背景:乙型肝炎病毒(HBV)和丁型肝炎病毒(HDV)共感染已被描述为病毒性肝炎的最严重形式,并且可以从母亲到孩子共同传播。雅温得孕妇报告HDV感染的血清阳性率为4.0%,喀麦隆总人口为11.9%。我们的目的是描述HBsAg阳性孕妇的HDV感染率,并确定与HDV母婴传播相关的危险因素。
方法:横截面,描述性研究于2019年1月至2022年7月在喀麦隆中部地区的7个健康机构中进行了产前接触的孕妇.采用连续抽样(非概率抽样),只选择年龄在21岁以上的孕妇,提供了书面知情同意书。在知情同意之后,使用开放式问卷进行知识调查,对这些女性的态度和实践(KAP)调查,和他们的血液标本收集和筛查HBsAg,通过快速检测和ELISA检测抗HIV和抗HCV抗体。HBsAg阳性样品进一步筛选HBeAg,抗HDV,抗HBs,和抗HBc抗体通过ELISA,和通过RT-qPCR测量的血浆HDVRNA负载。
结果:1992年孕妇,6.7%的HBsAg(133/1992),在农村地区发病率最高,记录了3.9%的肝炎疫苗接种率。130,42(32.3%)是抗HDV抗体阳性,47.6%有可检测的HDVRNA病毒血症。在44例抗HDV阳性病例中,2(4.5%)共感染HBV和HCV,而5例(11.4%)患有HIV和HBV。多胎妊娠,纹身和/或疤痕的存在与抗HDV抗体的存在显著相关.值得注意的是,80%的HBeAg阴性和抗HBe血清学阳性的女性,具有大于log3.25(>10.000拷贝/ml)的血浆HDVRNA载量。
结论:这些结果表明,在HDVRNA病毒血症水平较高的孕妇中,HDV感染率为中等,这表明HDV的垂直和水平共同传播的风险增加。
BACKGROUND: Hepatitis B virus (HBV) and hepatitis delta virus (HDV) co-infection has been described as the most severe form of viral hepatitis, and can be co-transmitted from mother-to-child. A seroprevalence of 4.0% of HDV infection was reported in pregnant women in Yaoundé, and 11.9% in the general population in Cameroon. Our objective was to describe the rate of HDV infection in HBsAg-positive pregnant women and to determine risk factors associated with mother-to-child transmission of HDV.
METHODS: A cross-sectional, descriptive study was conducted from January 2019 to July 2022 among pregnant women attending antenatal contacts in seven health structures in the Centre Region of Cameroon. A consecutive sampling (non-probability sampling) was used to select only pregnant women of age over 21 years, who gave a written informed consent. Following an informed consent, an open-ended questionnaire was used for a Knowledge, Attitude and Practice (KAP) survey of these women, and their blood specimens collected and screened for HBsAg, anti-HIV and anti-HCV antibodies by rapid tests and ELISA. HBsAg-positive samples were further screened for HBeAg, anti-HDV, anti-HBs, and anti HBc antibodies by ELISA, and plasma HDV RNA load measured by RT-qPCR.
RESULTS: Of 1992 pregnant women, a rate of 6.7% of HBsAg (133/1992) with highest rate in the rural areas, and 3.9% of hepatitis vaccination rate were recorded. Of 130, 42 (32.3%) were anti-HDV antibody-positive, and 47.6% had detectable HDV RNA viraemia. Of 44 anti-HDV-positive cases, 2 (4.5%) were co-infected with HBV and HCV, while 5 (11.4%) with HIV and HBV. Multiple pregnancies, the presence of tattoos and/or scarifications were significantly associated with the presence of anti-HDV antibodies. Of note, 80% of women with negative HBeAg and positive anti-HBe serological profile, had plasma HDV RNA load of more than log 3.25 (>10.000 copies/ml).
CONCLUSIONS: These results show an intermediate rate of HDV infection among pregnant women with high level of HDV RNA viremia, which suggest an increased risk of vertical and horizontal co-transmission of HDV.