Prevalence, risk factors, and impact of isolated antibody to hepatitis B core antigen and occult hepatitis B virus infection in HIV-1-infected pregnant women

Clin Infect Dis. 2013 Jun;56(12):1704-12. doi: 10.1093/cid/cit166. Epub 2013 Mar 13.

Abstract

Background: Prevalence and risk factors for isolated antibody to hepatitis B core antigen (anti-HBc) and occult hepatitis B virus (HBV) infection are not well known in human immunodeficiency virus type 1 (HIV-1)-infected pregnant women. It is unclear if women with occult infections are at risk of transmitting HBV to their infants.

Methods: HIV-1-infected and HBV surface antigen (HBsAg)-negative pregnant women were tested for antibody to HBsAg (anti-HBs) and anti-HBc using enzyme immunoassay. Women with isolated anti-HBc were assessed for occult HBV infection, defined as HBV DNA levels >15 IU/mL, using the Abbott RealTime HBV DNA assay. Infants born to women with isolated anti-HBc and detectable HBV DNA were tested at 4 months of age for HBV DNA. Logistic regression analysis was used to identify factors associated with isolated anti-HBc and occult HBV infection.

Results: Among 1812 HIV-infected pregnant women, 1682 were HBsAg negative. Fourteen percent (95% confidence interval [CI], 12%-15%) of HBsAg-negative women had an isolated anti-HBc that was independently associated with low CD4 count, age >35 years, birth in northern Thailand, and positive anti-hepatitis C virus serology. Occult HBV infection was identified in 24% (95% CI, 18%-30%) of women with isolated anti-HBc, representing 2.6% (95% CI, 1.9%-3.5%) of HIV-1-infected pregnant women, and was inversely associated with HIV RNA levels. None of the women with isolated anti-HBc and occult HBV infection transmitted HBV to their infants.

Conclusions: HIV-1-infected pregnant women with isolated anti-HBc and occult HBV infection have very low HBV DNA levels and are thus at very low risk to transmit HBV to their infants.

Keywords: HIV-1–infected pregnant women; isolated anti-HBc; occult HBV infection; perinatal transmission.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Cohort Studies
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / immunology
  • HIV Infections / virology
  • HIV-1 / isolation & purification*
  • Hepatitis B Antibodies / blood*
  • Hepatitis B Core Antigens / immunology*
  • Hepatitis B Surface Antigens / immunology
  • Hepatitis B, Chronic / epidemiology
  • Hepatitis B, Chronic / immunology
  • Hepatitis B, Chronic / virology*
  • Humans
  • Infant
  • Infectious Disease Transmission, Vertical / statistics & numerical data
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology
  • Pregnancy Complications, Infectious / immunology
  • Pregnancy Complications, Infectious / virology*
  • Prevalence
  • Risk Factors
  • Thailand / epidemiology
  • Viral Load

Substances

  • Hepatitis B Antibodies
  • Hepatitis B Core Antigens
  • Hepatitis B Surface Antigens