8.01%), all confirmed by laboratory testing. Two mothers, M1 and M4, were treated with TDF during their third trimester of pregnancy. Six HBV-exposed infants received the HBV vaccine within 24 hours of birth, of whom two were lost to follow-up and four (including the two born to M1 and M4) had undetectable levels of HBV DNA when tested at the two time points. CONCLUSION: We found that HBV screening using POC testing fulfilled the criteria considered necessary for implementation. It has acceptable performance, is inexpensive, reliable, and was well accepted by the study participants. Screening pregnant women as part of the HBV MTCT prevention strategy is therefore feasible in a South African clinical setting.
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spelling pubmed-55217922017-08-07 Point-of-care screening for hepatitis B virus infection in pregnant women at an antenatal clinic: A South African experience Chotun, Nafiisah Preiser, Wolfgang van Rensburg, Christoffel Johannes Fernandez, Pedro Theron, Gerhard Barnard Glebe, Dieter Andersson, Monique Ingrid PLoS One Research Article BACKGROUND & AIMS: Elimination of HIV and syphilis mother-to-child transmission (MTCT) has received much attention but little consideration has been given to the possibility of elimination of HBV MTCT. In sub-Saharan Africa, HBV vertical transmission continues to be reported and it remains an important public health problem. This study aimed to assess the feasibility of screening pregnant women for HBV using a point-of-care (POC) test and implementing interventions to prevent HBV MTCT. METHODS: In this observational prospective cohort study, HIV-uninfected pregnant women who consented to testing were screened for HBV using a rapid POC test for HBsAg. Positive results were laboratory-confirmed and tested for HBV DNA and serological markers. Women with viral loads ≥ 20 000 IU/ml received tenofovir (TDF) treatment and all infants received birth-dose HBV vaccine. Two blood samples collected six months apart from HBV-exposed infants within their first year of life were tested for HBV DNA. RESULTS: Of 144 women who were approached, 134 consented to participating (93% acceptance rate of HBV POC test). Six women tested positive for HBsAg (4.5%; 95% CI 0.99%–8.01%), all confirmed by laboratory testing. Two mothers, M1 and M4, were treated with TDF during their third trimester of pregnancy. Six HBV-exposed infants received the HBV vaccine within 24 hours of birth, of whom two were lost to follow-up and four (including the two born to M1 and M4) had undetectable levels of HBV DNA when tested at the two time points. CONCLUSION: We found that HBV screening using POC testing fulfilled the criteria considered necessary for implementation. It has acceptable performance, is inexpensive, reliable, and was well accepted by the study participants. Screening pregnant women as part of the HBV MTCT prevention strategy is therefore feasible in a South African clinical setting. Public Library of Science 2017-07-21 /pmc/articles/PMC5521792/ /pubmed/28732085 http://dx.doi.org/10.1371/journal.pone.0181267 Text en © 2017 Chotun et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Chotun, Nafiisah
Preiser, Wolfgang
van Rensburg, Christoffel Johannes
Fernandez, Pedro
Theron, Gerhard Barnard
Glebe, Dieter
Andersson, Monique Ingrid
Point-of-care screening for hepatitis B virus infection in pregnant women at an antenatal clinic: A South African experience
title Point-of-care screening for hepatitis B virus infection in pregnant women at an antenatal clinic: A South African experience
title_full Point-of-care screening for hepatitis B virus infection in pregnant women at an antenatal clinic: A South African experience
title_fullStr Point-of-care screening for hepatitis B virus infection in pregnant women at an antenatal clinic: A South African experience
title_full_unstemmed Point-of-care screening for hepatitis B virus infection in pregnant women at an antenatal clinic: A South African experience
title_short Point-of-care screening for hepatitis B virus infection in pregnant women at an antenatal clinic: A South African experience
title_sort point-of-care screening for hepatitis b virus infection in pregnant women at an antenatal clinic: a south african experience
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5521792/
https://www.ncbi.nlm.nih.gov/pubmed/28732085
http://dx.doi.org/10.1371/journal.pone.0181267
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