title: Hepatitis B virus infection among pregnant women in Haiti: A cross-sectional serosurvey.
abstract: BACKGROUND
  Hepatitis B vaccine administered shortly after birth is highly effective in preventing mother to child transmission (MTCT) of infection. While hepatitis B vaccine was introduced in Haiti as part of a combined pentavalent vaccine in 2012, a birth dose is not yet included in the immunization schedule.
  
  
  OBJECTIVE
  Determine the seroprevalence of hepatitis B virus (HBV) infection among pregnant women to evaluate the risk of MTCT.
  
  
  METHODS
  We selected 1364 residual serum specimens collected during a 2012 human immunodeficiency virus (HIV) sentinel serosurvey among pregnant women attending antenatal care clinics. Haiti was stratified into two regions: West, which includes metropolitan Port-au-Prince, and non-West, which includes all other departments. We evaluated the association between demographic and socioeconomic characteristics and HIV infection with HBV infection.
  
  
  RESULTS
  Of 1364 selected specimens, 1307 (96%) were available for testing. A total of 422 specimens (32.7%) tested positive for total anti-HBc (38.2% in West vs. 27% in non-West, p<0.001), and 33 specimens (2.5%) were HBsAg positive (2.1% in West vs. 3% in non-West, p=0.4). Of HBsAg positive specimens, 79% had detectable HBV DNA. Women aged 30 and older had more than double the odds of positive total anti-HBc than women aged 15-19 years (p<0.001). Women with secondary (adjusted odds ratio (aOR)=0.54; 95% CI: 0.36-0.81) and post-secondary education (aOR=0.40, 95% CI: 0.19-0.79) had lower odds of total anti-HBc positivity compared with women with no education. HIV-status was not associated with HBV infection.
  
  
  CONCLUSIONS
  Haiti has an intermediate endemicity of chronic HBV infection with high prevalence of positive HBV DNA among chronically infected women. Introduction of a universal birth dose of hepatitis B vaccine might help prevent perinatal HBV transmission.
authors: US Centers for Disease Control and Prevention, Atlanta, GA,USA. Electronic address: rtohme@cdc.gov.
authors: Rania A
authors: RA
authors: Tohme
authors: National Public Health Laboratory, Ministry of Public Health and Population, Haiti.
authors: Jocelyne
authors: J
authors: Andre-Alboth
authors: US Centers for Disease Control and Prevention, Atlanta, GA,USA.
authors: Alexandra
authors: A
authors: Tejada-Strop
authors: Emory University, Atlanta, GA, USA.
authors: Ran
authors: R
authors: Shi
authors: National Public Health Laboratory, Ministry of Public Health and Population, Haiti.
authors: Jacques
authors: J
authors: Boncy
authors: Expanded Program of Immunization, Ministry of Public Health and Population, Port-au-Prince, Haiti.
authors: Jeannot
authors: J
authors: François
authors: Haiti Country Office, Centers for Disease Control and Prevention, Port-au-Prince, Haiti.
authors: Jean Wysler
authors: JW
authors: Domercant
authors: Global Program, National Alliance of State and Territorial AIDS Directors, Washington DC, USA.
authors: Mark
authors: M
authors: Griswold
authors: National Alliance of State and Territorial AIDS Directors, Port-au-Prince, Haiti.
authors: Erlantz
authors: E
authors: Hyppolite
authors: Directorate of Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Port-au-Prince, Haiti.
authors: Paul
authors: P
authors: Adrien
authors: US Centers for Disease Control and Prevention, Atlanta, GA,USA.
authors: Saleem
authors: S
authors: Kamili
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology; D006205:Haiti / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage; D019694:Hepatitis B, Chronic / Q000097:blood / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines
keywords: Haiti; Hepatitis B; Hepatitis B vaccines; Pregnant women; Serosurvey