title: Hepatitis B virus infection among HIV-infected pregnant women in Malawi and transmission to infants.
abstract: OBJECTIVE
  The extent of HBV infection to infants of HBV/HIV-coinfected pregnant women in sub-Saharan Africa is unknown. The aim of this study was to assess prevalence of HBV infection among antiretroviral-naïve, HIV-infected pregnant women in Malawi and examine HBV transmission to their infants.
  
  
  METHODS
  Plasma from 2048 HIV-infected, Malawian women and their infants were tested for markers of HBV infection. Study participants were provided standard-of-care health services, which included administration of pentavalent vaccine to infants at 6, 10, and 14 weeks of age.
  
  
  RESULTS
  One-hundred and three women (5%) were HBsAg-positive; 70 of these HBsAg-positive women were also HBV-DNA-positive. Sixteen women (0.8%) were HBV-DNA-positive but HBsAg-negative. Five of 51 infants (9.8%) born to HBsAg-positive and/or HBV-DNA-positive women were HBV-DNA-positive by 48 weeks of age.HBV DNA concentrations of two infants of mothers who received extended lamivudine-containing anti-HIV prophylaxis were <4 log10 IU/ml compared to ⩾ 8 log10 IU/ml in three infants of mothers who did not.
  
  
  CONCLUSIONS
  HBV DNA was detected in nearly 10% of infants born to HBV/HIV-coinfected women. Antenatal testing for HIV and HBV, if instituted, can facilitate implementation of prophylactic measures against infant infection by both viruses.
authors.affiliation: UNC Project, P/Bag A-104, Lilongwe, Malawi; School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield Dublin 4, Ireland.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Chasela
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: apk3@cdc.gov.
authors.forename: Athena P
authors.initials: AP
authors.lastname: Kourtis
authors.affiliation: School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield Dublin 4, Ireland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Wall
authors.affiliation: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Jan
authors.initials: J
authors.lastname: Drobeniuc
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Caroline C
authors.initials: CC
authors.lastname: King
authors.affiliation: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Thai
authors.affiliation: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Eyasu H
authors.initials: EH
authors.lastname: Teshale
authors.affiliation: UNC Project, P/Bag A-104, Lilongwe, Malawi; School of Medicine, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Mina
authors.initials: M
authors.lastname: Hosseinipour
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Sascha
authors.initials: S
authors.lastname: Ellington
authors.affiliation: School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield Dublin 4, Ireland.
authors.forename: Mary B
authors.initials: MB
authors.lastname: Codd
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
authors.affiliation: Westat, Rockville, MD, USA.
authors.forename: Rod
authors.initials: R
authors.lastname: Knight
authors.affiliation: School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield Dublin 4, Ireland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Fitzpatrick
authors.affiliation: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Saleem
authors.initials: S
authors.lastname: Kamili
authors.affiliation: School of Medicine, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Irving
authors.initials: I
authors.lastname: Hoffman
authors.affiliation: UNC Project, P/Bag A-104, Lilongwe, Malawi.
authors.forename: Dumbani
authors.initials: D
authors.lastname: Kayira
authors.affiliation: UNC Project, P/Bag A-104, Lilongwe, Malawi.
authors.forename: Noel
authors.initials: N
authors.lastname: Mumba
authors.affiliation: UNC Project, P/Bag A-104, Lilongwe, Malawi.
authors.forename: Deborah D
authors.initials: DD
authors.lastname: Kamwendo
authors.affiliation: UNC Project, P/Bag A-104, Lilongwe, Malawi.
authors.forename: Francis
authors.initials: F
authors.lastname: Martinson
authors.affiliation: School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield Dublin 4, Ireland.
authors.forename: William
authors.initials: W
authors.lastname: Powderly
authors.affiliation: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Chong-Gee
authors.initials: CG
authors.lastname: Teo
authors.affiliation: School of Medicine, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: van der Horst
mesh_terms: D000328:Adult; D060085:Coinfection / Q000635:transmission*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006509:Hepatitis B / Q000635:transmission*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008295:Malawi; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology; D011256:Pregnancy Outcome
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens
keywords: Antiviral therapy; HIV; Hepatitis; Mother-to-child transmission; Sub-Saharan Africa