Seroprevalence, Viral Load and Associated Risk Factors of Hepatitis B and C Virus Infections Among Pregnant Women Attending Antenatal Care in Selected Health Facilities, Addis Ababa, Ethiopia.

Abstract

Abstract Background: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections are global public health problems in pregnancy that have a high risk of mother-to-child transmission (MTCT). Perinatal transmission accounts for more than 50% of cases worldwide. Globally, 65 million women of childbearing age are infected with chronic HBV, with a 90% likelihood of MTCT in HBeAg-positive mothers of the total HCV-infected people, 1 to 8% are pregnant women, and MTCT occurs in about 3 to 10% of HCV-infected mothers. However, although Ethiopia is highly endemic for viral hepatitis, screening for these viruses in pregnancy is not well implemented, and data on viral hepatitis during pregnancy are scarce. Objective: The objective of this study was to investigate the seroprevalence and associated factors of hepatitis B and C virus infections among pregnant women attending antenatal care at selected health facilities, Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted between April and September 2024, targeting pregnant women attending ANC. Using a consecutive sampling method, 456 study participants were enrolled after written informed consent. Kobotoolbox was used to collect socio-demographic data, associated factors for the study participants. Ten ml of venus blood was collected, serum specimens were tested to detect hepatitis B surface antigen (HBsAg), and anti-hepatitis C virus antibody (anti-HCV) using enzyme-linked immunosorbent assay (ELISA). For the HBsAg positive specimens, Viral load was determined using Abbot m2000/RT-PCR, and Hepatitis ee antigen (HBeAg) was detected using the Cobas 6000 analyzer. The data were transferred from Kobotoolbox to SPSS version 25 software. Bivariate and multivariable logistic regression were analysed to assess the relationship between factors associated with HBV and HCV infection. Results The seroprevalence of HBsAg among pregnant women in the current study was 5.8% (26/450), while the prevalence of the anti-HCV antibody was much lower at 0.4% (2/450). The Bivariate analysis HBsAg positivity showed associations with gestational stage, family history of liver disease, and contact with an HBV-infected person; however, after multivariate adjustment, only ix being in the third trimester remained significantly associated with HBsAg positivity. Among the HBsAg-positive cases, 30.8% (8/26) had detectable hepatitis B viral DNA with viral loads ranging from 48 IU/mL to 222 IU/mL. However, none of the HBsAg-positive subjects was positive for hepatitis B e-antigen (HBeAg). The HBV vaccination coverage among the study participants was low; only 20.9% of participants had taken the vaccine. Conclusion This study revealed an intermediate seroprevalence of HBsAg and low anti-HCV among pregnant women attending ANC in selected health centers in Addis Ababa. None of the HBsAg-positive participants were reactive for HBeAg, while 30.8% exhibited detectable HBV DNA levels. Keywords: Pregnant women, hepatitis B infection, hepatitis C infection, Antenatal care