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Seroepidemiology of Hepatitis B in the Democratic Republic of the Congo
Hepatitis B virus (HBV) is endemic throughout Africa, but its prevalence in the Democratic Republic of the Congo (DRC) is incompletely understood. We used dried blood spot (DBS) samples from the 2013 to 2014 Demographic and Health Survey in the DRC to measure the prevalence of HBV using the Abbott ARCHITECT HBV surface antigen (HBsAg) qualitative assay. We then attempted to sequence and genotype HBsAg-positive samples. The weighted national prevalence of HBV was 3.3% (95% CI: 1.8–4.7%), with a prevalence of 2.2% (95% CI: 0.3–4.1%) among children. Hepatitis B virus cases occurred countrywide and across age strata. Genotype E predominated (60%), and we found a unique cluster of genotype A isolates (30%). In conclusion, DBS-based HBsAg testing from a nationally representative survey found that HBV is common and widely distributed among Congolese adults and children. The distribution of cases across ages suggests ongoing transmission and underscores the need for additional interventions to prevent HBV infection.
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Author Notes
Disclosure: G. C., M. K., and V. H. are employees and shareholders of Abbott Laboratories.
Financial support: This work was supported by Abbott Laboratories, which performed the testing of samples for this study, by the Doris Duke Charitable Foundation to J. B. P., and by the National Institute of Allergy and Infectious Diseases (award numbers 5T32AI007151 to J. B. P. and 5R01AI107949 to S. R. M.).
Authors’ addresses: Peyton Thompson, Division of Infectious Diseases, Department of Pediatrics, University of North Carolina, Chapel Hill, NC, E-mail: peyton_thompson@med.unc.edu. Jonathan B. Parr, Division of Infectious Diseases, Department of Medicine, University of North Carolina, Chapel Hill, NC, E-mail: jonathan_parr@med.unc.edu. Vera Holzmayer, Mary Kuhns, and Gavin Cloherty, Abbott Laboratories, Abbott Park, IL, E-mails: vera.holzmayer@abbott.com, mary.kuhns@abbott.com, and gavin.cloherty@abbott.com. Margaret Carrel, Department of Geographical and Sustainability Sciences, University of Iowa, Iowa City, IA, E-mail: margaret-carrel@uiowa.edu. Antoinette Tshefu and Kashamuka Mwandagalirwa, Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo, E-mails: antotshe@yahoo.com and mwandaga@email.unc.edu. Jérémie Muwonga, Placide O. Welo, and Franck Fwamba, National AIDS Control Program, Kinshasa, Democratic Republic of Congo, E-mails: pmuwonga@hotmail.com, pwelo2018@gmail.com, and fwambafranck@gmail.com. Ravi Jhaveri, Division of Infectious Diseases, Department of Pediatrics, Northwestern University, Evanston, IL, E-mail: ravi.jhaveri@northwestern.edu. Steven R. Meshnick, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, E-mail: meshnick@email.unc.edu.
These authors contributed equally to this manuscript.