Hepatitis A Seroprevalence Among HIV-Exposed and Unexposed Pediatric Populations in South Africa

<b>Background:</b> There is limited evidence comparing hepatitis A seroprevalence among HIV-exposed uninfected (HEU), HIV-infected (HIV), and unexposed uninfected (HUU) children. This compromises rational vaccine decision-making. <b>Methods:</b> This study comprised a retrosp...

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Main Authors: Edina Amponsah-Dacosta, Lufuno Ratshisusu, Lorato M. Modise, Ntombifuthi Blose, Omphile E. Simani, Selokela G. Selabe, Benjamin M. Kagina, Rudzani Muloiwa
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Language:English
Published: MDPI AG 2024-11-01
Series:Vaccines
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Online Access:https://www.mdpi.com/2076-393X/12/11/1276
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author Edina Amponsah-Dacosta
Lufuno Ratshisusu
Lorato M. Modise
Ntombifuthi Blose
Omphile E. Simani
Selokela G. Selabe
Benjamin M. Kagina
Rudzani Muloiwa
author_facet Edina Amponsah-Dacosta
Lufuno Ratshisusu
Lorato M. Modise
Ntombifuthi Blose
Omphile E. Simani
Selokela G. Selabe
Benjamin M. Kagina
Rudzani Muloiwa
author_sort Edina Amponsah-Dacosta
collection DOAJ
description <b>Background:</b> There is limited evidence comparing hepatitis A seroprevalence among HIV-exposed uninfected (HEU), HIV-infected (HIV), and unexposed uninfected (HUU) children. This compromises rational vaccine decision-making. <b>Methods:</b> This study comprised a retrospective health facility-based population of children aged 1 month–12 years. Archival sera were tested for markers of acute (anti-HAV IgM) or past (total anti-HAV) HAV infection. Subgroup analysis was conducted based on perinatal HIV exposure or infection status. <b>Results:</b> Among 513 children, the median age was 10 (IQR: 4–25) months. The median maternal age was 29 (IQR: 25–34) years. An anti-HAV seropositivity of 95.1% (117/122 [95% CI 90.2–98.4]) was found among those ≤6 months of age, indicative of the rate of transplacental antibody transfer. Among 1–12-year-olds, hepatitis A seroprevalence was 19.3% (37/192 [95% CI 14.1–25.7]), while 1.1% (2/188 [95% CI 0.12–2.76]) had evidence of acute infection. Compared to HIV-exposed subgroups (HIV = 60%, 6/10 [95% CI 27.4–86.3] and HEU = 45%, 9/20 [95% CI 23.8–68]), hepatitis A seroprevalence among HUU children was low (29.2%, 47/161 [95% CI 22.4–37.0]). <b>Conclusions:</b> Natural immunity among HIV-exposed and unexposed children in South Africa is insufficient to protect against severe liver complications associated with HAV infection later in adulthood.
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spelling doaj-art-889be008ac3546d293cfc3b2555b2da32024-11-26T18:24:41ZengMDPI AGVaccines2076-393X2024-11-011211127610.3390/vaccines12111276Hepatitis A Seroprevalence Among HIV-Exposed and Unexposed Pediatric Populations in South AfricaEdina Amponsah-Dacosta0Lufuno Ratshisusu1Lorato M. Modise2Ntombifuthi Blose3Omphile E. Simani4Selokela G. Selabe5Benjamin M. Kagina6Rudzani Muloiwa7Vaccines for Africa Initiative, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South AfricaHIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria 0208, South AfricaHIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria 0208, South AfricaHealth Systems Trust, Durban 4001, South AfricaHIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria 0208, South AfricaHIV and Hepatitis Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria 0208, South AfricaVaccines for Africa Initiative, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South AfricaVaccines for Africa Initiative, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa<b>Background:</b> There is limited evidence comparing hepatitis A seroprevalence among HIV-exposed uninfected (HEU), HIV-infected (HIV), and unexposed uninfected (HUU) children. This compromises rational vaccine decision-making. <b>Methods:</b> This study comprised a retrospective health facility-based population of children aged 1 month–12 years. Archival sera were tested for markers of acute (anti-HAV IgM) or past (total anti-HAV) HAV infection. Subgroup analysis was conducted based on perinatal HIV exposure or infection status. <b>Results:</b> Among 513 children, the median age was 10 (IQR: 4–25) months. The median maternal age was 29 (IQR: 25–34) years. An anti-HAV seropositivity of 95.1% (117/122 [95% CI 90.2–98.4]) was found among those ≤6 months of age, indicative of the rate of transplacental antibody transfer. Among 1–12-year-olds, hepatitis A seroprevalence was 19.3% (37/192 [95% CI 14.1–25.7]), while 1.1% (2/188 [95% CI 0.12–2.76]) had evidence of acute infection. Compared to HIV-exposed subgroups (HIV = 60%, 6/10 [95% CI 27.4–86.3] and HEU = 45%, 9/20 [95% CI 23.8–68]), hepatitis A seroprevalence among HUU children was low (29.2%, 47/161 [95% CI 22.4–37.0]). <b>Conclusions:</b> Natural immunity among HIV-exposed and unexposed children in South Africa is insufficient to protect against severe liver complications associated with HAV infection later in adulthood.https://www.mdpi.com/2076-393X/12/11/1276hepatitis Ahepatitis A virusHIVinfantsmaternal antibodySouth Africa
spellingShingle Edina Amponsah-Dacosta
Lufuno Ratshisusu
Lorato M. Modise
Ntombifuthi Blose
Omphile E. Simani
Selokela G. Selabe
Benjamin M. Kagina
Rudzani Muloiwa
Hepatitis A Seroprevalence Among HIV-Exposed and Unexposed Pediatric Populations in South Africa
Vaccines
hepatitis A
hepatitis A virus
HIV
infants
maternal antibody
South Africa
title Hepatitis A Seroprevalence Among HIV-Exposed and Unexposed Pediatric Populations in South Africa
title_full Hepatitis A Seroprevalence Among HIV-Exposed and Unexposed Pediatric Populations in South Africa
title_fullStr Hepatitis A Seroprevalence Among HIV-Exposed and Unexposed Pediatric Populations in South Africa
title_full_unstemmed Hepatitis A Seroprevalence Among HIV-Exposed and Unexposed Pediatric Populations in South Africa
title_short Hepatitis A Seroprevalence Among HIV-Exposed and Unexposed Pediatric Populations in South Africa
title_sort hepatitis a seroprevalence among hiv exposed and unexposed pediatric populations in south africa
topic hepatitis A
hepatitis A virus
HIV
infants
maternal antibody
South Africa
url https://www.mdpi.com/2076-393X/12/11/1276
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