SEROPREVELANCE OF HEPATITIS B AND COINFECTION WITH HEPATITIS D IN PREGNANT FEMALES OF RURAL AREAS OF KARACHI

Authors

  • Zarrish Qasim Baqai Medical University, Karachi, Pakistan
  • Muhammad Younas Jamal Siddiqui Baqai Medical University, Karachi, Pakistan
  • Maeesa Wadood Baqai Medical University, Karachi, Pakistan
  • Iram Nazir Baqai Medical University, Karachi, Pakistan
  • Syeda Hira Abid Karachi Institute of Medical Sciences, Pakistan

DOI:

https://doi.org/10.69723/njms.03.03.0415

Keywords:

Hepatitis B, Hepatitis D, Pregnant females, Molecular characterization

Abstract

BACKGROUND: Viral hepatitis is a major global health concern affecting four hundred million people with chronic hepatitis B especially during the perinatal period and early childhood. 5% of them are superinfected with hepatitis D.HBV-HDV co-infection results in a higher risk of fulminant hepatitis. In Pakistan, the situation is worse than in the developed countries and there is paucity of available information.

OBJECTIVES: The objective of our study is primarily to determine seroprevalence of hepatitis B and co-infection with hepatitis D in pregnant females of rural areas of Karachi.

METHODOLOGY: A descriptive cross-sectional study was carried out for one year from January 2021. 385 blood samples of pregnant females from rural areas were collected from various hospitals of Karachi. All tests were performed at Muhammadi Laboratory and Diagnostic Centre Karachi. Screening for hepatitis B was done by electrochemiilluminiscence immunoassay (ECLIA) on cobas e 411 analyzer. Amplification and reporting of HBV and HDV was done using Real time PCR (QIAGEN 3rd generation, HRM channel Germany). Statistical analysis was done by using SPSS version 25.0.

RESULTS: Among 385 healthy pregnant females belonging to rural areas of Karachi the overall prevalence of HBV is 9.1% while HBV/HDV co-infection is found to be 1.3%.

CONCLUSION: There is an increasing trend observed in the prevalence of HBV and HDV in the pregnant females of rural areas of Karachi as compared to previous statistics. HBV positive patients should be screened for HDV. Education of masses is required in order to create awareness in the general population.

KEYWORDS:  Hepatitis B, Hepatitis D, pregnant females, molecular characterization

References

Komas NP, Ghosh S, Abdou-Chekaraou M, Pradat P, Al Hawajri N, Manirakiza A, et al. Hepatitis B and hepatitis D virus infections in the Central African Republic, twenty-five years after a fulminant hepatitis outbreak, indicate continuing spread in asymptomatic young adults. PLoS Negl Trop Dis. 2018;12(4):e0006377.

Bosan A, Qureshi H, Bile KM, Ahmad I, Hafiz R. A review of hepatitis viral infections in Pakistan. J Pak Med Assoc. 2010;60(12):14.

Ismail SA, Cuadros DF, Benova L. Hepatitis B in Egypt: A cross-sectional analysis of prevalence and risk factors for active infection from a nationwide survey. Liver Int. 2017 Dec 1;37(12):1814–22.

Khan F, Shams S, Qureshi ID, Israr M, Khan H, Sarwar MT, et al. Hepatitis B virus infection among different sex and age groups in Pakistani Punjab. Virol J. 2011 Dec;8(1):225.

Liu C, Wang YM, Fan K. Epidemiological and clinical features of hepatitis B virus related liver failure in China. World J Gastroenterol WJG. 2011 Jul 7;17(25):3054–9.

Sathiyasekaran M, Ramaswamy G. Diagnosis and Management of Hepatitis B and Hepatitis C Infections in Children. Pediatr Infect Dis. 2020;2(1):13.

Yan YP, Su HX, Ji ZH, Shao ZJ, Pu ZS. Epidemiology of Hepatitis B Virus Infection in China: Current Status and Challenges. J Clin Transl Hepatol. 2014 Mar;2(1):15.

Rizzetto M, Hamid S, Negro F. The changing context of hepatitis D. J Hepatol. 2021 May 1;74(5):1200–11.

Kao JH. Diagnosis of hepatitis B virus infection through serological and virological markers. Expert Rev Gastroenterol Hepatol. 2008 Aug 1;2(4):553–62.

The global prevalence of hepatitis D virus infection: Systematic review and meta-analysis | Elsevier Enhanced Reader [Internet]. [cited 2023 Mar 9]. Available from: https://reader.elsevier.com/reader/sd/pii/S0168827820302208?token=627F97E89B45A792A44CAA64CBCCE35E5BA4644758CA26F3A1F2F403594E8EB1311F488E25DE3EB8548FE715FAFCC535&originRegion=eu-west-1&originCreation=20230309065804

Ataei B, Yazdani MR, Kalantari H, Yaran M, Nokhodian Z, Javadi AA, et al. Hepatitis D virus infection in Isfahan, central Iran: Prevalence and risk factors among chronic HBV infection cases. Hepat Mon. 2011;11(4):269.

Hughes SA, Wedemeyer H, Harrison PM. Hepatitis delta virus. The Lancet. 2011 Jul 2;378(9785):73–85.

Jelen MM, Hošnjak L, Štunf Š, Zagožen A, Komloš KF, Markočič P, et al. Hepatitis D virus infection in Slovenian patients with chronic hepatitis B virus infection: a national prevalence study and literature review. :6.

Patel EU, Thio CL, Boon D, Thomas DL, Tobian AAR. Prevalence of Hepatitis B and Hepatitis D Virus Infections in the United States, 2011–2016. Clin Infect Dis. 2019 Aug 1;69(4):709–12.

Revisiting the estimation of hepatitis D global prevalence | Elsevier Enhanced Reader [Internet]. [cited 2021 Jul 8]. Available from: https://reader.elsevier.com/reader/sd/pii/S0168827820303111?token=D7E8FF70C793B6AABAB17E7F962363CB3CAFEB13BA3FC93C2EAC638458CCC724E291B9B2FA3C3CF216E7B5B151E6C246&originRegion=eu-west-1&originCreation=20210708115448

Murad EA, Babiker SM, Gasim GI, Rayis DA, Adam I. Epidemiology of hepatitis B and hepatitis C virus infections in pregnant women in Sana’a, Yemen. BMC Pregnancy Childbirth. 2013 Dec;13(1):127.

Khanna D, Kar P. Can the diagnostics of hepatitis in pregnant patients be improved? Expert Rev Mol Diagn [Internet]. 2022 Dec 3 [cited 2023 Mar 29]; Available from: https://www.tandfonline.com/doi/abs/10.1080/14737159.2022.2153039

Racicot K, Mor G. Risks associated with viral infections during pregnancy. J Clin Invest. 2017 May 1;127(5):1591–9.

Ntonifor H. Sero Prevalence of Human Immuno deficiency virus HIV and Hepatitis B virus Co infection in pregnant women in Bamenda. Int J Curr Microbiol Appl Sci. 2015 Dec 1;4:473–83.

Nayagam S, Thursz M, Sicuri E, Conteh L, Wiktor S, Low-Beer D, et al. Requirements for global elimination of hepatitis B: a modelling study. Lancet Infect Dis. 2016 Dec;16(12):1399–408.

de Almeida NAA, de Paula VS. Occult Hepatitis B virus (HBV) infection and challenges for hepatitis elimination: A literature review. J Appl Microbiol. 2022;132(3):1616–35.

Jelen MM, Hošnjak L, Štunf Š, Zagožen A, Komloš KF, Markočič P, et al. Hepatitis D virus infection in Slovenian patients with chronic hepatitis B virus infection: a national prevalence study and literature review. :6.

Popescu GA, Otelea D, Gavriliu LC, Neaga E, Popescu C, Paraschiv S, et al. Epidemiology of hepatitis D in patients infected with hepatitis B virus in bucharest: A cross-sectional study. J Med Virol. 2013;85(5):769–74.

Patel EU, Thio CL, Boon D, Thomas DL, Tobian AAR. Prevalence of Hepatitis B and Hepatitis D Virus Infections in the United States, 2011–2016. Clin Infect Dis. 2019 Aug 1;69(4):709–12.

Kamal H, Westman G, Falconer K, Duberg AS, Weiland O, Haverinen S, et al. Long-Term Study of Hepatitis Delta Virus Infection at Secondary Care Centers: The Impact of Viremia on Liver-Related Outcomes. Hepatology. 2020;72(4):1177–90.

Masood U, John S. Hepatitis D. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2021 Jul 12]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470436/

Kochhar S. Viral infections during pregnancy. Indep Nurse. 2015 Apr 6;2015(6):34–6.

Myers A, Oxner A, Sinnott J, Brechot C. Hepatitis in Pregnancy. In: Protocols for High-Risk Pregnancies [Internet]. John Wiley & Sons, Ltd; 2020 [cited 2021 Jul 13]. p. 241–52. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119635307.ch24

Nguyen G, Garcia RT, Nguyen N, Trinh H, Keeffe EB, Nguyen MH. Clinical course of hepatitis B virus infection during pregnancy. Aliment Pharmacol Ther. 2009;29(7):755–64.

Safir A, Levy A, Sikuler E, Sheiner E. Maternal hepatitis B virus or hepatitis C virus carrier status as an independent risk factor for adverse perinatal outcome. Liver Int. 2010 May 1;30(5):765–70.

Wan Z, Zhou A, Zhu H, Lin X, Hu D, Peng S, et al. Maternal Hepatitis B Virus Infection and Pregnancy Outcomes. J Clin Gastroenterol. 2018 Jan 1;52(1):73–8.

Revisiting the estimation of hepatitis D global prevalence | Elsevier Enhanced Reader [Internet]. [cited 2021 Jul 8]. Available from: https://reader.elsevier.com/reader/sd/pii/S0168827820303111?token=D7E8FF70C793B6AABAB17E7F962363CB3CAFEB13BA3FC93C2EAC638458CCC724E291B9B2FA3C3CF216E7B5B151E6C246&originRegion=eu-west-1&originCreation=20210708115448

Al Traif I, Ali A, Dafalla M, Al Tamimi W, Qassem L. Prevalence of hepatitis delta antibody among HBsAG carriers in Saudi Arabia. Ann Saudi Med. 2004;24(5):343–4.

Choi HJ, Ko SY, Choe WH, Seo YS, Kim JH, Byun KS, et al. Clinical features of acute viral hepatitis B in Korea: a multi-center study. Korean J Hepatol. 2011 Dec;17(4):307–12.

Sheng QJ, Wang SJ, Wu YY, Dou XG, Ding Y. Hepatitis B virus serosurvey and awareness of mother-to-child transmission among pregnant women in Shenyang, China. Medicine (Baltimore). 2018 Jun 1;97(22):e10931.

Kumari K, Seetlani NK, Akhter R. THE EMERGENT CONCERN OF SEROPOSITIVE STATUS OF HEPATITIS-B VIRUS AND HEPATITIS-C VIRUS IN THE PREGNANT FEMALES ATTENDING A TERTIARY CARE HOSPITAL. J Ayub Med Coll Abbottabad. 2015 Mar 1;27(1):155–7.

Khan A, Afzal S, Yaqoob A, Fatima R, Haq MU, Junaid K, et al. Epidemiology of viral hepatitis B and C in Punjab, Pakistan: a multicenter cross-sectional study, 2017-18 [Internet]. F1000Research; 2019 [cited 2023 Mar 8]. Available from: https://f1000research.com/articles/8-2065

HIRA, Awan ZUR. SERO PREVALENCE OF HEPATITIS B VIRUS (HBV) INFECTION IN PREGNANT WOMEN OF DISTRICT BANNU KP, PAKISTAN. FUUAST J Biol. 2021 Dec 31;11(2):145–9.

Israr M, Ali F, Nawaz A, Idrees M, Khattak A, Rehman SU, et al. Seroepidemiology and associated risk factors of hepatitis B and C virus infections among pregnant women attending maternity wards at two hospitals in Swabi, Khyber Pakhtunkhwa, Pakistan. PLOS ONE. 2021 Aug 20;16(8):e0255189.

Prevalence and risk factors of hepatitis B virus among pregnant women in Jazan Region- Kingdom of Saudi Arabia. [Internet]. [cited 2023 Apr 10]. Available from: https://www.cabdirect.org/globalhealth/abstract/20133057347

Lao TT, Sahota DS, Law LW, Cheng YK, Leung TY. Age-specific prevalence of hepatitis B virus infection in young pregnant women, Hong Kong Special Administrative Region of China. Bull World Health Organ. 2014 Sep 3;92:782–9.

Prevalence, genotype distribution and mutations of hepatitis B virus and the associated risk factors among pregnant women residing in the northern shores of Persian Gulf, Iran | PLOS ONE [Internet]. [cited 2023 Apr 11]. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265063

Zaidi G, Idrees M, Malik FA, Amin I, Shahid M, Younas S, et al. Prevalence of hepatitis delta virus infection among hepatitis b virus surface antigen positive patients circulating in the largest province of pakistan. Virol J. 2010 Oct 26;7(1):283.

Seetlani N, Abbas Z, Raza S, Yakoob J, Jafri W. Prevalence of Hepatitis D in HBsAg positive patients visiting liver clinics. J Pak Med Assoc. 2009 Jul 1;59(7):434–7.

Published

09/30/2024

How to Cite

SEROPREVELANCE OF HEPATITIS B AND COINFECTION WITH HEPATITIS D IN PREGNANT FEMALES OF RURAL AREAS OF KARACHI. (2024). NORTHWEST JOURNAL OF MEDICAL SCIENCES, 3(3), 8-13. https://doi.org/10.69723/njms.03.03.0415