الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hepatitis B is potential life threatening liver infection caused by HBV. About one third of the world population (equals 2 billion people) showed a current or past HBV infection. There are about 296 million chronic HBV infections worldwide, with 1.5 million new infections each year. Every year up to 820,000 of HBV carriers die due to complications including liver cirrhosis and HCC.
Transmission occurs via two modalities: horizontally via mucosal contact with infected bodily fluids or perinatally from infected mothers to their neonates. MTCT is the major route of HBV transmission and an important factor for the reservoir of chronic HBV infection in many parts of the world.
For newborns of HBsAg‐positive mothers, especially those who are HBsAg‐ and HBeAg‐positive, without any intervention, the incidence of HBV infection in babies delivered to HBeAg‐positive mothers is up to 95%. In contrast, if combined passive‐active immunization with a HepB vaccine and HBIG is given to newborns of HBeAg‐positive mothers at birth, the incidence of MTCT is reduced to 3%–7%. HBIG should be injected as early as possible within 24 hours of birth (preferably within 12 hours), at a dose of ≥ 100 IU.
This study aimed to determine the serological profile of HBV, its associated risk factors and to compare hepatitis B serological profile among vaccinated and non-vaccinated pregnant women in Kafr El-Sheikh Governorate.
This study was conducted on 456 pregnant women attending Kafr El-Sheikh Governorate general hospitals for follow up and treatment. They were screened for the following markers by ELISA technique: HBsAg, anti-HBc and anti-HBs. HBeAg was performed only for HBsAg positive women.
The main results of the study are:
1- Among the 456 pregnant women tested, 8 (1.8%), 64 (14%) and 70 (15.4%) were positive for HBsAg, anti-HBc and anti-HBs, respectively. All HBsAg positive pregnant women were negative for HBeAg. In addition no HBV markers were detected in 333 (73%) of the studied pregnant women.
2- HBsAg was not detected alone in any of the studied population. However, HBsAg was detected with anti-HBc in 8 (1.8%) of the studied pregnant women. Those positive for both markers were not vaccinated against HBV. Anti-HBc was a sole marker in 45(9.9%) of the pregnant women. All of them were not vaccinated against HBV.
3- Among the 456 studied pregnant women, anti-HBs was detected alone in 59 (12.9%), all of them received HBV vaccine. Both anti-HBs and anti-HBc were detected together in 11(2.4%) of the studied population, however all of them didn’t give history of HBV vaccination.
4- All the 392 anti-HBc negative pregnant women were negative for HBsAg. Most of them 333(84.9%) have undetectable anti-HBs while 59 (15.1%) were positive to it.
5- Among the 64 anti-HBc positive pregnant women, 56(87.5%) and 53 (82.5%) were negative for HBsAg and anti-HBs, respectively, while 8(12.5%) and 11(17.2%) were positive for HBsAg and anti-HBs, respectively.
6- Among the 213 vaccinated pregnant women, none was positive for HBsAg or anti-HBc while 59 (27.7%) had anti-HBs.
7- Among the studied sociodemographic factors, only age was significantly associated to HBV markers. HBsAg and anti-HBc positivity was significantly higher among women aged >29 years than those aged ≤ 29 years (p=0.008 and p<0.001, respectively). On the other hand anti-HBs seropositivity was higher among women aged ≤ 29 years than older women (p<0.001).
8- The percentages of HBsAg positive women among those with history of surgical operation, blood transfusion, tattooing and tooth manipulation were higher than those without history of such risk factors. However, these differences were not statistically significant. In addition, the percentages of HBsAg positive women among those with history of unsafe injection and family history of HBV infection were higher than those without history of such risk factors (19.4% vs 0.5% and 5% vs 2.1%, respectively). These differences were statistically significant.
9- There was a significant fair agreement between anti-HBc and HBsAg. However, no significant agreement was detected between anti-HBc and anti-HBs.
It can be concluded from the present study that:
• HBV is still detected among pregnant women, especially those with risk factors.
• Hepatitis B vaccine proved to be an effective tool against HBV infection among pregnant women.
from the results of the present study, the following recommendations are suggested:
1- The Ministry of Health and Population should implement a programme to screen all pregnant women for HBV markers at antenatal care units.
2- Health education to all the population categories about the risk factors and mode of transmission of HBV is highly required
Hepatitis B is potential life threatening liver infection caused by HBV. About one third of the world population (equals 2 billion people) showed a current or past HBV infection. There are about 296 million chronic HBV infections worldwide, with 1.5 million new infections each year. Every year up to 820,000 of HBV carriers die due to complications including liver cirrhosis and HCC.
Transmission occurs via two modalities: horizontally via mucosal contact with infected bodily fluids or perinatally from infected mothers to their neonates. MTCT is the major route of HBV transmission and an important factor for the reservoir of chronic HBV infection in many parts of the world.
For newborns of HBsAg‐positive mothers, especially those who are HBsAg‐ and HBeAg‐positive, without any intervention, the incidence of HBV infection in babies delivered to HBeAg‐positive mothers is up to 95%. In contrast, if combined passive‐active immunization with a HepB vaccine and HBIG is given to newborns of HBeAg‐positive mothers at birth, the incidence of MTCT is reduced to 3%–7%. HBIG should be injected as early as possible within 24 hours of birth (preferably within 12 hours), at a dose of ≥ 100 IU.
This study aimed to determine the serological profile of HBV, its associated risk factors and to compare hepatitis B serological profile among vaccinated and non-vaccinated pregnant women in Kafr El-Sheikh Governorate.
This study was conducted on 456 pregnant women attending Kafr El-Sheikh Governorate general hospitals for follow up and treatment. They were screened for the following markers by ELISA technique: HBsAg, anti-HBc and anti-HBs. HBeAg was performed only for HBsAg positive women.
The main results of the study are:
1- Among the 456 pregnant women tested, 8 (1.8%), 64 (14%) and 70 (15.4%) were positive for HBsAg, anti-HBc and anti-HBs, respectively. All HBsAg positive pregnant women were negative for HBeAg. In addition no HBV markers were detected in 333 (73%) of the studied pregnant women.
2- HBsAg was not detected alone in any of the studied population. However, HBsAg was detected with anti-HBc in 8 (1.8%) of the studied pregnant women. Those positive for both markers were not vaccinated against HBV. Anti-HBc was a sole marker in 45(9.9%) of the pregnant women. All of them were not vaccinated against HBV.
3- Among the 456 studied pregnant women, anti-HBs was detected alone in 59 (12.9%), all of them received HBV vaccine. Both anti-HBs and anti-HBc were detected together in 11(2.4%) of the studied population, however all of them didn’t give history of HBV vaccination.
4- All the 392 anti-HBc negative pregnant women were negative for HBsAg. Most of them 333(84.9%) have undetectable anti-HBs while 59 (15.1%) were positive to it.
5- Among the 64 anti-HBc positive pregnant women, 56(87.5%) and 53 (82.5%) were negative for HBsAg and anti-HBs, respectively, while 8(12.5%) and 11(17.2%) were positive for HBsAg and anti-HBs, respectively.
6- Among the 213 vaccinated pregnant women, none was positive for HBsAg or anti-HBc while 59 (27.7%) had anti-HBs.
7- Among the studied sociodemographic factors, only age was significantly associated to HBV markers. HBsAg and anti-HBc positivity was significantly higher among women aged >29 years than those aged ≤ 29 years (p=0.008 and p<0.001, respectively). On the other hand anti-HBs seropositivity was higher among women aged ≤ 29 years than older women (p<0.001).
8- The percentages of HBsAg positive women among those with history of surgical operation, blood transfusion, tattooing and tooth manipulation were higher than those without history of such risk factors. However, these differences were not statistically significant. In addition, the percentages of HBsAg positive women among those with history of unsafe injection and family history of HBV infection were higher than those without history of such risk factors (19.4% vs 0.5% and 5% vs 2.1%, respectively). These differences were statistically significant.
9- There was a significant fair agreement between anti-HBc and HBsAg. However, no significant agreement was detected between anti-HBc and anti-HBs.
It can be concluded from the present study that:
• HBV is still detected among pregnant women, especially those with risk factors.
• Hepatitis B vaccine proved to be an effective tool against HBV infection among pregnant women.
from the results of the present study, the following recommendations are suggested:
1- The Ministry of Health and Population should implement a programme to screen all pregnant women for HBV markers at antenatal care units.
2- Health education to all the population categories about the risk factors and mode of transmission of HBV is highly required