Prevalence Of Hepatitis Virus Infection Among Pregnant Women

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PREVALENCE OF HEPATITIS VIRUS INFECTION AMONG PREGNANT WOMEN

Background:

Viral hepatitis during pregnancy is associated with high risk of maternal complications and has become a leading cause of foetal death.

Aims:

This study aimed at determining the prevalence of hepatitis B and C viral infections among pregnant women attending the antenatal clinic of the University of Benin Teaching Hospital.

Patients and Methods:

This was a hospital based cross-sectional study that included 5760 pregnant women who attended the antenatal clinic of the hospital during the periods of October 2009 – October 2010. Relevant data was gathered and women having history of previous liver diseases, diabetes and pre-eclamptic toxemia were excluded from the study. Rapid diagnostic test kits were used to screen for Hepatitis B surface antigen (HBsAg) and anti-Hepatitis C virus (HCV) antibodies.

Results:

720 (12.5%) and 206 (3.6%) out of 5,760 pregnant women included in the study were found to be positive for Serum antibodies to hepatitis B and C respectively. 33 (0.57%) were found to have mixed infections of hepatitis B and C. None of the expected risk factors had significant outcome.

Conclusion:

This study showed that the prevalence of the Hepatitis B virus (HBV) among pregnant women in this study area is of intermediate endemicity (12.5%).

Keywords: HBsAg, HCV, pregnant women, prevalence, risk factor

Introduction

Hepatitis is an inflammation of the liver characterized by the presence of inflammatory cells in the tissue of the organ. It may occur with limited or no symptoms, but often leads to jaundice, anorexia (poor appetite) and malaise. Hepatitis is acute when it lasts less than six months and chronic when it persist longer. A group of viruses known as the hepatitis viruses cause most cases of hepatitis worldwide, but it can also be due to toxins (notably alcohol, certain medications and plants), other infections and autoimmune diseases. The hepatitis virus is found in the blood and other body fluids and is transmitted from person to person, the most common routes of infection includes blood transfusions and blood products where there is no screening for blood-borne viruses, medical or dental interventions in countries where equipment is not adequately sterilized mother to infant during childbirth, sexual transmission (in the case of hepatitis B), sharing equipment for injecting drugs, sharing straws, notes etc. for snorting cocaine (cocaine is particularly alkaline and corrosive), sharing razors, toothbrushes or other household articles, tattooing and body piercing if done using unsterile equipment

The hepatitis B virus is spread between people through contact with the blood or other body fluids (i.e. semen, vaginal fluid and saliva) of an infected person, while the hepatitis C virus is spread through direct contact with infected blood. Very rarely it can also be passed on through other body fluids. Many people infected with hepatitis B or C rarely displays any symptom, although they can still transmit the virus to others.

Hepatitis B is a major disease of serious global public health proportion. It is preventable with safe and effective vaccines that have been available since 1982. Of the 2 billion people who have been infected with the hepatitis B virus (HBV) globally, more than 350 million have chronic (lifelong) infections. Over 20 million people are infected annually with this virus. Hepatitis C is a viral infection of the liver and is the most common blood-borne (direct contact with human blood) infection. The major causes of HCV infection worldwide are use of unscreened blood transfusions, and re-use of needles and syringes that have not been adequately sterilized. The world health organization (WHO) estimates that about 3% of the world populations (200 million people) have so far been infected with the Hepatitis C virus. Almost 50% of all cases become chronic carriers and are at risk of liver cirrhosis and liver cancer.

Viral hepatitis during pregnancy is associated with high risk of maternal complications. There is a high rate of vertical transmission causing fetal and neonatal hepatitis which can have serious effects on the neonate, leading to impaired mental and physical health later in life. A leading cause in maternal mortality is also said to be the most familiar cause of jaundice in pregnancy. Peri-natal transmission of this disease occurs if the mother has had acute Hepatitis B infection during late pregnancy, in the first postpartum or if the mother is a chronic HBsAg carrier. Hepatitis C transmission occurs predominantly around time of delivery and pregnancy. Using this background information, the epidemiology of viral hepatitis during pregnancy is essential for health planners and program managers. Thus, the current study aimed at investigating the prevalence and the possible predisposing factors for Hepatitis B and C viruses among antenatal women attending the University of Benin Teaching Hospital.

Patients and Methods

This study was conducted at the University of Benin Teaching Hospital (UBTH) located in the heart of Benin City, Edo state Nigeria. UBTH is a major referral centre for a number of privately owned hospitals and state specialist hospitals within and outside the state. Hence it was thought germane to use this center as a study site among other hospitals in the City.

This study was a hospital based cross-sectional study that included 5760 pregnant women who attended the antenatal clinic of the University of Benin teaching hospital, during the periods of October 2009 – October 2010. Relevant data was gathered and women having history of previous liver diseases, diabetes and pre-eclamptic toxemia were excluded from the study.

Blood sample was obtained by vein-puncture, and serum was separated and stored in a refrigerator. The serum was brought out of the refrigerator for it to equilibrate with room temperature before testing. After centrifugation, the sera were tested for HBsAg and anti-HCV using ELISA kit (Clinotech Diagnostics, Canada). Positive and negative control serum samples were run alongside test.

Statistical Analysis

Data were analyzed using SPSS version 15.0 and an independent T-test method. Significance was determined at P < 0.05.

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