HEPATITIS B AND HEPATITIS C VIRUS IN WOMEN WITH FIRST PREGNANCY
AbstractBackground: Hepatitis B and Hepatitis C are amongst the leading causes of morbidity and mortality in pregnant women throughout the globe. This study is aimed at determining the frequency of these infections among primigravid females and the common factors that make them prone to these infections. Methods: This cross-sectional study was conducted at Ayub Teaching Hospital, Abbottabad from December 2015 to May 2016. A total of 174 jaundiced primigravida patients were included in the study through non-probability consecutive sampling. Blood samples were sent for HBsAg and anti-HCV ELISA. Samples were analysed by the pathologist with more than 5 years clinical experience. All data will be analysed using SPSS-16. Results: The mean age of the subjects was 24±5.7 years. Six (3.4%) patients were HBsAg positive and 13 (7.5%) were anti-HCV positive. About 9% of patients had undergone surgery in their life and 1.7% reported having received blood transfusion during their life. Thirty-two of them had history of intravenous or intramuscular injections. History of piercing of body part mostly ear-piercing for ornaments was present in 170 (97.7%) respondents. However, the frequency of blood transfusion, surgery and body piercing was not statistically significantly between HBsAg positive, HBsAg negative, and anti-HCV positive and negative patients (p>0.05). Conclusion: The incidence of these viral infections in our community is on the rise. It emphasizes the need of routine antenatal screening in pregnant ladies for these viruses and to educate the public about preventive measures against these infections.Keywords: Hepatitis B; Hepatitis C; Common factors, First pregnancy
Dunkelberg JC, Berkley EM, Thiel KW, Leslie KK. Hepatitis B and C in pregnancy: a review and recommendations for care. J Perinatol 2014;34(12):882–91.
Borgia G, Carleo MA, Gaeta GB, Gentile I. Hepatitis B in pregnancy. World J Gastroenterol 2012;18(34):4677–83.
Ho V, Ho W. Hepatitis B in Pregnancy: Specific Issues and Considerations. J Antivir Antiretrovir 2012;4(3):51–9.
Centers for Disease Control and Prevention, Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep 2006;55(RR-11):1–94.
American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 86: Viral hepatitis in pregnancy. Obstet Gynecol 2007;110(4):941–56.
Franco E, Bagnato B, Marino MG, Meleleo C, Serino L, Zaratti L. Hepatitis B: Epidemiology and prevention in developing countries. World J Hepatol 2012;4(3):74–80.
Schiff E. Hepatitis Central, Current information on Hepatitis C and treatment for medical profession, Uni Miami 2002;1–2.
Wang JS, Zhu QR, Wang XH. Breastfeeding does not pose any additional risk of immunoprophylaxis failure on infants of HBV carrier mothers. Int J Clin Pract 2003;57(2):100–2.
WHO. Guidelines for the Prevention Care and Treatment of Persons with Chronic Hepatitis B Infection: Mar-15. World Health Organization; 2015.
Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380(9859):2095–128.
Tong MJ, el-Farra NS, Reikes AR, Co RL. Clinical outcomes after transfusion-associated hepatitis C. N Engl J Med 1995;332(22):1463–6.
Jittiwutikarn J, Thongsawat S, Suriyanon V, Maneekarn N, Celentano D, Razak MH, et al. Hepatitis C infection among drug users in northern Thailand. Am J Trop Med Hyg 2006;74(6):1111–6.
Armstrong GL, Alter MJ, McQuillan GM, Margolis HS. The past incidence of hepatitis C virus infection: implications for the future burden of chronic liver disease in the United States. Hepatology 2000;31(3):777–82.
WHO. Hepatitis C. Fact sheet no. 164. Geneva World Health Organization. 2000.
Wiese M, Berr F, Lafrenz M, Porst H, Oesen U. Low frequency of cirrhosis in a hepatitis C (genotype 1b) single-source outbreak in Germany: a 20-year multicenter study. Hepatology 2000;32(1):91–6.
Abbas Z, Jafri W, Shah SH, Khokhar N, Zuberi SJ. PGS consensus statement on management of hepatitis B virus infection–2003. J Pak Med Assoc 2004;54(3):150–8.
Luby S, Khanani R, Zia M, Vellani Z, Ali M, Qureshi AH, et al. Evaluation of blood bank practices in Karachi, Pakistan, and the government’s response. Health Policy Plan 2000;15(2):217–22.
Memon AR, Shafique K, Memon A, Draz AU, Rauf MU, Afsar S. Hepatitis B and C prevalence among the high risk groups of Pakistani population. A cross sectional study. Arch Public Health 2012;70(1):9.
Abdul-Mujeeb S, Jamal Q, Khanani R, Iqbal N, Kaher S. Prevalence of hepatitis B surface antigen and HCV antibodies in hepatocellular carcinoma cases in Karachi, Pakistan. Trop Doct 1997;27(1):45–6.
Zuberi S. Hepatitis B: Pakistani Perspective. In National consensus conference on guidelines for hepatitis B and C, Karachi; 2003.
Khan AA, Haider Z, Shafqat F. Sero-markers of hepatitis B and C in patients with cirrhosis. J Coll Physician Surg Pak 2002;12(2):105–7.
Umar M, Khaar HB, Anwar F, Zahid M. The management of acute variceal bleeding by octreotide. J Rawal Med Coll 2000;4:14–6.
Hamid S, Tabbasum S, Jafri W, Shah H, Khan AH. Hepatitis C has replaced Hepatitis B as the major cause of chronic liver disease in Pakistan. Hepatology 1999;30(4):212.
Chohan AR, Umar M, Khaar B, Khurram M, Zahid M, Shah SF, et al. Demographic features of hepatocellular carcinoma. A study of 30 cases. J Rawal Med Coll 2001;5:81–3.
Khan AJ, Luby SP, Fikree F, Karim A, Obaid S, Dellawala S, et al. Unsafe injections and the transmission of hepatitis B and C in a periurban community in Pakistan. Bull World Health Organ 2000;78(8):956–63.
Bari A, Akhtar S, Rahbar MH, Luby SP. Risk factors for hepatitis C virus infection in male adults in Rawalpindi-Islamabad, Pakistan. Trop Med Int Health 2001;6(9):732–8.
Khan F, Shams S, Qureshi ID, Israr M, Khan H, Sarwar MT, et al. Hepatitis B virus infection among different sex and age groups in Pakistani Punjab. Virol J 2011;8:225.
Ohto H, Terazawa S, Sasaki N, Sasaki N, Hino K, Ishiwata C, et al. Transmission of hepatitis C virus from mothers to infants. The vertical transmission of Hepatitis C virus collaborative study group. N Engl J Med 1994;330(11):744–50.
Resti M, Azzari C, Mannelli F, Moriondo M, Novembre E, de Martino M, et al. Mother to child transmission of hepatitis C virus: Prospective study of risk factors and timing of infection in children born to women Seronegative for HIV-1. Tuscany study group on Hepatitis C virus infection. BMJ 1998;317(7156):437–41.
Aghemo A, Lampertico P, Colombo M. Assessing long-term treatment efficacy in chronic hepatitis B and C: between evidence and common sense. J Hepatol 2012;57(6):1326–35.
Obi SN, Onah HE, Ezugwu FO. Risk factors for hepatitis B infection during pregnancy in a Nigerian obstetric population. J Obstet Gynaecol 2006;26(8):770–2.
Alric L, Fort M, Izopet J, Vinel JP, Charlet JP, Selves J, et al. Genes of the major histocompatibility complex class II influence the outcome of hepatitis C virus infection. Gastroenterology 1997;113(5):1675–81.
Jonas MM. Hepatitis B and pregnancy: an underestimated issue. Liver Int 2009;29(Suppl 1):133–9.
Hay JE. Liver disease in pregnancy. Hepatology 2008;47(3):1067–76.
Dwivedi M, Misra SP, Misra V, Pandey A, Pant S, Singh R, et al. Seroprevalence of hepatitis B infection during pregnancy and risk of perinatal transmission. Indian J Gastroenterol 2011;30(2):66–71.
National Survey on Prevalence of Hepatitis B and C in General Population of Pakistan. 2007. [Internet]. [cited 2016 Sep 10]. Available from: http://www.pmrc.org.pk/hepatitisbc.htm
Ogunro PS, Adekanle DA, Fadero FF, Ogungbamigbe TO, Oninla SO. Prevalence of anti-hepatitis C virus antibodies in pregnant women and their offspring in a tertiary hospital in Southwestern Nigeria. J Infect Dev Ctries 2007;1(3):333–6.
Khattak ST, Ali Marwat M, Khattak Iu, Khan TM, Naheed T. Comparison of frequency of hepatitis B and hepatitis C in pregnant women in urban and rural area of district Swat. J Ayub Med Coll Abbottabad 2009;21(2):12–5.
Sheikh SM. Hepatitis B and C: value of universal antenatal screening. J Coll Physicians Surg Pak 2009;19(3):179–82.
Zahran KM, Badary MS, Agban MN, Abdel Aziz NH. Pattern of hepatitis virus infection among pregnant women and their newborns at the Women’s health center of Assiut University, upper Egypt. Int J Gynaecol Obstet 2010;111(2):171–4.
Taseer IU, Ishaq F, Hussain L, Safdar S, Mirbahar AM, Faiz SA. Frequency of anti-HCV, HBsAg and related risk factors in pregnant women at Nishtar Hospital, Multan. J Ayub Med Coll Abbottabad 2010;22(1):13–6.
Altinbas S, Erdogan M, Danişman N. The seroprevalences of HBs Ag and anti-HCV in pregnant women in Ankara. Arch Gynecol Obstet 2010;281(2):371.
Todd CS, Ahmadzai M, Atiqzai F, Miller S, Smith JM, Ghazanfar SA, et al. Seroprevalence and correlates of HIV, syphilis, and hepatitis B and C virus among intrapartum patients in Kabul Afghanistan. BMC Infect Dis 2008;8:119.
Elsheikh RM, Daak AA, Elsheikh MA, Karsany MS, Adam I. Hepatitis B virus and hepatitis C virus in pregnant Sudanese women. Virol J 2007;4:104.