[Hepatitis B virus infection in Tunisian pregnant women: risk factors and viral DNA levels in HBe antigen negative women].
OBJECTIVE
To evaluate the seroprevalence and the risk factors of hepatitis B virus (HBV) infection in 2303 Tunisian pregnant women and to estimate the risk of perinatal transmission in women positive for hepatitis B surface antigen (HBsAg) but negative for hepatitis B e-antigen (HBeAg).


METHODS
Positive samples were tested for HBeAg and anti-HBe antibody using enzyme immunoassays. Serum HBV-DNA was determined by real time PCR assay.


RESULTS
Overall, 4% of women were HBsAg positive and for the majority of them (96.8%) this status was unknown. Only 1.4% of studied population were vaccinated previously against hepatitis B. Study of risk factors revealed association between the HBsAg status and presence of intrafamilial hepatitis cases (p<0.05). Only four women were positive for HBeAg. Among patients with HBeAg negative status, only 11% were negative for HBV DNA. For the others, DNA level ranged from 34 to 10(8)copies/ml; it was greater than 10(4)copies/ml in 26.5% of them.


CONCLUSIONS
Hepatitis B virus (HBV) prevalence in pregnant women is of intermediate endemicity in Tunisia. Universal vaccination before pregnancy and antenatal screening is recommended. Pregnant women who are found to be HBsAg positive and HBeAg negative should be tested systematically for DNA level to evaluate the risk of perinatal infection and to prevent it by sero-prophylactic for babies or by treatment during the third trimester of pregnancy.
Hannachi
N
N
Unité de Recherche << Caractérisation Génomique des Agents Infectieux UR 02SP13 >>, Laboratoire de Microbiologie-Immunologie, CHU Farhat-Hached, Avenue Ibn-Jazzar, 4000 Sousse, Tunisie. nhannachi@lycos.com
Bahri
O
O
Mhalla
S
S
Marzouk
M
M
Sadraoui
A
A
Belguith
A
A
Triki
H
H
Boukadida
J
J
D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006509:Hepatitis B / Q000196:embryology / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D017325:Hepatitis B Vaccines / Q000627:therapeutic use; D006513:Hepatitis B e Antigens / Q000097:blood*; D006801:Humans; D018580:Mandatory Testing; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000821:virology; D012307:Risk Factors; D014416:Tunisia / Q000453:epidemiology; D019562:Viral Load
D004279:DNA, Viral; D017325:Hepatitis B Vaccines; D006513:Hepatitis B e Antigens