HBV and HCV prevalence and viraemia in HIV‐positive and HIV‐negative pregnant women in Abidjan, Côte d'Ivoire: The ANRS 1236 study

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Abstract
A retrospective survey estimating the prevalence of hepatitis viruses B (HBV) and C (HCV) was conducted on samples taken in 1,002 African pregnant women (501 diagnosed as HIV‐1 positive and 501 HIV‐1 negative) participating in a clinical trial program conducted in Abidjan, Côte d'Ivoire (West Africa). Hepatitis B markers studied were HBs antigen (HBsAg), and if positive, HBe antigen/anti‐HBe antibodies and HBV DNA. Two third generation (G3) HCV enzyme immunoassays (EIAs) were used for primary HCV screening. All anti‐HCV antibody‐positive sera were assessed further with supplementary assays (one another G3 EIA, RIBA 3.0, and HCV RNA). HCV genotypes were also determined. HBsAg was found in a similar proportion among HIV‐positive (45/499, 9.0%, 95% confidence interval [95% CI], 6.6–11.9) and HIV‐negative (40/498, 8.0%, 95% CI, 5.8–10.8) women (P = 0.58). The diagnosis of chronic hepatitis B, based on HBV DNA positive results, was more frequent in HIV‐positive women (26.7%), compared to HIV‐negative women (9.4%) (P = 0.06). In the case of hepatitis C infection, after supplementary testing allowing the elimination of frequent false‐positive screening results, a prevalence rate of about 1% was found, both in HIV‐positive (6/501, 1.2%, 95% CI, 0.44–2.59) and HIV‐negative (4/501, 0.8%, 95% CI, 0.22–2.03) women (P = 0.53). Of the 10 samples confirmed positive and assessed for HCV RNA, eight (80%) were viraemic and belonged to HCV genotypes 1 or 2. The relative high frequency of HIV/HBV coinfection in Côte d'Ivoire emphasises the need for monitoring the risk of hepatotoxicity by antiretroviral therapy in such patients. We propose an accurate and cost‐efficient algorithm for HCV diagnosis in Africa. J. Med. Virol. 74:34–40, 2004.
Funding Information
  • The French Agence Nationale de Recherches sur le SIDA (ANRS, Paris, France)
  • The French Ministry of Foreign Affairs, within the Coordinated Action AC12