Main Article Content
Abstract
BJECTIVES. Little data is available on the prevalence of HIV, Hepatitis B and C, Co-and or triple infection during pregnancy in Cameroon as well as many other resource limited settings. HIV and Hepatitis B and C are major public health concerns world wide. Our study aimed at assessing the seroprevalence of Hepatitis B and C amongst HIV infected pregnant women in Buea, located in the Southwest region of Cameroon.
METHODS. A cross-sectional study of consented pregnant women were conducted from March 2015 to August 2015. HIV-1 infections were detected using the national HIV-1 test algorithms. Hepatitis B surface antigen (HBsAg), anti-HBe and anti- Hepatitis C (anti-HCV) were detected using Enzyme linked Immunosorbent Assays (ELISAs).
RESULTS. Our study group had an HIV prevalence rate of 7.8% (N = 97 / 1230). Of the HIV-1 positive group, 14 women (17.5%; N = 97) were co-infected with HBV and 11 (11.3%; N = 97) were co-infected with HCV. 8 (8.2%; N = 97) were triple infected with HIV, HBV and HCV. Anti-HBe was detected in all 14 HBV-infected pregnant women (100% N= 14) (14/14,(95%CI: 65.8, 100%).
CONCLUSION. Co- and triple infections of HIV,Hepatitis B and C were present amongst pregnant women in Buea. Epidemiological data generated from this study are limited due to the existence of triple infected. It will nevertheless serve as a guide to the government policies to reinforce screening, treatment and prevention strategies, through its Mother–to-Child–transmission (pMTCT) Programme nationwide
Résumé
OBJECTIFS . Nous disposons de peu de données relatives à la prévalence des co- et des tri-infections entre le VIH et le virus de l’hépatite B et/ou C chez les femmes enceintes au Cameroun. Le VIH-SIDA, l’hépatite B et l’hépatite C sont tous les trois, des problèmes majeurs de santé publique dans le monde. Notre étude avait pour but d’évaluer la séroprévalence de l’hépatite B et C chez des femmes enceintes infectées par le VIH dans la ville de Buéa, située dans la région Sud-Ouest du Cameroun.
MÉTHODE. Une étude transversales a été menée de mars 2015 à Août 2015 sur des femmes enceintes consentantes. Des infections à VIH-1 ont été détectées en utilisant l’algorithme de dépistage national. L’antigène de surface du virus de l’hépatite B (HBsAg), l’anticorps anti-HBe et l’anticorps anti-hépatite C (anti-HCV) ont été détectés par dosage immuno-enzymatique (ELISA).
RÉSULTATS. Sur la population étudiée, une prévalence de 7,8 % (n = 97/1230) du VIH a été trouvée. Dans le groupe des patients VIH-1 positifs, I4 femmes (17,5% ; n = 97) étaient co-infectées par le VHB et 11 (11.2% ; n = 97) par le VHC. 8 femmes (8,2% ; n = 97) présentaient une triple infection par le VIH, le VHB et le VHC. Les anti-HBe ont été détectés chez les 14 femmes enceintes infectées par le VHB (14/14 ; IC à 95% : 39,8 , 100 %).
CONCLUSION. Des co et des tri-infections par le VIH, le VHB et/ou le VHC ont été dépistées chez des femmes enceintes vivant à Buéa. Mais les données épidémiologiques générées par cette étude sont limitées du fait de l’existence de triple infection. Ces données serviront néanmoins aux politiques gouvernementales afin d’améliorer le dépistage, le traitement et les stratégies préventives à travers le programme mondial de transmission de la mère à l’enfant.
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References
- WHO: Hepatitis B. Fact Sheet No. 204. Geneva, Switzerland: World Health Organization; 2014. Teo E-K, Lok ASF: Epidemiology, transmission, and prevention of hepatitis B virus infection. In UpToDate. Edited by Basow DS. Waltham, MA: UpToDate; 2009. WHO: Hepatitis B vaccines.
- FouelifackYmele F, Keugoung B, Fouedjio JH, Kouam N, Mendibi S, DongtsaMabou J: High Rates of Hepatitis B and C and HIV Infections among Blood Donors in Cameroon: A Proposed Blood Screening Algorithm for Blood Donors in Resource-Limited Settings. J Blood Transfus 2012, 2012:1-7.
- Noubiap JJN, Joko WYA, Nansseu JRN, Tene UG, Siaka C: Sero-epidemiology of human immunodeficiency virus, hepatitis B and C viruses, and syphilis infections among first-time blood donors in Edéa, Cameroon. Int J Infect Dis 2013, 17:e832-e837. PubMed Abstract | Publisher Full Text
- Euler GL, Wooten KG, Baughman AL, Williams WW: Hepatitis B surface antigen prevalence among pregnant women in urban areas: implications for testing, reporting, and preventing perinatal transmission. Pediatrics 2003, 11:1192-1197
- Gutierrez, R. Garcia, E. Ntsama, C. Parra-Fariñas, M.C. Fariñas and C. Fariñas-Alvarez HBV, HIV seroprevalence high among pregnant women at Cameroon clinic
- Chiaramonte M, Stroffolini T, Ngatchu T, Rapicetta M, Lantum D, Kaptue L, Chionne P, Conti S, Sarrecchia B, Naccarato R: Hepatitis B virus infection in Cameroon: a seroepidemiological survey in city school children. J Med Virol 1991, 33:95-99
- Njouom R, Pasquier C, Ayouba A, Tejiokem MC, Vessiere A, Mfoupouendoun J, Tene G, Eteki N, Lobe MM, Izopet J: Low risk of mother-to-child transmission of hepatitis C virus in Yaounde, Cameroon: the ANRS 1262 study. Am J Trop Med Hyg 2005, 73:460-466.PubMed Abstract | Publisher Full Text
- Fomulu NJ, Morfaw FL, Torimiro JN, Nana P, Koh MV, William T: Prevalence, correlates and pattern of Hepatitis B among antenatal clinic attenders in Yaounde-Cameroon: is perinatal transmission of HBV neglected in Cameroon? BMC Pregnancy Childbirth 2013, 13:1-10. PubMed Abstract | BioMed Central Full Text | PubMed Central Full Text
- Frambo AA, Atashili J, Fon PN, Ndumbe PM : Prevalence of HBsAg and knowledge about hepatitis B in pregnancy in the Buea Health District, Cameroon: a cross-sectional study.BMC 2014 Jun 25;7:394. doi: 10.1186/1756-0500-7-394.
- Parry E, Godfrey R, Mabey D, Gill G: Hepatitis Viruses. In Princ Med Afr. 3rd edition. Cambridge: Cambridge University Press; 2009:710-712.
- E. Collenberg,T. Ouedraogo, J. Ganame, H. Fickenscher, G. Kynast-Wolf, H. Becher, et al.Seroprevalence of six different viruses among pregnant women and blood donors in rural and urban Burkina Faso: a comparative analysis ,J Med Virol, 78 (2006), pp. 683–692
- J.Simpore, D. Ilboudo, A. Samandoulougou, P. Guardo, P. Castronovo, S. Musumeci HCV and HIV co-infection in pregnant women attending St. Camille Medical Centre in Ouagadougou (Burkina Faso)J Med Virol, 75 (2005), pp. 209–212
- J. Simpore, M. Granato, R. Santarelli, R.A. Nsme, M. Coluzzi, V. Pietra, et al. Prevalence of infection by HHV-8, HIV, HCV and HBV among pregnant women in Burkina Faso J Clin Virol, 31 (2004), pp. 78–80
- C. Laurent, A. Bourgeois, M. Mpoudi, C. Butel, E. Mpoudi-Ngole, E. Delaporte HIV and hepatitis C virus coinfection, Cameroon Emerg Infect Dis, 13 (2007), pp. 514–516
- D.N. Mbanya, D. Takam, P.M. Ndumbe Serological findings amongst first-time blood donors in Yaounde, Cameroon: is safe donation a reality or a myth? Transfus Med, 13 (2003), pp. 267–273
- J.M. Pawlotsky, L. Belec, G. Gresenguet, L. Deforges, M. Bouvier, J. Duval, et al.High prevalence of hepatitis B, C, and E markers in young sexually active adults from the Central African Republic J Med Virol, 46 (1995), pp. 269–272
- C. Laurent, D. Henzel, C. Mulanga-Kabeya, G. Maertens, B. Larouze, E. Delaporte Seroepidemiological survey of hepatitis C virus among commercial sex workers and pregnant women in Kinshasa, Democratic Republic of Congo Int J Epidemiol, 30 (2001), pp. 872–877
- F. Rouet, M.L. Chaix, A. Inwoley, P. Msellati, I. Viho, P. Combe, et al. HBV and HCV prevalence and viraemia in HIV-positive and HIV-negative pregnant women in Abidjan, Cote d’Ivoire: the ANRS 1236 study J Med Virol, 74 (2004), pp. 34–40
- P. Combe, G. La Ruche, D. Bonard, T. Ouassa, H. Faye-Ketté, F. Sylla-Koko, et al. Hepatitis B and C infections, human immunodeficiency virus and other sexually transmitted infections among women of childbearing age in Cote d’Ivoire, West Africa
- Obi SN, Onah HE, Ezugwu FO: Risk factors for hepatitis B infection during pregnancy in a Nigerian obstetric population. J ObstetGynecol 2006, 26:770-772. Publisher Full Text
- Kfutwah AK, Tejiokem MC, Njouom R: A low proportion of HBeAg among HBsAg-positive pregnant women with known HIV status could suggest low perinatal transmission of HBV in Cameroon. Virol J 2012, 9:422X-9.
- Ndumbe PM, Skalsky J, Joller-Jemelka H: Seroprevalence of hepatitis and HIV infection among rural pregnant women in Cameroon. Apmis 1994, 102:662-666. PubMed Abstract | Publisher Full Text
- Okoth F, Mbuthia J, Gatheru Z, Murila F, Kanyingi F, Mugo F, Esamai F, Alavi Z, Otieno J, Kiambati H: Seroprevalence of hepatitis B markers in pregnant women in Kenya. East Afr Med J 2009, 83:485-493.
- Okada K, Kamiyama I, Inomata M, Imai M, Miyakawa Y, Mayumi M: e antigen and anti-e in the serum of asymptomatic carrier mothers as indicators of positive and negative transmission of hepatitis B virus to their infants. N Engl J Med 1976, 294:746-749.
References
WHO: Hepatitis B. Fact Sheet No. 204. Geneva, Switzerland: World Health Organization; 2014. Teo E-K, Lok ASF: Epidemiology, transmission, and prevention of hepatitis B virus infection. In UpToDate. Edited by Basow DS. Waltham, MA: UpToDate; 2009. WHO: Hepatitis B vaccines.
FouelifackYmele F, Keugoung B, Fouedjio JH, Kouam N, Mendibi S, DongtsaMabou J: High Rates of Hepatitis B and C and HIV Infections among Blood Donors in Cameroon: A Proposed Blood Screening Algorithm for Blood Donors in Resource-Limited Settings. J Blood Transfus 2012, 2012:1-7.
Noubiap JJN, Joko WYA, Nansseu JRN, Tene UG, Siaka C: Sero-epidemiology of human immunodeficiency virus, hepatitis B and C viruses, and syphilis infections among first-time blood donors in Edéa, Cameroon. Int J Infect Dis 2013, 17:e832-e837. PubMed Abstract | Publisher Full Text
Euler GL, Wooten KG, Baughman AL, Williams WW: Hepatitis B surface antigen prevalence among pregnant women in urban areas: implications for testing, reporting, and preventing perinatal transmission. Pediatrics 2003, 11:1192-1197
Gutierrez, R. Garcia, E. Ntsama, C. Parra-Fariñas, M.C. Fariñas and C. Fariñas-Alvarez HBV, HIV seroprevalence high among pregnant women at Cameroon clinic
Chiaramonte M, Stroffolini T, Ngatchu T, Rapicetta M, Lantum D, Kaptue L, Chionne P, Conti S, Sarrecchia B, Naccarato R: Hepatitis B virus infection in Cameroon: a seroepidemiological survey in city school children. J Med Virol 1991, 33:95-99
Njouom R, Pasquier C, Ayouba A, Tejiokem MC, Vessiere A, Mfoupouendoun J, Tene G, Eteki N, Lobe MM, Izopet J: Low risk of mother-to-child transmission of hepatitis C virus in Yaounde, Cameroon: the ANRS 1262 study. Am J Trop Med Hyg 2005, 73:460-466.PubMed Abstract | Publisher Full Text
Fomulu NJ, Morfaw FL, Torimiro JN, Nana P, Koh MV, William T: Prevalence, correlates and pattern of Hepatitis B among antenatal clinic attenders in Yaounde-Cameroon: is perinatal transmission of HBV neglected in Cameroon? BMC Pregnancy Childbirth 2013, 13:1-10. PubMed Abstract | BioMed Central Full Text | PubMed Central Full Text
Frambo AA, Atashili J, Fon PN, Ndumbe PM : Prevalence of HBsAg and knowledge about hepatitis B in pregnancy in the Buea Health District, Cameroon: a cross-sectional study.BMC 2014 Jun 25;7:394. doi: 10.1186/1756-0500-7-394.
Parry E, Godfrey R, Mabey D, Gill G: Hepatitis Viruses. In Princ Med Afr. 3rd edition. Cambridge: Cambridge University Press; 2009:710-712.
E. Collenberg,T. Ouedraogo, J. Ganame, H. Fickenscher, G. Kynast-Wolf, H. Becher, et al.Seroprevalence of six different viruses among pregnant women and blood donors in rural and urban Burkina Faso: a comparative analysis ,J Med Virol, 78 (2006), pp. 683–692
J.Simpore, D. Ilboudo, A. Samandoulougou, P. Guardo, P. Castronovo, S. Musumeci HCV and HIV co-infection in pregnant women attending St. Camille Medical Centre in Ouagadougou (Burkina Faso)J Med Virol, 75 (2005), pp. 209–212
J. Simpore, M. Granato, R. Santarelli, R.A. Nsme, M. Coluzzi, V. Pietra, et al. Prevalence of infection by HHV-8, HIV, HCV and HBV among pregnant women in Burkina Faso J Clin Virol, 31 (2004), pp. 78–80
C. Laurent, A. Bourgeois, M. Mpoudi, C. Butel, E. Mpoudi-Ngole, E. Delaporte HIV and hepatitis C virus coinfection, Cameroon Emerg Infect Dis, 13 (2007), pp. 514–516
D.N. Mbanya, D. Takam, P.M. Ndumbe Serological findings amongst first-time blood donors in Yaounde, Cameroon: is safe donation a reality or a myth? Transfus Med, 13 (2003), pp. 267–273
J.M. Pawlotsky, L. Belec, G. Gresenguet, L. Deforges, M. Bouvier, J. Duval, et al.High prevalence of hepatitis B, C, and E markers in young sexually active adults from the Central African Republic J Med Virol, 46 (1995), pp. 269–272
C. Laurent, D. Henzel, C. Mulanga-Kabeya, G. Maertens, B. Larouze, E. Delaporte Seroepidemiological survey of hepatitis C virus among commercial sex workers and pregnant women in Kinshasa, Democratic Republic of Congo Int J Epidemiol, 30 (2001), pp. 872–877
F. Rouet, M.L. Chaix, A. Inwoley, P. Msellati, I. Viho, P. Combe, et al. HBV and HCV prevalence and viraemia in HIV-positive and HIV-negative pregnant women in Abidjan, Cote d’Ivoire: the ANRS 1236 study J Med Virol, 74 (2004), pp. 34–40
P. Combe, G. La Ruche, D. Bonard, T. Ouassa, H. Faye-Ketté, F. Sylla-Koko, et al. Hepatitis B and C infections, human immunodeficiency virus and other sexually transmitted infections among women of childbearing age in Cote d’Ivoire, West Africa
Obi SN, Onah HE, Ezugwu FO: Risk factors for hepatitis B infection during pregnancy in a Nigerian obstetric population. J ObstetGynecol 2006, 26:770-772. Publisher Full Text
Kfutwah AK, Tejiokem MC, Njouom R: A low proportion of HBeAg among HBsAg-positive pregnant women with known HIV status could suggest low perinatal transmission of HBV in Cameroon. Virol J 2012, 9:422X-9.
Ndumbe PM, Skalsky J, Joller-Jemelka H: Seroprevalence of hepatitis and HIV infection among rural pregnant women in Cameroon. Apmis 1994, 102:662-666. PubMed Abstract | Publisher Full Text
Okoth F, Mbuthia J, Gatheru Z, Murila F, Kanyingi F, Mugo F, Esamai F, Alavi Z, Otieno J, Kiambati H: Seroprevalence of hepatitis B markers in pregnant women in Kenya. East Afr Med J 2009, 83:485-493.
Okada K, Kamiyama I, Inomata M, Imai M, Miyakawa Y, Mayumi M: e antigen and anti-e in the serum of asymptomatic carrier mothers as indicators of positive and negative transmission of hepatitis B virus to their infants. N Engl J Med 1976, 294:746-749.