title: 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.
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.
authors.affiliation: Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai. Thailand.
authors.forename: Woottichai
authors.initials: W
authors.lastname: Khamduang
authors.forename: Nicole
authors.initials: N
authors.lastname: Ngo-Giang-Huong
authors.forename: Catherine
authors.initials: C
authors.lastname: Gaudy-Graffin
authors.forename: Gonzague
authors.initials: G
authors.lastname: Jourdain
authors.forename: Weerapong
authors.initials: W
authors.lastname: Suwankornsakul
authors.forename: Tapnarong
authors.initials: T
authors.lastname: Jarupanich
authors.forename: Veeradate
authors.initials: V
authors.lastname: Chalermpolprapa
authors.forename: Sirisak
authors.initials: S
authors.lastname: Nanta
authors.forename: Noossara
authors.initials: N
authors.lastname: Puarattana-Aroonkorn
authors.forename: Sakchai
authors.initials: S
authors.lastname: Tonmat
authors.forename: Marc
authors.initials: M
authors.lastname: Lallemant
authors.forename: Alain
authors.initials: A
authors.lastname: Goudeau
authors.forename: Wasna
authors.initials: W
authors.lastname: Sirirungsi
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification*; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D015995:Prevalence; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D019562:Viral Load
chemical_list: D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens
keywords: HIV-1–infected pregnant women; isolated anti-HBc; occult HBV infection; perinatal transmission