Hepatitis B Virus Prevalence and Mother-to-Child Transmission Risk in an HIV Early Intervention Cohort in KwaZulu-Natal, South Africa.
Hepatitis B Virus Prevalence and Mother-to-Child Transmission Risk in an HIV Early Intervention Cohort in KwaZulu-Natal, South Africa.
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DOI：
10.1093/ofid/ofad366
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发表时间：
2023-08
影响因子：
4.2
通讯作者：
中科院分区：
文献类型：
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作者：
南非夸祖鲁-纳塔尔的艾滋病毒和B型肝炎病毒（HBV）流行率都很高。HIV合并感染对HBV预后有负面影响，并可能增加HBV母婴传播（MTCT）的可能性。在夸祖鲁-纳塔尔的HIV传播母婴对的早期HIV婴儿治疗干预队列中，我们描述了母亲HBV患病率并筛查了高危婴儿。婴儿在出生时接受艾滋病毒母婴传播治疗，并在21天内开始联合治疗，偶然对HBV有活性。在出生时筛查母体样本（N = 175）的HBV感染（HBV表面抗原[HBsAg]）、HBV暴露（HBV抗核心IgG）和疫苗接种应答（HBV抗S阳性，无其他HBV标志物）。婴儿的母亲谁是乙肝病毒阳性筛查HBsAg在1个月和12个月。HBV感染的证据存在于8.6%（n = 15）的产妇样本。HBV暴露的生物标志物存在于31.4%（n = 55）。HBV疫苗接种的证据是罕见的母亲（8.0%; n = 14）。尽管抗逆转录病毒治疗（ART）的处方对HBV的活性，HBVDNA检测在46.7%（7/15）的母亲谁是HBsAg阳性。三位母亲的HBV病毒载量> 5.3 log10 IU/mL，使其具有HBV母婴传播的高风险。在1个月（n = 14）的可用婴儿样本的筛查显示没有HBV母婴传播病例。在12个月时，我们发现1例HBV感染（1/13），53.8%（7/13）的婴儿存在疫苗接种的血清学证据。这一易受感染的HIV传播母亲队列中，未确诊的HBV患病率很高。早期婴儿抗逆转录病毒疗法可能降低了高危病例中母婴传播的风险。目前的HBV指南推荐ART预防，但这些数据强调迫切需要增加出生剂量疫苗的可用性。
HIV and hepatitis B virus (HBV) prevalence are both high in KwaZulu-Natal, South Africa. HIV coinfection negatively affects HBV prognosis and can increase the likelihood of HBV mother-to-child transmission (MTCT). In an early HIV infant treatment intervention cohort of HIV-transmitting mother-child pairs in KwaZulu-Natal, we characterized maternal HBV prevalence and screened infants at risk. Infants were treated for HIV MTCT at birth, and combination regimens incidentally active against HBV were initiated within 21 days. Maternal samples (N = 175) were screened at birth for HBV infection (HBV surface antigen [HBsAg]), exposure to HBV (HBV anti-core IgG), and vaccination responses (HBV anti-S positive without other HBV markers). Infants of mothers who were HBV positive were screened for HBsAg at 1 and 12 months. Evidence of HBV infection was present in 8.6% (n = 15) of maternal samples. Biomarkers for HBV exposure were present in 31.4% (n = 55). Evidence of HBV vaccination was uncommon in mothers (8.0%; n = 14). Despite prescription of antiretroviral therapy (ART) active against HBV, HBV DNA was detectable in 46.7% (7/15) of mothers who were HBsAg positive. Three mothers had HBV viral loads >5.3 log10 IU/mL, making them high risk for HBV MTCT. Screening of available infant samples at 1 month (n = 14) revealed no cases of HBV MTCT. At 12 months, we identified 1 HBV infection (1/13), and serologic evidence of vaccination was present in 53.8% (7/13) of infants. This vulnerable cohort of HIV-transmitting mothers had a high prevalence of undiagnosed HBV. Early infant ART may have reduced the risk of MTCT in high-risk cases. Current HBV guidelines recommend ART prophylaxis, but these data underline the pressing need to increase availability of birth dose vaccines.
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影响因子：
15.1
作者：
Millar, Jane R.;Bengu, Nomonde;Goulder, Philip
通讯作者：
Goulder, Philip
影响因子：
8.4
作者：
Samsunder, Natasha;Ngcapu, Sinaye;Kharsany, Ayesha B. M.
通讯作者：
Kharsany, Ayesha B. M.
DOI：
10.1016/j.jadohealth.2019.10.023
发表时间：
2020-04
期刊：
The Journal of adolescent health : official publication of the Society for Adolescent Medicine
影响因子：
--
作者：
Burrage AB;Mushavi A;Shiraishi RW;Barr BT;Shambira G;Nyakura J;Balachandra S;Kilmarx PH;Dinh TH
通讯作者：
Dinh TH
DOI：
10.1097/qad.0000000000001454
发表时间：
2017-05-15
期刊：
AIDS (London, England)
影响因子：
--
作者：
Price H;Dunn D;Zachary T;Vudriko T;Chirara M;Kityo C;Munderi P;Spyer M;Hakim J;Gilks C;Kaleebu P;Pillay D;Gilson R;DART Virology Group
通讯作者：
DART Virology Group
影响因子：
34.3
作者：
Shimakawa, Yusuke;Veillon, Pascal;Lunel-Fabiani, Francoise
通讯作者：
Lunel-Fabiani, Francoise