Prevalence and Genetic Diversity of Hepatitis B and C Viruses Among Couples Attending Antenatal Care in a Rural Community in Rwanda

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Onesphore Majyambere
Andrew K. Nyerere
Louis S. Nkaka
Nadine Rujeni
Raphael L. Wekessa

Abstract

Background:
Globally, over 325 and 170 million people are infected
with hepatitis B virus (HBV) and hepatitis C virus (HCV), respectively.
If untreated, these infections can progress to cirrhosis or
hepatocellular carcinoma. The primary aim of this study was to determine
the prevalence, genetic diversity, and factors associated with HBV and
HCV among couples attending antenatal care in rural Rwanda.


Methods: This was a
cross-sectional survey of HBV and HCV seroprevalence. Study participants
were administered a brief structured questionnaire to obtain information
on sociodemographic and behavioural risk factors for HBV and HCV.
Participant blood samples were screened for hepatitis B surface antigen
(HBsAg) and anti-HCV antibodies (anti-HCV) using rapid diagnostic kits;
confirmatory testing was done by enzyme immunoassay and nucleic acid
tests. HBV genotypes were determined using nested polymerase chain
reaction; HCV genotypes were determined by reverse transcriptase PCR
followed by hybridisation with sequence-specific oligonucleotides.
Statistical associations between risk factors and infection status were
determined using Chi-square tests and bivariate logistic
regression.

Results:
In total, 220 individuals participated in the study. This
includes 110 pregnant women and 110 male partners who were attending
antenatal care at Gitare and Cyanika health centres. Two participants
(0.9%) had serological evidence of HBV infection, and 4 participants
(1.8%) were infected with HCV. HBV genotype A accounted for all HBV
infections; HCV genotype 4 accounted for all HCV infections. None of the
assessed factors were associated with HBV infection while occupation
type and scarification were significantly associated with HCV infection
(P values were .03 and <.01 respectively).
All cases of infection were discordant with their respective
partners.

Conclusion:
Prevalence rates of HBsAg and anti-HCV are low in couples
attending antenatal clinics in rural Rwanda. Consideration should be
given to interventions aimed at reducing the risk of transmission in
discordant couples and infants of infected mothers.

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