Prevalence and risk factors of transmission of hepatitis delta virus in pregnant women in the Center Region of Cameroon

• Published in: PloS one 2024-06, Vol.19 (6), p.e0287491
• Main Authors: Ndzie Ondigui, Juliette-Laure, Mafopa Goumkwa, Nadège, Lobe, Cindy, Wandji, Brigitte, Awoumou, Patrick, Voussou Djivida, Prisca, Peyonga, Puinta, Manju Atah, Solange, Verbe, Vivian, Kamgaing Simo, Rachel, Moudourou, Sylvie Agnès, Gutierrez, Ana, Garcia, Rosi, Fernandez, Isabelle, Riwom Essama, Sara Honorine, Mbu, Robinson, Torimiro, Judith
• Format: Article
• Language: English
• Subjects: Adult; Antibodies; Biology and Life Sciences; Cameroon - epidemiology; Coinfection - epidemiology; Coinfection - virology; Cross-Sectional Studies; Development and progression; Disease transmission; Enzyme-linked immunosorbent assay; Ethylenediaminetetraacetic acid; Female; Hepatitis; Hepatitis B; Hepatitis B - epidemiology; Hepatitis B - transmission; Hepatitis B - virology; Hepatitis B e antigen; Hepatitis B surface antigen; Hepatitis B Surface Antigens - blood; Hepatitis C; Hepatitis C virus; Hepatitis D - epidemiology; Hepatitis D - transmission; Hepatitis delta virus; Hepatitis Delta Virus - genetics; Hepatitis Delta Virus - immunology; HIV; HIV (Viruses); Human immunodeficiency virus; Humans; Immunization; Infection; Infectious Disease Transmission, Vertical; Informed consent; Load distribution; Medicine and Health Sciences; People and Places; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Complications, Infectious - virology; Pregnant women; Prevalence; Ribonucleic acid; Risk Factors; RNA; Rural areas; Sampling; Seroepidemiologic Studies; Serology; Vaccination; Viral antibodies; Viremia; Viruses; Womens health; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0287491

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. 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. 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). 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.