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Open AccessArticle

Chronic and Occult Hepatitis B Virus Infection in Pregnant Women in Botswana

Botswana Harvard AIDS Institute Partnership, Gaborone BO320, Botswana
Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Botswana, Gaborone 0022, Botswana
Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone 0022, Botswana
Harvard College, Cambridge, MA 02138, USA
Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Goodtables Data Consulting, Norman, OK 73019, USA
University of Cincinnati College of Medicine, Cincinnati, OH 45627, USA
Department of Psychiatry, Boston Children’s Hospital, Boston, MA 02115, USA
Brigham and Women’s Hospital, Boston, MA 02115, USA
Author to whom correspondence should be addressed.
Genes 2018, 9(5), 259;
Received: 27 February 2018 / Revised: 11 May 2018 / Accepted: 11 May 2018 / Published: 17 May 2018
The hepatitis B virus (HBV) is a global problem; however, the burden of HBV infection in pregnant women in Botswana is unknown. We sought to determine the prevalence of chronic and occult HBV infection in human immunodeficiency virus (HIV)-infected and -uninfected pregnant women in Botswana. Samples from 752 pregnant women were tested for hepatitis B surface antigen (HBsAg), and HBsAg-positive samples were tested for hepatitis B e antigen (HBeAg) and HBV DNA load. Samples that were HBsAg negative were screened for occult HBV infection by determining the HBV DNA load. HBV genotypes were determined based on a 415-base-pair fragment of the surface gene. Among the 752 women tested during pregnancy or early postpartum, 16 (2.1%) (95% confidence interval (CI): 2.0–2.2) were HBsAg-positive. The prevalence of chronic HBV infection was higher (3.1%) among HIV-infected (95% CI: 3.0–3.2) compared with HIV-uninfected women (1.1%) (95% CI: 1.07–1.1, p = 0.057). Among the 622 HBsAg-negative women, the prevalence of occult HBV infection was 6.6% (95% CI: 6.5–6.7). Three of thirteen HBsAg-positive participants were HBeAg-positive, and all were HIV-negative. Of the 11 maternal samples successfully genotyped, five (45.5%) were genotype D3, five (45.5%) were genotype A1, and one was genotype E (9%). Low and similar proportions of HIV-infected and -uninfected pregnant women in Botswana had occult or chronic HBV infection. We identified a subset of HIV-negative pregnant women who had high HBV DNA levels and were HBeAg-positive, and thus likely to transmit HBV to their infants. View Full-Text
Keywords: pregnant women; hepatitis B virus (HBV); human immunodeficiency virus (HIV); Botswana pregnant women; hepatitis B virus (HBV); human immunodeficiency virus (HIV); Botswana
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Mbangiwa, T.; Kasvosve, I.; Anderson, M.; Thami, P.K.; Choga, W.T.; Needleman, A.; Phinius, B.B.; Moyo, S.; Leteane, M.; Leidner, J.; Blackard, J.T.; Mayondi, G.; Kammerer, B.; Musonda, R.M.; Essex, M.; Lockman, S.; Gaseitsiwe, S. Chronic and Occult Hepatitis B Virus Infection in Pregnant Women in Botswana. Genes 2018, 9, 259.

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