Hepatitis B virus infection among HIV-infected pregnant women in Malawi and transmission to infants

J Hepatol. 2014 Mar;60(3):508-14. doi: 10.1016/j.jhep.2013.10.029. Epub 2013 Nov 6.


Background & aims: The extent of HBV infection to infants of HBV/HIV-coinfected pregnant women in sub-Saharan Africa is unknown. The aim of this study was to assess prevalence of HBV infection among antiretroviral-naïve, HIV-infected pregnant women in Malawi and examine HBV transmission to their infants.

Methods: Plasma from 2048 HIV-infected, Malawian women and their infants were tested for markers of HBV infection. Study participants were provided standard-of-care health services, which included administration of pentavalent vaccine to infants at 6, 10, and 14 weeks of age.

Results: One-hundred and three women (5%) were HBsAg-positive; 70 of these HBsAg-positive women were also HBV-DNA-positive. Sixteen women (0.8%) were HBV-DNA-positive but HBsAg-negative. Five of 51 infants (9.8%) born to HBsAg-positive and/or HBV-DNA-positive women were HBV-DNA-positive by 48 weeks of age.HBV DNA concentrations of two infants of mothers who received extended lamivudine-containing anti-HIV prophylaxis were <4 log10 IU/ml compared to ⩾ 8 log10 IU/ml in three infants of mothers who did not.

Conclusions: HBV DNA was detected in nearly 10% of infants born to HBV/HIV-coinfected women. Antenatal testing for HIV and HBV, if instituted, can facilitate implementation of prophylactic measures against infant infection by both viruses.

Keywords: Antiviral therapy; HIV; Hepatitis; Mother-to-child transmission; Sub-Saharan Africa.

Publication types

  • Research Support, American Recovery and Reinvestment Act
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Coinfection / transmission*
  • DNA, Viral / analysis
  • Female
  • HIV Infections / transmission*
  • Hepatitis B / transmission*
  • Hepatitis B Surface Antigens / analysis
  • Humans
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical*
  • Malawi
  • Pregnancy
  • Pregnancy Complications, Infectious / virology
  • Pregnancy Outcome


  • DNA, Viral
  • Hepatitis B Surface Antigens