Multiplex Rapid Test with Acceptable Diagnosis Performance as a Solution to Increase Diagnosis of Hepatitis B and C Viruses in Pregnant Women in an Area of High Prevalence of Both Hepatitis Viruses Associated with HIV
BackgroundandObjective: HIV, hepatitis B virus (HBV) and hepatitis C virus
(HCV) are very widespread in the world, however, less than 20% of the
people affected are diagnosed and treated. This study aimed to determine the
prevalence of HIV, HCV and HBV co-infections in pregnant women at Bangui
Community University Hospital and the cost of screening. Methods: A
cross-sectional study involving consenting pregnant women who came for
antenatal care was performed. HIV, HCV antibodies and HBV antigens were detected using Exacto Triplex? HIV/HCV/HBsAg rapid test,
cross-validated by ELISA tests.
Sociodemographic and professional data, the modes of transmission and
prevention of HIV and both hepatitis viruses were collected in a standard sheet
and analyzed using the Epi-Info software version 7. Results: Pregnant
women aged 15 to 24 were the most affected (45.3%); high school girls (46.0%), and pregnant women living in cohabitation (65.3%) were the most represented.
Twenty-five (16.7%) worked in the formal sector, 12.7% were unemployedhousewivesand the remainder in the
informal sector. The prevalence of HIV, HBV, and HCV viruses was 11.8%, 21.9%
and 22.2%, respectively. The prevalence of co-infections
was 8.6% for HIV-HBV, 10.2% for HIV-HCV, 14.7% for HBV-HCV and 6.5% for
HIV-HBV-HCV. All positive results and
10% of negative results by the rapid test were confirmed by ELISA tests. The
serology of the three viruses costs 39,000 FCFA (60 Euros) by ELISA compared to
10,000 FCFA (15.00 Euros) with Exacto Triplex? HIV/HCV/AgHBs (BioSynex,
Strasbourg, France). Conclusion: The low level of education and
awareness of hepatitis are barriers to
References
[1]
World Health Organization (WHO) (2015) Guidelines for the Prevention, Care and Treatment of Persons with Chronic Hepatitis B Infection. Geneva. https://www.who.int/publications/i/item/9789241549059
[2]
World Health Organization (2017) Global Hepatitis Report 2017. Geneva.
[3]
WHO (2017) New Hepatitis Data Highlight Need for Urgent Global Response. Geneva
[4]
Thomas, D.L. (2019) Global Elimination of Chronic Hepatitis. The New England Journal of Medicine, 380, 2041-2050. https://doi.org/10.1056/NEJMra1810477
[5]
WHO (2023) Hepatitis C Facts Sheet 2023. Geneva. https://www.who.int/news-room/fact-sheets/detail/hepatitis-c
[6]
UNAIDS (2012) Fact Sheet 2012: Latest Global and Regional Statistics on the Status of the AIDS Epidemic. Geneva. https://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf
[7]
World Health Organization (2016) Global Health Sector Strategy on Viral Hepatitis 2016-2021. Towards Ending Viral Hepatitis. Geneva.
[8]
Stinco, M., Rubino, C., Trapani, S. and Indolfi, G. (2021) Treatment of Hepatitis B Virus Infection in Children and Adolescents. World Journal of Gastroenterology, 27, 6053-6063. https://doi.org/10.3748/wjg.v27.i36.6053
[9]
Hønge, B.L., Olesen, J.S., Jensen, M.M., Jespersen, S., Da Silva, Z.J., Amabelia Rodrigues, A., Laursen, A.L., Wejse, C., Krarup, H., Aaby, P. and Erikstrup, C. (2020) Hepatitis B and C in the Adult Population of Bissau, Guinea-Bissau: A Cross-Sectional Survey. Tropical Medicine and International Health, 25, 255-263. https://doi.org/10.1111/tmi.13335
[10]
Farci, P., Quinti, I., Farci, S., Alter, H.J., Strazzera, R., Palomba, E., Coiana, A., Cao, D., Casadei, A.M., Ledda, R., Iorio, R., Vegnente, A. and Diaz, G. (2006) Evolution of Hepatitis C Viral Quasispecies and Hepatic Injury in Perinatally Infected Children followed Prospectively. Proceedings of the National Academy of Sciences of the United States of America, 103, 8475-8480. https://doi.org/10.1073/pnas.0602546103
[11]
Preciado, M.V., Valva, P., Escobar-Gutierrez, A., Rahal, P., Ruiz-Tovar, K., Yamasaki, L., Vazquez-Chacon, C., Martinez-Guarneros, A., Carpio-Pedroza, J.C., Fonseca-Coronado, S. and Cruz-Rivera, M. (2014) Hepatitis C Virus Molecular Evolution: Transmission, Disease Progression and Antiviral Therapy. World Journal of Gastroenterology, 20, 15992-16013. https://doi.org/10.3748/wjg.v20.i43.15992
[12]
WHO (2020) World Hepatitis Day 2020: Fast-Tracking the Elimination of Hepatitis B among Mothers and Children. Geneva. https://www.who.int/fr/news/item/27-07-2020-world-hepatitis-day-fast-tracking-the-elimination-of-hepatitis-b-among-mothers-and-children
[13]
Mossoro-Kpinde, C.D., Gbangba-Ngai, E., Mossoro-Kpinde, H.D., Camengo Police, S.M., Kobangue, L., Selehina, E., Mbale, M. and Baipo, F. (2016) Dépistage de l’antigene HBs chez les malades du VIH à Bangui. Revue Bio-Africa, 15, 39-43.
[14]
Komas, N.P., Bai-Sepou, S., Manirakiza, A., Léal, J., Béré, A. and Le Faou, A. (2010) The Prevalence of Hepatitis B Virus Markers in a Cohort of Students in Bangui, Central African Republic. BMC Infectious Diseases, 10, Article No. 226. https://doi.org/10.1186/1471-2334-10-226
[15]
Komas, N.P., Vickos, U., Hübschen, J.M., Béré, A., Manirakiza, A., Muller, C.P. and Le Faou, A. (2013) Cross-Sectional Study of Hepatitis B Virus Infection in Rural Communities, Central African Republic. BMC Infectious Diseases, 13, Article No. 286. https://doi.org/10.1186/1471-2334-13-286
[16]
Nambei, W.S., Rawago-Mandjiza, D. and Gbangba-Ngai, E. (2016) Séroépidémiologie du VIH, De la syphilis et des virus des hépatites B et C chez les donneurs de sang à Bangui, République Centrafricaine. Médecine et Santé Tropicales, 26, 192-198. https://doi.org/10.1684/mst.2016.0553
[17]
Camengo Police, S.M., Mbeko Simaleko, M., Boua Akelelo, N.P., Longo, J.D., Molowa Kobendo, J.R., Tekpa, G. and Fogang, E. (2013) La cirrhose et ses complications à l’hôpital universitaire de l’Amitié de Bangui: Etude du cout de la prise en charge. Journal Africain d’Hépato-Gastroentérologie, 7, 78-81. https://doi.org/10.1007/s12157-013-0454-3
[18]
Robin, L., Mboumba Bouassa, R.S., Nodjikouambaye, Z.A., Charmanta, L., Matta, M., Simona, S., Filali, M., Mboup, S. and Bélec, L. (2018) Analytical Performances of Simultaneous Detection of HIV-1, HIV-2 and Hepatitis C-Specific Antibodies and Hepatitis B Surface Antigen (HBsAg) by Multiplex Immunochromatographic Rapid Test with Serum Samples: A Cross-Sectional Study. Journal of Virological Methods, 253, 1-4. https://doi.org/10.1016/j.jviromet.2017.12.001
[19]
Mossoro-Kpinde, C.D., Kalla, G.C.M., Baguida-Bokia, C., Sombot-Ndicki, S., Bobossi, C., Tonen-Wolyec, S., Mbopi-Kéou, F.X. and Bélec, L. (2022) Diagnostic Performances of Exacto® Triplex Rapid Test for Diagnosis of HIV/HCV/HBsAg: A Multicenter, cross sectional, Field Study in the Central African Republic. The Pan African Medical Journal, 43, Article 21. https://doi.org/10.11604/pamj.2022.43.21.36041
[20]
Mboumba Bouassa, R.S., Nodjikouambaye, Z.A., Sadjoli, D., Moussa, A.M., Adawaye, C., Koyalta, D. and Bélec, L. (2018) Usefulness of Simultaneous Screening for HIV- and Hepatitis C-Specific Antibodies and Hepatitis B Surface Antigen by Capillary-Based Multiplex Immunochromatographic Rapid Test to Strengthen Prevention Strategies and Linkage to Care in Childbearing-Aged Women Living in Resource-Limited Settings. Open Forum Infectious Diseases, 5, ofy069. https://doi.org/10.1093/ofid/ofy069
[21]
Tonen-Wolyec, S., Djang’eing’a, R.M., Batina-Agasa, S., Kayembe Tshilumba, C., Muwonga Masidi, J., Hayette, P. and Bélec, L. (2021) Self-Testing for HIV, HBV, and HCV Using Finger-Stick Whole-Blood Multiplex Immunochromatographic Rapid Test: A Pilot Feasibility Study in Sub-Saharan Africa. PLOS ONE, 16, e0249701. https://doi.org/10.1371/journal.pone.0249701
[22]
Schwartz, D. (1969) Méthodes statistiques à l’usage des médecins et biologistes. Flammarion Médecins Sciences, Paris. http://www.numdam.org/item?id=RSA_1960__8_3_5_0
[23]
Institut Centrafricain des Etudes Economiques et Sociales (ICASEES) (2019) Enquête par grappe à indicateurs Multiples 2018-2019. 6ème édition (MICS 6). Rapport final 2018-2019. Bangui, https://icasees.org/index.php/actualites/rapport-final-mics-2018-2019-en-francais
[24]
Njoya, O., Essi, M.J., Ongolo, B. and Obama, M.T. (2013) Connaissances, Perceptions et Pratiques des Femmes Enceintes Vis-à-vis de l’Hépatite Virale B en Milieu Urbain au Cameroun. Health Sciences and Disease, 14, 1-4.
[25]
Kambourou, J., Moyen-Engoba Okoko, A.R., Bourangon, C., Oko, A.P.G., Nika, E.R., Ekouya, G., Atanda, H.L. and Moyen, G. (2016) Connaissances et attitudes des femmes congolaises sur la prévention de la transmission mère-enfant du VIH. Annales de l’université Marien Ngouabi, 16, 7-14.
[26]
UNAIDS (2019) Central African Republic Country Factsheets 2022. Geneva. Country Factsheets Central African Republic 2022. https://doi.org/10.5089/9798400201837.002
[27]
Pamatika, C.M., Diemer, H.S.C., Mossoro-Kpindé, C.D., Ndakouzou, G., Nguida, H., Lenguetama, R. and Longo, J.D.D. (2021) Place de l’hépatite B parmi les pathologies à l’origine de la perte de statut des donneurs bénévoles de sang de Bangui et Bimbo en Centrafrique: Analyse rétrospective de cinq années. Annales Africaines de Medecine, 15, e4417-e4430. https://doi.org/10.4314/aamed.v15i1.2
[28]
Bigna, J.J., Kenne, A.M., Hamroun, A., Ndangang, M.S., Foka, A.J., Tounouga, D.N., Lenain, R., Amougou, M.A. and Nansseu, J.R. (2019) Gender Development and Hepatitis B and C Infections among Pregnant Women in Africa: A Systematic Review and Meta-Analysis. Infectious Diseases of Poverty, 8, Article No. 16. https://doi.org/10.1186/s40249-019-0526-8
[29]
Ndong-Atome, G.R., Makuwa, M., Njouom, R., Branger, M., Brun-Vézinet, F., Mahé, A., Rousset, D. and Kazanji, M. (2008) Hepatitis C Virus Prevalence and Genetic Diversity among Pregnant Women in Gabon, Central Africa. BMC Infectious Diseases, 8, Article No. 82. https://doi.org/10.1186/1471-2334-8-82
[30]
Petruzziello, A., Marigliano, S., Loquercio, G., Cozzolino, A. and Cacciapuoti, C. (2016) Global Epidemiology of Hepatitis C Virus Infection: An Up-Date of the Distribution and Circulation of Hepatitis C Virus Genotypes. World Journal of Gastroenterology, 22, 7824-7840. https://doi.org/10.3748/wjg.v22.i34.7824
[31]
Camengo Police, S.M., Mbeko Simaleko, M., Mossoro-Kpinde, C.D., Longo, J.D.D., Tekpa, G., Bako, A., Betchem, R., Gabouga, F., Sana, C., Gresenguet, G. and Belec, L. (2013) Prévalence de l’AgHBs chez les homosexuels masculins à Bangui. Médecine d’Afrique Noire, 60, 513-518.
[32]
Longo, J.D.D. (2016) Groupes à Haut Risque du VIH en République Centrafricaine: Classification et interventions précoces. Master’s Thesis, Université Paris Saclay, Paris. http://www.theses.fr/2016SACLS220
[33]
Kandeel, A., Genedy, M, El-Refai, S., Funk, A.L., Fontanet, A. and Talaat, M. (2017) The Prevalence of Hepatitis C Virus Infection in Egypt 2015: Implications for Future Policy on Prevention and Treatment. Liver International, 37, 45-53. https://doi.org/10.1111/liv.13186
[34]
Aboubakar, M., Kpossou, A.R., Glago, B.R.G.H., Aguiah, A.G., Mboreha, Z.H. and Sehonou, J. (2020) Prévalence et facteurs associés au portage des anticorps anti-VHC chez des femmes enceintes à Cotonou. Pan African Medical Journal, 36, Article 182. https://doi.org/10.11604/pamj.2020.36.182.23122
[35]
Njouom, R., Pasquier, C., Ayouba, A., Sandres-Saune, K., Mfoupouendoun, J., Lobe, M.M., Tene, G., Thonnon, J., Izopet, J. and Nerrienet, E. (2003) Hepatitis C Virus Infection among Pregnant Women in Yaounde, Cameroon: Prevalence, Viremia, and Genotypes. Journal of Medical Virology, 69, 384-390. https://doi.org/10.1002/jmv.10300
[36]
Longo, J.D.D., Mboumba Bouassa, R.S., Mbeko Simaleko, M., Kouabosso, A., Mossoro-Kpinde, C.D., Robin, L., Charmant, L., Grésenguet, G. and Bélec, L. (2018) Usefulness of Simultaneous Screening for HIV-Specific and HCV-Specific Antibodies and HBsAg by a Capillary-Based Multiplex Rapid Diagnostic Test to Strengthen Linkage-to-Care in Sub-Saharan Patients Attending Sexually Transmitted Infection Clinic. Journal of Medical Virology, 90, 1549-1552. https://doi.org/10.1002/jmv.25209
[37]
Kalla, G.C.M., Voundi, E.V., Angwafo III, F., Bélec, L. and Mbopi-Keou, F.X. (2018) Mass Screening for Hepatitis B and C and HIV in Sub-Saharan Africa. The Lancet Infectious Diseases, 18, 716. https://doi.org/10.1016/S1473-3099(18)30343-8
[38]
Smith, S., Harmanci, H., Hutin, Y., Hess, S., Bulterys, M., Peck, R., Rewari, B., Mozalevskis, A., Shibeshi, M., Mumba, M., Le, L.V., Ishikawa, N., Nolna, D., Sereno, L., Gore, C., Goldberg, D.J. and Hutchinson, S. (2019) Global Progress on the Elimination of Viral Hepatitis as a Major Public Health Threat: An Analysis of WHO Member State Responses 2017. JHEP Reports, 1, 81-89. https://www.jhep-reports.eu/article/S2589-5559(19)30032-1/fulltext https://doi.org/10.1016/j.jhepr.2019.04.002
[39]
Ménard, D., Mairo, A., Mandeng, M.J., Doyemet, P., Koyazegbe, T.A., Rochigneux, C. and Talarmin, A. (2005) Evaluation of Rapid HIV Testing Strategies in under Equipped Laboratories in the Central African Republic. Journal of Virological Methods, 126, 75-80. https://doi.org/10.1016/j.jviromet.2005.01.023
[40]
COFRAC (2022) Guide technique d’accréditation de vérification (portée A)/validation (portée B) des méthodes de Biologie médicale. Paris. https://tools.cofrac.fr/documentation/sh-gta-04
