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Investigators Identify Risk Factors for HBV, HCV Among Pregnant Women

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There were several risk factors identified, including abortion, hospitalization, past surgical procedure, dental extraction, delivery in hospital, injection in hospitals, and household contact with jaundice.

Investigators Identify Risk Factors for HBV, HCV Among Pregnant Women

Credit: MART PRODUCTION

New research has identified several new risk factors explaining the risk of hepatitis B virus (HBV), hepatitis C virus among pregnant women.1

A team, led by Jalwa Javed Farooqi, Department of Medicine, Khyber Teaching Hospital Peshawar & Department of Community Health Sciences, Peshawar Medical College, Riphah International University Islamabad- Pakistan, determined the prevalence, risk factors, and their association with Hepatitis B and C infection among pregnant individuals visiting Tertiary Care Hospitals of Peshawar.

A Case-Control Study

In the pilot case-control study, the investigators examined 21 patients in the Gynecology & Obstetrics units of Tertiary Care Hospitals of Peshawar.

The investigators used a consecutive sampling technique to enroll the patient population in an equal ratio between patients with and without HBV, including HBsAg positive with ELIZA positive HCV, while the negative ones were in the control group.

They also used a validated research tool from previous studies.

The mean age of the HBV group was 38 years, while the mean age of the control group was 28 years.

Overall, the seroprevalence of HBV was 28.9% and the seroprevalence of HCV was 61.9%.

Risk Factors

The team did identify several significant risk factors, including abortion history (odds ratio [OR], 1.23; 95% confidence interval [CI], 0.34-4.35), hospitalization (OR, 2.90; 95% Cl, 0.77-10.8), past surgical procedure (OR, 3.69; 95% Cl, 0.81-16.6), dental extraction (OR, 1.25; 95% Cl, 0.33-4.63), delivery in hospi­tal (OR, 4.26; 95% Cl, 1.13-16.05), injection in hospitals (OR, 1.47; 95% Cl, 0.43-5.04), and household contact with jaundice (OR, 5.66; 95% Cl, 1.41-22.7).

On the other hand, normal vaginal delivery (OR, 1.96; 95% CI, 0.51-7.48) was independently associated with HBV, while history of sexually transmitted infections (OR, 2.23; 95% CI, 0.36-13.7) was associated with HCV.

“Hepatitis C prevalence rate was more with blood transfusions, unsafe injections, tooth extractions, home deliveries with past history of sexually transmitted infections, abortion, hepatitis infection, and hospital ad­missions as the significant risk factors among pregnant women,” the authors wrote.

Mental Health and Hepatitis

Patients with severe mental disorders who do not use drugs are not at a higher risk of developing HCV or hepatitis B virus (HBV) than the general population.2

A team, led by Tábatha Fernández, Psychiatry and Psychology Department, Hospital Clínic de Barcelona, evaluated the real prevalence of hepatitis B and C virus in individuals with severe mental disorders in the area of influence of Hospital Clínic in Barcelona.The team also analyzed who achieved HCV microelimination in the subpopulation.

One common issue is that access to HCV treatment historically has been limited or outright avoided by patients with severe mental disorders due to treatment with interferon-based regimens, known to generate adverse neuropsychiatric effects, including depression and suicidal ideation.

Of the patients in the first cohort, 0.7% (n = 3) had HBV, all of which had a history of drug use. In addition, 3% (n = 12) were anti-HCV positive, 8 of which had a history of drug use.

Among the patients who were positive for HCV, only 2 patients were viremic. Both of these patients received DAA treatment and achieved SVR.

The remaining 6 patients had already been cured with DAA therapy.

In the second cohort, there were no cases of HCV or HBV identified.

References:

1. Jalwa Javed Farooqi, Malik FRM, Noor F, Farooqi KJ. PREVALENCE AND RISK FACTORS ASSOCIATION WITH HEPATITIS B AND C INFECTED PREGNANT LADIES VISITING TERTIARY CARE HOSPITALS OF PESHAWAR: AN UNMATCHED PILOT CASE-CONTROL STUDY. J Postgrad Med Inst [Internet]. 2023 May 22 [cited 2023 May 26];37(2):91-6. Available from: https://www.jpmi.org.pk/index.php/jpmi/article/view/3176

2. Walter, K. (2023, April 12). Drug use linked to HBV, HCV prevalence in patients with severe mental disorders. HCP Live. https://www.hcplive.com/view/drug-linked-hbv-hcv-prevalence-patients-severe-mental-disorders

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