Hepatitis B virus (HBV) status of children born to HIV/HBV co-infected women in a French hospital: a cross-sectional study.
BACKGROUND
Human Immunodeficiency Virus (HIV) Mother-To-Child-Transmission (MTCT) and prevention by combined antiretroviral therapy (cART) have been extensively studied. Hepatitis B Virus (HBV) MTCT from HIV/HBV co-infected women and prevention by antiretroviral therapy with dual activity have been poorly studied. The aim of the study was to assess HBV MTCT from HIV/HBV co-infected women in a developed country with a large access to cART.


METHODS
HIV/HBV co-infected pregnant women attending the Obstetrics Department from 1st January 2000 to 1st January 2012 could be included in the study (NCT02044068). Antiretroviral therapy during pregnancy, injection of immunoglobulin and/or vaccine to newborns was retrospectively recorded. We assessed HBV status of children at least as old as two years.


RESULTS
Forty nine (9.2%) from 530 HIV-infected women followed in the hospital were HIV/HBV co-infected. 34 (69.4%) had given birth to 57 children in the hospital. 13 of these women (22 children) were lost-to-follow-up, 21 women (35 children) could be studied. Twenty six children (74.3%) had HBs Ab at a protective level, 22 of them had received immunoglobulin at birth; 24 had received a complete vaccine schedule during the first six months of life (with immunoglobulin in 21 cases). The women had been given lamivudine or tenofovir/emtricitabine during eight and nine pregnancies respectively. Eight children (22.8%) were tested negative for HBs Ag, HBs Ab and HBc Ab: 4 (11.4%) had received immunoglobulin and a complete vaccine schedule; in two children, immunoglobulin was uncertain; in one child, the vaccine schedule was incomplete; in the last one, data about immunoglobulin and the vaccine schedule were lacking. The women had been given lamivudine or tenofovir/emtricitabine during five and two pregnancies respectively. One child had HBc Ab and HBs Ab, immunoglobulin was uncertain and the vaccine schedule was incomplete. The woman had been given lamivudine during the last trimester.


CONCLUSIONS
Three quarters of the children were protected. HBs Ab were negative in more than a tenth of the children who had received immunoglobulin and a complete vaccine schedule, questioning on long-term protection and underlining the need of control.
Internal Medicine, Hopital Lariboisière 75010, Paris, France.
Pierre
P
Sellier
Hopital Saint-Louis 75010, Virologie, Paris, France.
Nathalie
N
Schnepf
Hopital Lariboisière 75010, Virologie, Paris, France.
Rishma
R
Amarsy
Hopital Saint-Louis 75010, Virologie, Paris, France.
Sarah
S
Maylin
Internal Medicine, Hopital Lariboisière 75010, Paris, France.
Martin
M
Coutellier
Internal Medicine, Hopital Lariboisière 75010, Paris, France.
Amanda
A
Lopes
Hopital Saint-Louis 75010, Virologie, Paris, France.
Marie-Christine
MC
Mazeron
Hopital Bichat-Claude Bernard, Service des Maladies Infectieuses et Tropicales, Paris, France.
Clara
C
Flateau
Internal Medicine, Hopital Lariboisière 75010, Paris, France.
Marjolaine
M
Morgand
Hopital Lariboisière 75010, Gynecologie-Obstetrique, Paris, France.
Nicole
N
Ciraru-Vigneron
Hopital Lariboisière 75010, Pharmacie, Paris, France.
Aurore
A
Berthe
Hopital Lariboisière 75010, Gynecologie-Obstetrique, Paris, France.
Aude
A
Ricbourg
Hopital Lariboisière 75010, Gynecologie-Obstetrique, Paris, France.
Anne-Marie
AM
Dolores-Moreno
Internal Medicine, Hopital Lariboisière 75010, Paris, France.
Guy
G
Simoneau
Internal Medicine, Hopital Lariboisière 75010, Paris, France.
John
J
Evans
Internal Medicine, Hopital Lariboisière 75010, Paris, France.
Safia
S
Souak
Hopital Bichat-Claude Bernard, Service des Maladies Infectieuses et Tropicales, Paris, France.
Sophie
S
Matheron
Internal Medicine, Hopital Lariboisière 75010, Paris, France.
Stephane
S
Mouly
Hopital Lariboisière 75010, Gynecologie-Obstetrique, Paris, France.
Jean-Louis
JL
Benifla
Hopital Saint-Louis 75010, Virologie, Paris, France.
François
F
Simon
Internal Medicine, Hopital Lariboisière 75010, Paris, France.
Jean-François
JF
Bergmann