Hepatitis B virus infection among pregnant women in Haiti: A cross-sectional serosurvey.

BACKGROUND

Hepatitis B vaccine administered shortly after birth is highly effective in preventing mother to child transmission (MTCT) of infection. While hepatitis B vaccine was introduced in Haiti as part of a combined pentavalent vaccine in 2012, a birth dose is not yet included in the immunization schedule.

OBJECTIVES

Determine the seroprevalence of hepatitis B virus (HBV) infection among pregnant women to evaluate the risk of MTCT.

STUDY

DESIGN

We selected 1364 residual serum specimens collected during a 2012 human immunodeficiency virus (HIV) sentinel serosurvey among pregnant women attending antenatal care clinics. Haiti was stratified into two regions: West, which includes metropolitan Port-au-Prince, and non-West, which includes all other departments. We evaluated the association between demographic and socioeconomic characteristics and HIV infection with HBV infection.

RESULTS

Of 1364 selected specimens, 1307 (96%) were available for testing. A total of 422 specimens (32.7%) tested positive for total anti-HBc (38.2% in West vs. 27% in non-West, p<0.001), and 33 specimens (2.5%) were HBsAg positive (2.1% in West vs. 3% in non-West, p=0.4). Of HBsAg positive specimens, 79% had detectable HBV DNA. Women aged 30 and older had more than double the odds of positive total anti-HBc than women aged 15-19 years (p<0.001). Women with secondary (adjusted odds ratio (aOR)=0.54; 95% CI: 0.36-0.81) and post-secondary education (aOR=0.40, 95% CI: 0.19-0.79) had lower odds of total anti-HBc positivity compared with women with no education. HIV-status was not associated with HBV infection.

CONCLUSIONS

Haiti has an intermediate endemicity of chronic HBV infection with high prevalence of positive HBV DNA among chronically infected women. Introduction of a universal birth dose of hepatitis B vaccine might help prevent perinatal HBV transmission.