Prevalence of hepatitis B surface antigen and serological markers of other endemic infections in HIV-infected children, adolescents and pregnant women in Sierra Leone: A cross-sectional study

Int J Infect Dis. 2021 Jan:102:45-52. doi: 10.1016/j.ijid.2020.09.1459. Epub 2020 Sep 28.

Abstract

Objective: To assess the prevalence of serological markers of HBV and endemic acute and chronic infections (HAV, HCV, CMV, HTLV-1/2 and syphilis) in HIV-infected children, adolescents and pregnant women in Sierra Leone.

Method: We conducted a cross-sectional study at the national children's and women's hospitals in Freetown. Logistic regression was used to assess predictors of HBsAg positivity.

Results: 183 HIV-infected participants were enrolled, comprising children (n = 88), adolescents (n = 47) and pregnant women (n = 48). All participants (100%) were CMV IgG-positive, while 56.8%, 93.6% and 100% of children, adolescents and pregnant women, respectively, were HAV IgG-positive. The prevalence of HCV, HTLV-1/2 and syphilis were <4%. HBV markers were distributed as follows-children: HBsAg (2.3%), HBeAg (0%), anti-HBc (5.7%); adolescents: HBsAg (17.0%), HBeAg (6.4%), anti-HBc (27.7%); and pregnant women: HBsAg (18.8%), HBeAg (4.2%), anti-HBc (77.1%). Age >10 years, i.e., being born pre-2009 before implementation of routine hepatitis B immunization (aOR 5.05 [1.18-21.28]; p = 0.029) and CD4 count <350 cells/mm3 (aOR 3.97 [1.07-14.71]; p = 0.039) predicted HBsAg positivity.

Conclusion: A high burden of chronic HBV and other endemic infections was observed among HIV-infected patients born pre-2009 before implementation of routine HBV immunization in Sierra Leone, warranting targeted screening and immunization of this high-risk population.

Keywords: CMV; HIV; HTLV; Hepatitis viruses; Sierra Leone; Syphilis.

MeSH terms

  • Adolescent
  • Adult
  • CD4 Lymphocyte Count
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • HIV Infections / complications
  • HIV Infections / epidemiology*
  • Hepatitis B / complications
  • Hepatitis B / epidemiology*
  • Hepatitis B Antibodies / blood*
  • Hepatitis B Surface Antigens / blood*
  • Hepatitis B e Antigens / blood*
  • Humans
  • Male
  • Pregnancy
  • Pregnant Women
  • Prevalence
  • Sierra Leone / epidemiology
  • Syphilis / complications
  • Syphilis / epidemiology*
  • Young Adult

Substances

  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens
  • Hepatitis B e Antigens